[Study of weight deficiency in a representative sample of newborns]. / Etude de l'insuffisance ponderale a la naissance.

A study of a representative sample of 11,330 newborns allowed to establish the distribution of birth weights in terms of gestation-age. The comparison with Lubchenco's curves shows important differences since the 10th percentile of the American curve is below the 3rd percentile of the French sample for prematures. The use of a technique of multivariant analysis distinguishes groups with low and high risks of prematurity and hypotrophy. The distinction is more obvious for the first group than for the second. The study of the rate of early neonatal mortality in terms of weight and gestation-age, led to individualize the risk related to hypotrophy from that related to prematurity.

[The concept of risk in perinatology. Results of epidemiologic surveys (author's transl)]. / La notion de risque en périnatologie. Résultats d'enquêtes épidémiologiques

A national survey of pregnancy and childbirth was conducted in 1972 in France from which for the first time risk factors for all pregnancies and practical consequences for prevention were obtained. Risk factors were determined by multivariate analysis for stillbirth, prematury, and low birth weight infants. Two groups of women were found to be at higher than average risk. The first included those under 18 or over 40 years old, or having a history of previous stillbirth or infant with birth weight less than 2 500 g. The 13% of all pregnant women in this group had double the overall population rate of stillbirth, prematurity and low birth weight infants. The second group, 7% of all pregnant women, included widowed, divorced, and separated women, as well as immigrant workers or wives of immigrant workers. These two groups of women, as well as those with pathological findings during pregnancy should be more closely followed during pregnancy as specified by law. However, the survey showed that the surveillance of high risk pregnancies is on the whole inferior to that of the overall population. Several solutions have been proposed to remedy this situation: -- to double the number of obligatory prenatal examinations, to 10 per woman, for all pregnancies, which would double the present total number of prenatal examinations from 4 000 000 to 8 000 000; -- to apply the legislation to women with high risk pregnancies by increasing either the inducements (educating these women and their doctors, more reembursements of costs), or constraints (requiring more medical appointments, home visits, or financial sanctions).