Home visits during pregnancy: consequences on pregnancy outcome, use of health services, and women's situations.

This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (< 37 weeks) was 1.

Porcine surfactant replacement therapy in newborns of 25-31 weeks' gestation: a randomized, multicentre trial of prophylaxis versus rescue with multiple low doses. The French Collaborative Multicentre Study Group.

The aim of the study was to determine if prophylaxis with multiple low doses of porcine surfactant would increase survival, without bronchopulmonary dysplasia, compared with rescue therapy, for respiratory distress syndrome in newborns of 25-31 weeks' gestation. Compared with rescue therapy (n = 122), prophylaxis (n = 134) decreased the need for oxygenation and ventilatory support within 3-72 h. It did not, however, increase survival without bronchopulmonary dysplasia (60% versus 46%) (odds ratio (OR) = 1.

[Women in clinical trials].

In a workshop held in Giens in September 1994, representatives of drug companies and scientists met to discuss the place of women in clinical trials. They recommend that, in phase II and III studies, men and women should be included in a proportion equivalent to that observed for the condition studied. They also recommend that the impact of the gender on the results should be systematically studied.

Did preterm deliveries continue to decrease in France in the 1980s?

To study the trends in gestational age and birthweight in France, we compared data from three surveys that were based on representative samples of births in 10 French regions and were conducted in 1972, 1981 and 1988-89. Only single livebirths were considered in the analysis. The rate of preterm births decreased from 7.

[Prevalence and risk factors of hepatitis C virus infection in a hospitalized population in a gastroenterology unit. Role of endoscopic biopsies].

Objectives And Methods: In order to study the prevalence and risk factors of HCV infection in a population hospitalized in a Gastroenterology Unit, 3,767 patients were tested for serum anti-HCV, and 2,607 filled out a questionnaire about risk factors.

Results: With the RIBA 2 test, the overall prevalence was 5.9%.

[Epidemiology of falls and fall-related injuries in the aged].

Approximately one third of elderly persons over the age of 65 who live in the community fall each year. About 5% of falls result in a fracture, and 5 to 10% of them result in other serious injuries requiring medical care. Even in the absence of serious physical injury, falls may have severe psychological consequences leading to an accelerated decline in functional capacities.

Maternal deaths and substandard care: the results of a confidential survey in France. Medical Experts Committee.

Objective: Confidential enquiries were carried out to attempt to understand why the level of maternal mortality has been high in France.

Study Design: A descriptive retrospective survey has been carried out. Five administrative regions participated in the survey.

Menopause and perceived health status among the women of the French GAZEL cohort.

The aim of this study was to evaluate the effect of menopause on women's quality of life. Women (1171) aged from 45-52 years who work for the French national gas and electricity company volunteered for this study (response rate 75%). They completed a self-administered questionnaire pertaining to general health.

Bone mass measurements around menopause and prevention of osteoporotic fractures.

The objective of this work is to try to answer the question: is it useful to recommend bone densitometry at the time of the menopause as a screening test for women at high risk of osteoporotic fractures? This analysis is based on a review of the literature for the period 1981-1993, considering published articles in English or French. Prospective studies demonstrate that low bone mass (BM) in women who have been menopausal for more than 10 years is actually a risk factor for fracture, with a fracture risk multiplied by about two for a decrease in BM of one standard deviation. At present no studies have shown this association when BM determinations have been realised at the age of 50 years.

Determinants of hormone replacement therapy among postmenopausal women enrolled in the French GAZEL cohort.

Although the efficacy of hormonal replacement therapy (HRT) regarding numerous consequences of menopause is proven, its prevalence of use is low, as is compliance with the prescribed treatment. The aim of this work was to study the factors influencing a woman's decision to take HRT by analyzing the determinants of HRT use of at least 6 months' duration among post-menopausal women working for a French company and enrolled in a cohort study. Special attention was paid to the women's expectations of HRT.

Comparative efficacy and tolerance of ibuprofen syrup and acetaminophen syrup in children with pyrexia associated with infectious diseases and treated with antibiotics.

A double-blind, randomised, parallel group study has been done comparing the efficacy and tolerability of 7.5 mg/kg ibuprofen syrup (n = 77) and 10 mg.kg-1 acetaminophen syrup (n = 77) in 154 children (6 months to 5 years) with fever (> or = 38 degrees C) associated with infectious diseases and treated with antibiotic therapy.

[Risk related to methodologically disputable studies: the example of vitamin therapy for the prevention of neural tube defects].

Due to the non acceptance by ethics committees of its double blind controlled study for prevention of neural-tube defects recurrence by vitamin supplementation versus mineral components, a British group underwent methodologically debatable epidemiological study which has become quite controversial. This survey concluded that vitaminotherapy is effective. The aim of this article was to analyze the consequences induced by such a procedure which probably resulted in delaying the onset of the Medical Research Council controlled trial, performed with the necessary rigorous methodology, and which gave the final answer only 11 years later, a time during which concerned women could not take advantage of a valuable preventive treatment.

[Evaluation of urinary rapid strip-tests for screening of urinary infection in pregnant women].

Repeated screening for asymptomatic bacteriuria using a reagent strip-test was conducted in a population of 859 pregnant women. The women performed 4,125 tests at home, and 2,867 tests were performed by the nursing staff at the antenatal clinics. The tests done by the women at home had a higher predictive value than the tests done in the antenatal clinics (24% versus 10%).

Transabdominal amnioinfusion for the management of nonlaboring postdates with severe oligohydramnios.

A retrospective study compared two comparable consecutive groups of nonlaboring primiparas beyond 41 weeks with severe oligohydromanios (no amniotic pocket more than 2 cm deep). Transabdominal amnioinfusions were not done in the historical control group (n = 14) but were done in the second group (n = 11). Fetal heart rate patterns and neonatal outcome were better in the group with amnioinfusion than in controls, and the rate of cesarean delivery was significantly lower (18 vs.

Consequences of misdiagnosis of intrauterine growth retardation for preterm elective cesarean section.

We studied the consequences of misdiagnosis of intrauterine growth retardation (IUGR) for preterm elective cesarean section among live singleton newborns in two teaching hospitals in Paris between 1978 and 1983. The population studied comprised the 16,540 babies who were normal for date, according to the 10th percentile of the reference curve established in this population. For 118 of these infants, IUGR had been diagnosed during pregnancy.