[Medical care and perinatal health in twin pregnancies: situation in 2010 and recent trends in France].
OBJECTIVE
To compare medical care and health status of twins and singletons in 2010 and to describe the trends between 1995 and 2010 in metropolitan France.


METHODS
Data were derived from the national perinatal surveys from 1995 to 2010, on representative samples of births, and included 14,460 singletons and 440 twins in 2010. We compared prenatal care, childbirth and health status of children between twin and singleton pregnancies and between years.


RESULTS
In 2010, mothers of twins had more intensive medical care than mothers of singletons. The preterm birth rate was higher (42.7% versus 6.3%). The medical care of twins has increased (for example 51% of women had 11 or more prenatal visits in 2010 versus 26% in 1995), often following the same trends as singletons. The proportion of non-spontaneous labors increased between 1998 and 2003. The cesarean section rate increased from 42.2% in 1995 to 54.8% in 2010 among twins, and from 15.2% to 19.9% among singletons. The preterm birth did not increase, but the proportion of twins born at 39 weeks of gestation or more declined significantly.


CONCLUSIONS
Medical care takes into account the high risks of twin pregnancies. Twins are still a medical cause for concern because of their continued increase.
Inserm, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre d'épidémiologie et biostatistiques (U1153), université Paris Descartes, 75014 Paris, France.
C
C
Prunet
Inserm, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre d'épidémiologie et biostatistiques (U1153), université Paris Descartes, 75014 Paris, France; Maternité Port-Royal, hôpital Cochin-Saint-Vincent-de-Paul, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.
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Goffinet
Inserm, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre d'épidémiologie et biostatistiques (U1153), université Paris Descartes, 75014 Paris, France. Electronic address: beatrice.blondel@inserm.fr.
B
B
Blondel
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007246:Infertility / Q000453:epidemiology / Q000628:therapy; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000379:methods / Q000639:trends; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data; D014427:Twins / Q000706:statistics & numerical data; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data; D055815:Young Adult
Accouchement; Delivery; France; Grossesse gémellaire; Jumeaux; Prenatal care; Preterm birth; Prématurité; Surveillance prénatale; Trends; Twin pregnancy; Twins; Évolution