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What is a pathological pregnancy (or pregnancy at risk)?
France remains the birth rate champion with 728 births in 000 and a fertility rate that remains at almost two children per woman … The number of pathological (or at risk) pregnancies is also on the rise, with concrete consequences on the child health. Each year, about 2017% of women face a complication during their pregnancy. According to the latest figures from the Euro-Peristat report, the prematurity rate is still on the rise in France. The latter has increased since 20 (from 1995% in 4,5 to 1995% in 6,0 among only children born alive).
It is said that a pregnant woman has a pathological pregnancy when an obstetric, fetal or maternal risk is identified during her pregnancy, including in the phase preceding childbirth, and that this requires specific care. In other words, a pathological pregnancy is a pregnancy that directly threatens the health of mother and child.
What are the complications of a high risk pregnancy?
The most frequent complications are:
- eclampsia, also called toxemia of pregnancy,
- gestational diabetes,
- Threat of Premature Childbirth (PAD).
For the fetus, the consequences are also potentially serious: growth retardation in utero, macrosomia, prematurity, etc.
The causes of pathological pregnancies
Apart from risky behavior (tobacco, alcohol), several factors contribute to increasing the prevalence of pathological pregnancies.
- The age of first childbearing is one of the reasons.
More and more women are delaying their first pregnancy. In 2017, they have their first child on average at 30,7 years old, six years later than in the late 60s, and around 3,5% of pregnant women are over 40. The average age of mothers at childbirth, regardless of the birth order of the child, reached 30 years in 2010 (against 27,3 years in 1967) and it continues to increase. In 2016, 21% of women aged 35 and over were pregnant against 19% in 2010. The higher the woman’s diploma, the later the first child arrives. Gold with age, the risks to the health of mother and child increase significantly. “A 42-year-old woman has a one in 15 chance of having a child with Down syndrome,” warns Alexandra Benachi, head of the gynecology-obstetrics department at Antoine Béclère hospital in Clamart. The risk of abnormality increases significantly with age, as does preeclampsia, diabetes.
- La multiplication of pregnancies after Medically assisted procreation results in increase in multiple pregnancies which in fact carry more risks.
- Finally, theobesity induces an over risk during pregnancy.
Women uninformed about high-risk pregnancies
Women are very poorly informed about the risks that can arise during pregnancy. According to the latest PremUp survey, while 97% have heard of prematurity, only 58% are stunted. Even more worrying: 61% of them say they have not received advice to avoid a pathological pregnancy. In addition, nearly 1 in 2 women think that pathological pregnancies have decreased over the past 10 years when it is in fact the opposite.
The PremUp Foundation also makes an alarming observation: 1 in 4 women would be willing to forgo some care for financial reasons. In recent years, the crisis has led to an increase in social inequalities. For the first time since 1995, the percentage of women who declared their pregnancy after the first trimester increased between 2003 and 2010, from 4,9% to 7,8% in 2010 (perinatal survey). This figure has remained stable since, since the 2016 figures indicate that 7,3% of women were concerned (6,2% having declared their pregnancy in the second trimester and 1,1% in the third trimester). One of the perverse effects of this increase is the delay in prenatal surveillance for some women, especially the most isolated and in precarious situations. « We actually see women coming to their term without having had any pregnancy follow-up, without ultrasound, notes Professor Alexandra Benachi. Lack of information on the importance of medical follow-up can have disastrous consequences. »