Mainland France Research Articles

Combined use of environmental and spectral variables with vegetation archives for large-scale modeling of grassland habitats

Grassland habitats provide many ecosystem services but are threatened by agricultural intensification and urbanization. While the lack of accurate and comprehensive inventories at the national scale makes them difficult to manage, advances in spatial modeling using open remote sensing data and open-source software, as well as the increasing use of ecological archives, provide new perspectives for mapping natural habitats. In this context, this study evaluated the contribution of spectral and environmental variables to discriminate and then map grassland habitats throughout France. To this end, 92 spectral variables derived from moderate-resolution imaging spectroradiometer data, 19 bioclimatic variables derived from WorldClim data, 4 topographic variables derived from the European Union Digital Elevation Model (DEM), and 8 soil variables derived from SoilGrids data were combined at a spatial resolution of 250 m. Reference plots that characterized 6 and 21 grassland ecosystems at European Nature Information System (EUNIS) levels 2 (broad habitats) and 3 (habitats), respectively, were collected from vegetation archives. We first performed descriptive analysis that included habitat description, ordination, and pairwise separability. We then performed predictive analysis of grassland habitats using a cross-validated random forest model that included a spatial constraint. While environmental and spectral variables characterized most grassland habitats well and consistently, some confusion occurred between habitats with similar abiotic conditions. The main grassland habitat types were correctly mapped at EUNIS level 2 ( F1 score = 0.68), but not at EUNIS level 3 ( F1 score = 0.52). In addition, the two variables that contributed most to the model were the near-infrared spectral band in spring and the minimum temperature of the coldest month. The model’s prediction at EUNIS level 2 for mainland France provides the map of grassland habitats at a new spatial scale.

Maternal characteristics associated with gestational weight gain in France: a population-based, nationally representative study

ObjectivesTo provide nationally representative estimates of gestational weight gain (GWG) and identify maternal characteristics associated with inadequate GWG in France.DesignA population-based study using data from the French National Perinatal Survey:...

Minors are the most affected by Chlamydia trachomatis in Reunion Island: A cross-sectional study, 2017–2018

ObjectivesTo determine the prevalence of Chlamydia trachomatis (CT) in the population screened at sexually transmitted infection (STI) clinics on Reunion Island and to identify risk factors for CT infection. Patients and methodsThis cross-sectional multicenter study was conducted in 2017–2018. Data were obtained from self-administered questionnaires and multiplex PCR tests. ResultsThe overall prevalence of CT in the screened population was 8.6% (95% CI 7.7–9.5%). The prevalence of urogenital CT was highest in women under 18 (13.2%, 95% CI 9.3–18.1%) and in men who have sex with men under 18 (13.3%, 95% CI 1.6–48.2%). Risk factors associated with CT infection in multivariate analysis were: female gender, being born in Reunion Island, having had a large number of sexual partners in the past year, and being co-infected with another STI. ConclusionsThe prevalence of CT in the screened population is higher in Reunion Island than in mainland France, especially in minors. Prevention campaigns targeting minors should be strengthened.

Provenance study of oyster shells by LA-ICP-MS

Provenance determination of archaeological remains is a valuable tool for reconstruction of past exchange networks. Among these materials, oyster shells are ubiquitous in sites from all prehistorical and historical periods. Thus, they seem to be promising candidates for provenance identification as they include chemical elements from the environment in their shells, which implies that an elemental fingerprint of the region of origin can be recorded in the shell composition. In this study, we present elemental measurements from 15 groups of modern and archaeological shells from 13 continental localities in mainland France and the island of Corsica (western Mediterranean Sea). Two of these localities had two oyster species (Crassostrea gigas and Ostrea edulis). Results indicate that (i) a species-specific elemental fingerprint exists and (ii) the Atlantic Ocean and Mediterranean Sea provenances can be identified for O. edulis shells. Moreover, if the shell originated from a locality only partially connected to the ocean (e.g. an estuary or lagoon), a fingerprint specific to the watershed can also be observed, even between groups originating from the same bay. Using these measurements as reference fingerprints, we characterize the Mediterranean origin of two groups of shells unearthed at Lyons (central France, 200 km away from the nearest shoreline), dated from the 1st c. CE.

Estimation of winter soil cover by vegetation before spring-sown crops for mainland France using multispectral satellite imagery

Winter soil cover by vegetation is associated with multiple benefits. In this study, winter soil cover rate before spring-sown crops was estimated for mainland France from multispectral imagery. For 67% and 84% of the area under spring-sown crops for years 2018 and 2019, soil cover during the previous winter was estimated through the computation of the Normalized Difference Vegetation Index (NDVI), using Sentinel-2 multispectral images. At country scale, winter soil cover rate before spring-sown crops was estimated between 37% and 48% for 2018 and between 31% and 43% for 2019, depending on the NDVI threshold for a soil to be considered covered by at least 50% of vegetation. Spatial patterns were relatively similar between the two years studied, highlighting strong heterogeneities between French departments. Cropping systems may explain some of these heterogeneities, as it has been shown that there is a large variability in the soil cover rate between spring-sown crops, but also depending on the previous crop. Winter soil cover rate was higher for crops associated with livestock production, such as maize silage (between 59% and 74% of plots covered before this crop). It was also shown that winter soil cover could be ensured by other means than cover crops: temporary grasslands were the previous crop with the highest soil cover, probably due to late ploughing. For these reasons, mixed systems combining livestock and crop productions may be a solution to increase winter soil cover before spring-sown crops.

Psychological support in general population during the COVID-19 lockdown in France: Needs and access.

IntroductionWith France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17–May 10). This study explored the perception of the adult population about the need for—and access to—psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown.Material and methodThis online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7–10, 2020).ResultsOne in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35–64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019.ConclusionThe perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities’ understanding of the population’s psychological needs in this situation and to enhance HCPs’ abilities to meet them. In particular, further research of its specific impact on youth is necessary.

Newborn screening for sickle cell disease in France

Newborn screening (NBS) for sickle cell disease (SCD) in France has allowed the identification of 9,260 children with SCD since 1989, including 583 in 2019. In mainland France, however, SCD screening is targeted to newborns identified at risk of SCD, i.e born from parents originating from countries with a high SCD prevalence. This screening program, combined to prophylactic measures and a well-organized social and health network in France, has demonstrated considerable efficacy in reducing childhood mortality as well as severe infectious, anemic and neurovascular complications in childhood. SCD NBS has additionally allowed the identification of 180,687 heterozygous (AS) children since 1989. The increasing incidence of SCD (1/1,303 new-borns identified in 2019 versus 1/2,089 in 2009) now pleads for universal NBS and strong advocacy regarding SCD, the most frequent disease identified by NBS in France, and a major public health issue.

Residential exposure to natural background radiation at birth and risk of childhood acute leukemia in France, 1990–2009

BackgroundThe role of natural background radiation (NBR) in childhood acute leukemia (AL) remains unclear. Several large record based studies have recently reported heterogeneous results. Differences in exposure assessment timing may explain this heterogeneity. ObjectivesIn a previous ecological study we did not observe any association between childhood AL incidence in France and NBR exposure at the time of diagnosis. With the same methodology, the present study focused on NBR exposure at the time of birth. Based on data from the French national registry of childhood cancer, we analyzed all AL together, and lymphoblastic and myeloid AL, separately. MethodsWe included 6,059 childhood AL cases born and diagnosed in mainland France between 1990 and 2009. NBR levels in municipalities of residence at birth were estimated by cokriging models, using NBR measurements and precise geological data. The incidence rate ratio (IRR) per unit variation of exposure was estimated with Poisson regression models, with adjustment for socio-demographic indicators and ultraviolet radiation levels. NBR exposures were considered at the time of birth, and cumulatively from birth to diagnosis. We also estimated a total NBR dose to red-bone marrow (RBM). ResultsThere was no evidence for an association between NBR exposure at birth and childhood AL incidence, neither overall (gamma radiation: IRR = 0.99 (0.94,1.05) per 50 nSv/h; radon: IRR = 0.97 (0.91,1.03) per 100 Bq/m3) nor for the main AL types. The conclusions were similar with the cumulative exposures, and the total RBM dose. ConclusionsThe study was based on high quality incidence data, large numbers of AL cases, and validated models of NBR exposure assessment. In all, the results further support the hypothesis that NBR are not associated to childhood AL in France.

Prise en charge du retard de croissance intra-utérin en France : enquête auprès des centres hospitalo-universitaires et maternités de type III

ObjectivesFrench Guidelines on Fetal Growth Restriction (FGR) were published in December 2013. It seemed interesting to us to carry out an inventory on the management of FGR in teaching hospitals and tertiary referral centers Material and methodsWe carried out a retrospective survey on the academic year 2020/2021. All teaching hospitals and level III maternity in mainland France were contacted (67). The questionnaire focused on the growth curves used, the etiological assessment carried out, the rate and modalities of antenatal surveillance as well as the criteria indicating a birth. ResultsThe response rate was 76%. The CFEF curves are used for screening in 78.4% of centers and in the event of FGR in 39.2% of them. The etiological assessment includes a referent ultrasound in 62.7% of cases and amniocentesis is offered in 74.5% of hospitals in case of severe and early FGR. All centers use umbilical Doppler for FGR. The fetal heart rate is monitored between once a week to three times a day in the event of cerebro-placental redistribution. In case of reverse flow, birth is induced from 28 weeks on for some teams while others continue the pregnancy until 39 weeks. In case of cessation of fetal growth, the expected terms of birth are between 28 and 38 weeks. ConclusionThere is great heterogeneity in the management of FGR, particularly in terms of antenatal surveillance and the term of birth envisaged.

Feasibility of the 4 per 1000 aspirational target for soil carbon: A case study for France.

Increasing soil organic carbon (SOC) stocks is a promising way to mitigate the increase in atmospheric CO2 concentration. Based on a simple ratio between CO2 anthropogenic emissions and SOC stocks worldwide, it has been suggested that a 0.4% (4 per 1000) yearly increase in SOC stocks could compensate for current anthropogenic CO2 emissions. Here, we used a reverse RothC modelling approach to estimate the amount of C inputs to soils required to sustain current SOC stocks and to increase them by 4‰ per year over a period of 30 years. We assessed the feasibility of this aspirational target first by comparing the required C input with net primary productivity (NPP) flowing to the soil, and second by considering the SOC saturation concept. Calculations were performed for mainland France, at a 1 km grid cell resolution. Results showed that a 30%–40% increase in C inputs to soil would be needed to obtain a 4‰ increase per year over a 30‐year period. 88.4% of cropland areas were considered unsaturated in terms of mineral‐associated SOC, but characterized by a below target C balance, that is, less NPP available than required to reach the 4‰ aspirational target. Conversely, 90.4% of unimproved grasslands were characterized by an above target C balance, that is, enough NPP to reach the 4‰ objective, but 59.1% were also saturated. The situation of improved grasslands and forests was more evenly distributed among the four categories (saturated vs. unsaturated and above vs below target C balance). Future data from soil monitoring networks should enable to validate these results. Overall, our results suggest that, for mainland France, priorities should be (1) to increase NPP returns in cropland soils that are unsaturated and have a below target carbon balance and (2) to preserve SOC stocks in other land uses.

Seasonal variations in childhood leukaemia incidence in France, 1990-2014.

Several studies have addressed the potential seasonality of childhood acute leukaemia (AL) without conclusive results. Using data from the National Registry of Childhood Cancers over 1990-2014 in mainland France, we investigated the seasonal variations in childhood AL taken together, and lymphoblastic (ALL) and myeloid (AML) leukaemia separately. Assuming constant variations over 1990-2014, we used a Poisson regression model to evaluate variations in standardized incidence ratios (SIRs) by month of birth or diagnosis. A scan method for temporal cluster detection was used to identify windows of several consecutive months with high or low SIR. The yearly reproducibility of the observed monthly variations was then evaluated. We included 11,528 AL, of which 9493 ALL and 1,843 AML. No seasonal variation was detected for ALL. With a clear seasonal pattern, differences in AML incidence rates were evidenced between January-April and May-December birth periods (SIR = 0.85, 95% CI 0.77-0.94 and SIR = 1.07, 95% CI 1.01-1.14, respectively). AML incidence variations by month of diagnosis were less clear-cut. Based on a large number of cases from a high-quality registry, we did not evidence any seasonality in ALL incidence rates but evidenced seasonal variations in AML incidence rates by month of birth.

Local public authorities’ and French mainland landscape advisers’ perception of landscape in Mayotte Island: The issues of quality of life in a developing region

The European Landscape Convention (ELC) has affirmed and legitimised the role of the landscape in the quality of life of people, emphasizing the importance of both remarkable and ordinary landscapes. Therefore, the convention should ensure that landscape issues are taken into account everywhere - in rich and poor regions and in different cultural contexts especially where the term ‘landscape’ does not exist in the local languages. We choose to study Mayotte, a French Overseas Department off the east coast of Africa, characterised by a particular territorial context with similar issues to those of the countries in the Global South. The aim of our research was to reveal how the concept of landscape is understood and defined by local public authorities and their landscape advisers and the extent to which the wider framework of the ELC is relevant to encourage landscape to be effectively taken into account in land use planning. Semi-structured interviews with 14 key stakeholders (local authorities and landscape advisers from mainland France) brought to light different ways of understanding the term ‘landscape’, and different approaches for including the issue of the landscape in land use management. The results show how integrating the issue of landscape can improve the quality of life in a poor region especially through the adoption of landscape tools. This adoption is still characterised by a top-down approach in which the French legislation and State services play an important role but which nonetheless clearly highlights the potential of these tools to coordinate a territorial project.

Taitoko, an advanced code for tsunami propagation, developed at the French Tsunami Warning Centers

This paper presents the new version of the operational code used at the Tsunami Warning Centers in French Polynesia and in mainland France. This nested multigrid code solves either the nonlinear shallow water or the weakly nonlinear Boussinesq equations in a spherical or Cartesian coordinates system. The objective is to simulate the propagation of tsunamis both in the context of tsunami early warning and in the context of research. The originality of this code is to simulate the tsunami propagation through a series of nested grids in which the numerical scheme is specified by the user. Three standard finite-difference methods and two finite volume schemes are available to take into account the dispersive nature of waves or to capture flow discontinuities. The performance of the five numerical schemes has been assessed through idealized 1D and 2D test cases. The convergence rate with grid refinement is evaluated for three of these tests. Diffusion and dispersion of the five schemes are evaluated through the 1D far-field propagation in a channel of constant depth. Finally, two-dimensional simulations of the 2011 Japanese tsunami are performed considering a homogeneous tectonic source. Coastal inundation is simulated in the bay of Kamaishi where run-up heights reached 10 m. The ability of the five schemes to propagate trans-Pacific tsunamis is evaluated through comparisons of time series between simulations and observations at DART buoys. In the context of tsunami early warning, numerical results show that standard finite-difference methods reproduce most of the observed time gauges and that numerical errors associated to these schemes are acceptable.

Revisiting global biogeography of freshwater diatoms: new insights from molecular data

The high-dispersal rates of microorganisms have driven to the expectation of their cosmopolitan geographic distribution. However, recent studies demonstrate that microorganisms instead show particular biogeography. Despite the existence of cosmopolitan species, geographically limited microbial groups have been found in aquatic and terrestrial environments worldwide. Diatoms are long time used model to study the biogeography of microorganisms. They are unicellular eukaryotic microalgae that contribute significantly to the aquatic primary production and have huge taxonomic diversity and marked species-specific ecological preferences. Several authors considered that diatoms have no limits in dispersion and are ubiquitously present. On the other hand, recent studies have shown that endemism exists for several genera, and species may have low dispersal capacity. However, all these studies are based on data obtained by microscopy and therefore suffer from the many well-identified biases associated with the optical identification of microorganisms at large scale. Metabarcoding technologies provide an access to taxonomic precision with a higher resolution compared to microscopy and open therefore the possibility of analyzing microbial diversity at genetic level. Recent bioinformatics tools allow reliable and standardized comparison of large datasets originating from distant geographic regions, overcoming issues related to biases in species identification. In this study we used metabarcoding data to revisit central questions in freshwater diatom biogeography. We assembled a large dataset of samples of benthic diatoms collected from rivers in seven different geographic regions. These regions cover the subpolar (Fennoscandia), temperate (France Mainland) and tropical (West Africa, French Guyana, New Caledonia, Tahiti island and Mayotte island) climate zones. The selected geographic regions can also be classified into four continental areas (Fennoscandia, France Mainland, West Africa, and French Guyana) and three islands (New Caledonia, Tahiti and Mayotte). We analyzed diatom alpha, beta and gamma diversity patterns in this dataset to address two main questions: 1) the presence of a latitudinal gradient in diatom diversity and 2) the cosmopolitanism of diatoms. Similarly to results previously reported by Soininen et al. 2016, our data showed a decrease in diatom richness with a decrease in latitude. However, testing the effect of land type (island vs. mainland) showed that this factor explains the actual variability of richness along the climatic gradient and the effect of latitude is not significant. Differences in community structure between regions and climate zones were significant. In multivariate analysis, tropical samples did not overlap with any of the other climate zones, suggesting the specificity of these communities.

Google Reviews: a descriptive study of 700orthodontic practices

As it is the case in the medical sector, Google reviews of orthodontic practices are on the rise. The main objective of the study was to describe the internet ratings and opinions on orthodontic practices in France. The second objective was to test the factors that influence the number of reviews and the overall rating. We conducted a descriptive study on Google reviews, on 700specialists in orthodontics in mainland France. 87% of offices got at least one review on Google. An office receives an average of 9.6comments; 63.6% of reviews are associated with comments; 10.8% of opinions receive a response from practitioners. The average number of stars is 4.1 (+/- 0.7) out of 5. Four types of comments are significant in the context of a multivariate analysis: monetary considerations, the level of hygiene felt, temporal parameters (punctuality…) and the setting of the office. Opinions regarding therapeutic assessments, even though they are the most frequent, only concern 40% of the comments. The socio-economic level of the city, the population density and the concentration of practices are not explanatory factors for the number of reviews or the average rating. A comment related to punctuality or fees lowers the grade. Opinions are given spontaneously and do not necessarily reflect patient satisfaction. A comparative study of the patient actual satisfaction with the average rating on Google could be interesting.

“Incommensurate Ontologies”?

In recent years, scholars and activists in France and the United States have questioned whether discrimination against Muslims constitutes a form of racism. In France, some on the left have claimed that religion is a category of belief and therefore should remain separate from discrimination based on skin color or other physical characteristics. In the United States, Afropessimist approaches insist on the specificity of anti-Black racism, rooted in the historical difference between the native and slave. This article, by contrast, argues that race and religion should be studied relationally and highlights how being Muslim exceeded the frame of personal conviction in colonial Algeria, where religious identity was the basis of a political and economic project that were constructed in their wake. The works of Frantz Fanon are particularly instructive in this regard, as he insisted on viewing Blackness as fundamentally relational and also drew on his analysis of anti-Black racism in mainland France to understand the dynamics of settler colonialism in Algeria. The porous line between religious and racial categories also sheds light on discussions of sectarianism in the Middle East more broadly, as colonial regimes irrevocably shaped the contours of the nation-state that were constructed in their wake. Postcolonial sectarianism inherited the intimate relationship between race and religion constructed by empire.

Epidemiology of scorpionism in France: nationwide scorpion exposure

Introduction In France, 57 species of scorpions are described with a limited number of clinical studies. In this article, we report the epidemiology of scorpion sting events in mainland France and its overseas territories based on cases reported to the French poison-control centres (FPCC). Material and method This retrospective multicentre study was conducted with data from FPCC’s files about scorpion stings between January 1, 2011 and December 31, 2020. Result Among 975 recorded files, 624 patients were included because they were stung by scorpions native to French territories. Most stings occurred along the Mediterranean coast in summer and indoors (in persons’ homes) during the daytime. The scorpions were identified in 50% of cases. According to signs of envenoming, patients were divided into class III (2 cases; 1%), class II (51 cases; 8%), class I (444 cases; 71%) and asymptomatic stings (127 cases; 20%). Twelve pregnant women were stung and two of them had contractions, which triggered childbirth in one woman. Ten patients had local infections in the first week after the sting. One patient had venous thrombosis 2 days after the sting. Life-threatening scorpions, i.e., Tityus obscurus, Tityus sylvestris and Centruroides pococki, in French territories are limited to French Guiana and Lesser Antilles. Class II envenoming cases are recorded for Buthus occitanus, Euscorpius spp. in mainland France, and Isometrus maculatus in French Guiana, the Lesser Antilles (Guadeloupe and Martinique) and territories in the Indian Ocean (Mayotte and Réunion Island) and Pacific Ocean (French Polynesia). Only cases of local manifestation was reported for Belisarius xambeui in mainland France. Conclusion Scorpion stings in French territories are frequently on the Mediterranean coast and French Guiana. Life-threatening cases are limited to T. obscurus, T. sylvestris and Centruroides pococki stings in French Guiana and Lesser Antilles.

Diabetes in French Guiana, adapting national standards of therapeutic education and care to the amazonian challenge.

French Guiana is a territory located more than 7000 km from France. It is also the largest French territory, with almost 84000 km2 and 90% of it is covered by forest. Some municipalities are isolated due to the scarcity of transportation and the poor road infrastructure. The population is extremely diverse ethnically and culturally, and includes more than thirty ethnic groups. Immigration is high because it is one of the richest countries in the area bordering northern Brazil, Suriname, Guyana, and as a result of socio-economic crises in some other countries such as Haiti, and it has permeable natural borders. Diabetes and obesity, are emerging issues, with double the prevalence of Mainland France, whereas infectious diseases, such as HIV, take second place. Therapeutic and educational management are challenging because they require the adaptation of tools and treatments to the mul-ticulturalism and precariousness often encountered in these populations. The French and European recommendations are unsuited to the needs of the territory and must take into account the epidemiological, sociological and cultural parameters of these populations in order to provide appropriate and graded management of diabetes in the French Amazon.

Les arbovirus en France métropolitaine : diagnostic et actualités épidémiologiques

AbstractSince 2004, Aedes albopictus has been established in metropolitan France, with more than 58 colonized departments in 2020. The occurrence of this mosquito, vector of the Dengue, Chikungunya and Zika viruses, together with viremic travelers returning from tropical areas, induced several emergences of autochthonous cases since 2010. In addition, neurotropic arboviruses (West-Nile, Toscana and Tick-borne encephalitis) are endemic in some regions of metropolitan France. The etiologic exploration of arboviruses infections should therefore not be limited to travelers, but should also be implemented in diagnostic assumptions upon evocative clinical presentation arising in patient from a French area colonized by the vector. The diagnostic strategy for these arboviruses includes the choice of tools and samples to be taken. It also relies on the clinical form and the time elapsed between onset of disease and sampling. Finally, the diagnosis of arboviruses in mainland France is also of major public health interest with outcomes on vector control and securing blood and organs donations.

381 Association between maternal birthplace and non catching-up among pregnant women overdue for cervical cancer screening

In France, the HAS recommends performing a pap test every 3 years for all sexually active women aged from 25 to 65 years old. Currently, screening access is inequitable, and pregnancy may be an ideal moment to catch-up with women who are overdue for cervical cancer screening. As in general population, several social factors associated with place of birth are also associated with less access to screening. Our objective was to study the association between maternal place of birth and non catching-up during pregnancy among the sample of women from the National Perinatal Survey (ENP 2016). The National Perinatal Survey 2016 has included 13,147 women who delivered after 22 weeks in mainland France. The factors associated with non-catching up (defined by the lack of pap test during pregnancy for overdue women) has been modelled by log-binomial regression. Multivariate analysis was adjusted on level of education, health insurance and the moment of initiation of prenatal care. Among all women included in the National Perinatal Survey and concerned by screening, 43% were overdue. Among them, 45% of women were not caught-up during pregnancy. After adjustment on covariates, women born in Northern Africa had higher risk of being not caught-up than women born in France (adjusted RR 1.14 95% CI [1.03,1.26]). A low level of education and the late initiation of prenatal care were also associated with non-catching up. 45% of overdue women are not caught-up during pregnancy. Being born in Northern Africa increases the risk of being not caught-up.