Prenatal screening with evaluated high risk scores.
This paper reviews data that support the effectiveness of the French approach of using risk scoring for evaluating the risk of preterm delivery. This approach, which was developed in 1969 and spread to obstetricians and midwives throughout France in the early 1970s, includes systematic information about the recognition of uterine contractions, advice about reduction of physical exercise, and the prescription of work-leave for women with heavy or physically demanding work loads. The effectiveness of this prevention strategy is assessed using three different data sets: an evaluation of a preterm prevention program in the Alsace Region of France, five successive French national sample surveys which collected data on pregnant women, and a study of the effectiveness of a prevention program for twins in the district of Haut de Seine near Paris. The authors show that the rate of preterm birth in France declined substantially, but that the decline was concentrated among singleton spontaneous births. Since the 1970s induced preterm births have increased, and, interventions have not reduced the high rates of preterm birth among twins.
Papiernik
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Department of Obstetrics and Gynecology, Maternité de Port Royal, University René Descartes, Paris, France.
Grangé
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D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D014427:Twins; D014592:Uterine Hemorrhage