[Usefulness of follow-up in pregnancies. Risk of pregnancies with not enough or no follow-up examinations].
The French system of antenatal care, based on financial incentive, recommends 7 antenatal visits for all pregnancies. Would fewer visits increase perinatal risk? The higher risk of low birthweight and perinatal mortality in women with little or no antenatal care is a well-known observation but data are certainly biased by socioeconomic and environmental conditions. In Western populations, for example, very high risk pregnancies are certainly under-represented in the little or no care comparison groups. Even if the effects of antenatal care may be underestimated, it is highly unlikely that extremely massive risks would be associated with few or no antenatal visits since even in the most favourable conditions, antenatal examinations cannot detect all the possible anomalies which can occur during pregnancy and available means of avoiding perinatal mortality are not perfect. The debate now focuses on optimal antenatal care. Are the 7 visits in France adequate? At present, are there risks of over-medicalization and excessive medical cost? Some answers to these questions may be forth coming from research projects. The perinatal plan, begun in France in 1994, will also provide recommendations for improving the quality of antenatal care.
Blondel
B
B
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk / Q000502:physiology*; D011295:Prenatal Care / Q000592:standards*; D012959:Socioeconomic Factors
Utilité du suivi des grossesses. Risques des grossesses peu ou pas suivies.