[Socio-economic aspects of abstention from work of pregnant women]. / Aspects socio-économiques de l'arrêt de travail de la femme enceinte.

In pregnant women rest is essential to the prevention of some accidents at birth (e.g. prematurity). A survey of 357 women examined and delivered in the maternity department of hospital A. Béclère in 1984 shows that abstention from work is general and prolonged, irrespective of the degree of risk inherent in pregnancy: 50% of women have stopped work 7 weeks before their legal maternity leave. This wide prescription of rest seems to have been requested by the women themselves. Its financial cost to the Social security is negligible, but prescriptions for rest from work have probably not yet ceased to increase.

[Analysis of the attraction of an obstetrical service. Analysis of preferences according to geographic distance, sociocultural level and previous medical experiences]. / Analyse de l'attraction d'un service d'obstétrique. Analyse des préférences par la distance géographique, en fonction du niveau socio-culturel et des antécédents médicaux.

This study analyses selected characteristics of 13,676 women, all single pregnancies, attending the Department of Obstetrics and Gynaeocology of the A. Béclère Maternity Hospital in Clamart (in the greater Paris region of France). The characteristics analysed for each women were: sociocultural level, occupation, place of residence (i.e. distance from the hospital), frequency and time of prenatal visits, and selected aspects of obstetric history (treatment for infertility, previous preterm birth, perinatal mortality). A comparison was made between the patients living near the institution and the patients living far from the hospital; this revealed four separate groups: Women living near by the hospital followed-up early by the department, and whose social class distribution is similar to that of the parisian population as a whole. Women living near the hospital, followed-up late or not at all by the department, most have a low sociocultural level, and are referred to the hospital by local homes for single mothers. Women living far from the hospital, followed-up early and often having a high socio-cultural level. In this group, a higher level of information about pregnancy, obstetrics, and medical services are observed. However this group also shows a high frequency of previous obstetric incidents: previous contact with a medical institution appears to be an important factor in the choice made by these women, independent of their sociocultural level. Women living far from the hospital and followed-up late by the department. These patients have a high sociocultural level, and show a high frequency of previous obstetric incidents: they tend to present as emergencies requiring the department's technical services.(ABSTRACT TRUNCATED AT 250 WORDS)

[True primary prevention of premature birth]. / Prévention primaire véritable de la naissance prématurée.

The authors are interested in the social differences observed in rates of preterm births. Most of the published studies show a social gradient. Their hypothesis is that these differences are accessible to a simple preventive policy. The propositions are first a better information given to the pregnant women on the risks, and on the relationship of the way of living with uterine contractions and preterm labour and second a reduction in physical efforts, common triggers to uterine pains. The study deals with 11,017 singles pregnancies. It is shown that the social gradient disappears for the women following the program (80% of the pregnancies). The social gradients are those expected for the women followed by other means and referred during pregnancy.

Cost of care and prevention of preterm births in twin pregnancies.

This study describes a 5-year survey of activity in a single institution, and the effects of a change of policy for prevention of preterm birth in twin pregnancies. The results show the advantages and drawbacks from the financial and medical viewpoints.