Management of pregnancy based on healthcare consumption of women who delivered in France in 2015: Contribution of the national health data system (SNDS)

Abstract

ObjectiveThis study was designed to further our knowledge of the management of pregnant women based on the national health data system (SNDS). Material and methodsWomen covered by the national health insurance general scheme or a local mutualist section, who delivered in 2015. ResultsAmong the 672,182 women included (mean age: 31 years, SD 5.3), 0.3% were under the age of 18 years, 4% lived in a French overseas department (<18 years: 21%), 17% had complementary universal health insurance coverage (<18 years: 75%), 1.2% presented a mental illness, 0.6% had a cancer, and 0.4% had cardiovascular disease. At least one outpatient visit with a gynaecologist or midwife was detected for 93% of women (first trimester (T1): 75%), specific or nonspecific pelvic ultrasound was performed in 98% (T1: 92%), blood glucose assay was performed in 78% (T1: 61%), and an oral glucose tolerance test was performed in 58%. Before delivery, 0.2% of women had at least one admission to the intensive care unit and 22% had at least one hospital stay (<18 years: 38%), for which the principal diagnoses were: false labour (4.5%), threatened preterm labour (2.5%), surveillance of high-risk pregnancy (2.6%), diabetes (2.6%), and hypertension (0.7%). The preterm delivery rate was 6.7% (<18 years: 14%, ≥40 years: 9%). Although 20% of deliveries were performed by caesarean section, 16% of vaginal deliveries required instrumental extraction. DiscussionSNDS data enrich the data derived from periodic national perinatal surveys, such as the poor follow-up of adolescent girls. These data can promote the elaboration and monitoring of annual indicators.