Publications by authors named "Nathalie LeLong"
Background: The French guidelines have recommended a restrictive policy of episiotomy since 2005. We aimed to assess variations in the prevalence of both episiotomy and obstetric anal sphincter injury (OASI) from the 2010, 2016, and 2021 National Perinatal Surveys.
Methods And Findings: A total of 29,750 women who had given birth to a live infant by vaginal delivery were included.
Background: Despite French national recommendations since 2012 that all pregnant women be vaccinated against influenza, in 2021 this vaccine coverage is low - around 30 % - in France.
Objectives: To identify barriers to influenza vaccination during pregnancy by assessing how often women were offered this vaccination and how often they accepted it.
Study Design: We used data from the French national perinatal survey (ENP), which covered all births during one week in March 2021 (N = 12,614).
Article Synopsis
- Congenital ocular anomalies (COA) are a leading cause of visual impairment in children in high-income countries, and this study aimed to evaluate their prevalence in European registries.
- Data from 19 EUROmediCAT registries and one healthcare database revealed a prevalence of COA at 3.47 cases per 10,000 births, with congenital lens anomalies being the most common type.
- The findings suggest the need for better screening and early diagnosis of COA, highlighting the importance of large-scale epidemiological studies for understanding these conditions.
Article Synopsis
- - The study investigated the impact of prolonged extreme heat exposure during early pregnancy (specifically during the August 2003 heatwave in France) on the risk of neural tube defects (NTDs) in newborns.
- - Researchers analyzed data from the Paris Registry of Congenital Malformations, finding that out of 1272 NTD cases recorded between 1994 and 2018, ten cases were linked to conceptions during the extreme heat period, showing a significantly higher risk (relative risk = 2.14).
- - Overall, the findings indicate that exposure to extreme heat in the early stages of pregnancy is associated with an increased risk of NTDs, highlighting potential environmental health risks during critical periods of fetal development.
Objective: International migration from source countries has meant that clinicians in high income countries, that is, receiving countries, are increasingly caring for affected women affected by female genital mutilation/cutting (FGM/C). The aim of the present study was to assess the prevalence of FGM/C among women at childbirth, and its association with pregnancy outcomes.
Methods: This was an observational study using data from a cross-sectional population-based study from the French National Perinatal Survey of 2021 (ENP) conducted in all maternity units in mainland France and including all women delivering a live birth during 1 week in March 2021 (N = 10 928).
Objective: To assess the frequency of fetal therapy for fetuses with congenital pulmonary malformations (CPMs) and to investigate their short-term outcomes.
Method: The study population included 435 singleton fetuses diagnosed with CPMs from a national population-based cohort study in France in 2015-2018. Information was obtained from medical records on CPM volume ratio (CVR), signs of compression, fetal therapy and perinatal outcomes.
Consent for interventions during childbirth: A national population-based study.
Int J Gynaecol Obstet
January 2025
Objective: To assess the frequency and determinants of medical interventions during childbirth without women's consent at the population level.
Methods: The nationwide cross-sectional Enquête Nationale Périnatale 2021 provided a representative sample of women who delivered in metropolitan France with a 2-month postpartum follow-up (n = 7394). Rates and 95% confidence intervals (CI) of interventions during childbirth (oxytocin administration, episiotomy or emergency cesarean section) without consent were calculated.
Background: Small for gestational age is defined as a birthweight below a birthweight percentile threshold, usually the 10th percentile, with the third or fifth percentile used to identify severe small for gestational age. Small for gestational age is used as a proxy for growth restriction in the newborn, but small-for-gestational-age newborns can be physiologically small and healthy. In addition, this definition excludes growth-restricted newborns who have weights more than the 10th percentile.
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- Registries of congenital anomalies (CAs) provide important data for monitoring CAs, and a study analyzed the prevalence and related outcomes in Paris from 1981 to 2020.
- The prevalence of CAs remained stable at around 2.9% of total births, with genetic anomalies being the most common, while prenatal diagnoses significantly increased from about 17% to 70%.
- Infant mortality rates varied by condition, reaching as high as 86% for hypoplastic left heart syndrome, indicating differing outcomes based on the type of anomaly.
Article Synopsis
- Congenital heart defects (CHDs) are the most common congenital anomalies, affecting almost 1% of newborns, and vary widely in severity and treatment.
- The study aimed to analyze long-term survival rates in newborns with CHD and to create predictive models for infant mortality using the Anatomic and Clinical Classification of CHD (ACC-CHD).
- Results showed an overall 8-year survival rate of 96% for isolated CHDs, with survival rates differing significantly among categories, from 99.5% for some conditions to as low as 34% for more severe cases.
Article Synopsis
- The study aimed to estimate the prevalence and trends of congenital eye anomalies (CEAs) in Paris from 2010 to 2020, analyzing data from all maternity units in the area.
- Out of 115 identified cases of CEAs, the overall prevalence was 4.1 cases per 10,000 births, with 23.5% being prenatally diagnosed.
- It was found that CEAs were commonly associated with other anomalies, as 20.9% had genetic issues, and 53% had additional extraocular anomalies, with a lower prenatal detection rate for isolated CEAs at only 13.3%.
Background: Gastroschisis is a serious birth defect with midgut prolapse into the amniotic cavity. The objectives of this study were to evaluate the prevalence and time trends of gastroschisis among programs in the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR), focusing on regional variations and maternal age changes in the population.
Methods: We analyzed data on births from 1980 to 2017 from 27 ICBDSR member programs, representing 24 countries and three regions (Europe , Latin America, North America).
Article Synopsis
- * COVID-19 prevalence in pregnant women was found to be 5.7%, with multiple factors influencing diagnosis, such as non-French nationality and multiparity.
- * Women diagnosed with COVID-19 during pregnancy experienced higher rates of preterm births and cesarean deliveries, especially those diagnosed shortly before childbirth.
Many human teratogens are associated with a spectrum of congenital anomalies rather than a single defect, and therefore the identification of congenital anomalies occurring together more frequently than expected may improve the detection of teratogens. Thirty-two EUROCAT congenital anomaly registries covering 6,599,765 births provided 123,566 cases with one or more major congenital anomalies (excluding chromosomal and genetic syndromes) for the birth years 2008-2016. The EUROCAT multiple congenital anomaly algorithm identified 8804 cases with two or more major congenital anomalies in different organ systems, that were not recognized as part of a syndrome or sequence.
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- Preterm birth significantly increases the risk of mortality in children with major congenital anomalies (CAs), with the risks being higher for those born at very low gestational ages.
- Maternal age under 20 years is linked to higher mortality rates both in infancy and early childhood, while female children have a slightly increased risk compared to males.
- Understanding these risk factors can improve clinical care and provide better support for parents of children born with CAs.
Background: Prenatal screening for congenital anomalies is an important component of maternity care, with continual advances in screening technology. However, few recent studies have investigated the overall effectiveness of a systematic policy of prenatal screening for congenital anomalies, such as in France where an ultrasound per trimester is recommended for all pregnant individuals.
Objective: This study aimed to assess the proportion and the type of congenital anomalies that are not detected during pregnancy.
Results of the 2021 French National Perinatal Survey and trends in perinatal health in metropolitan France since 1995.
J Gynecol Obstet Hum Reprod
December 2022
Objective: To report results of the 2021 French National Perinatal Survey (ENP) in metropolitan France and assess trends in the main indicators of perinatal health, medical practices, and risk factors in France since 1995.
Population And Method: All the samples included all women giving birth at a gestational age of at least 22 weeks of gestation and/or to an infant weighing at least 500 grams in all maternity units in metropolitan France during one week in 1995 (N=13 048), 2003 (N=14 324), 2010 (N=14 546), 2016 (N=12 553), and 2021 (N=12 088). The data came from postpartum interviews of the women at the hospital and their medical records.
Article Synopsis
- The study analyzed data from various birth defect surveillance programs across 18 countries to assess the prevalence and mortality rates of anorectal malformation (ARM) between 1974 and 2014.
- The overall prevalence of ARM was found to be 3.26 cases per 10,000 births, with a notable decrease in cases that were multiple, syndromic, or stillborn from 2001 to 2012.
- The research highlights a significant mortality risk during the first week of life, especially in multiple and syndromic cases, suggesting a need for tailored clinical services and further investigation into factors affecting ARM prevalence and mortality.
Prevalence of vascular disruption anomalies and association with young maternal age: A EUROCAT study to compare the United Kingdom with other European countries.
Birth Defects Res
December 2022
Article Synopsis
- Younger mothers in the UK face a higher risk of pregnancy complications like gastroschisis, which is linked to vascular disruptions, prompting a study to explore the prevalence of other similar anomalies in this demographic.
- An analysis of data from 26 European congenital anomaly registries revealed that the UK had a significantly higher prevalence of vascular disruption anomalies (8.85 per 10,000 births) compared to other European countries (5.44 per 10,000 births), even after adjusting for maternal age.
- The study found that younger mothers had increased rates of anomalies like gastroschisis and congenital constriction bands, while anomalies with weaker links to maternal age, such as transverse limb reduction defects,
Epidemiology of aplasia cutis congenita: A population-based study in Europe.
J Eur Acad Dermatol Venereol
March 2023
Article Synopsis
- Aplasia cutis congenita (ACC) is a rare skin condition present at birth, primarily affecting the scalp, with most knowledge derived from individual case reports and small studies.
- This study utilized data from a large European network (EUROCAT) to assess the prevalence and trends of ACC across 28 registries in 16 European countries, finding 500 cases from 1998-2017.
- Results showed an ACC prevalence of 5.10 per 100,000 births, with significant prevalence variation across regions, and many cases (33.8%) were associated with other congenital anomalies, particularly Patau syndrome and limb defects.
Background: Congenital anomalies are a major cause of perinatal, neonatal and infant mortality.
Objectives: The aim was to investigate temporal changes and geographical variation in survival of children with major congenital anomalies (CA) in different European areas.
Methods: In this population-based linkage cohort study, 17 CA registries members of EUROCAT, the European network for the surveillance of CAs, successfully linked data on 115,219 live births with CAs to mortality records.
Article Synopsis
- Bladder exstrophy (BE) is a rare birth defect impacting the lower abdomen; this study investigates its prevalence, trends, and age-specific mortality rates using data from 20 surveillance programs across 16 countries from 1974 to 2014.
- The overall prevalence of BE was found to be 2.58 cases per 100,000 births, with a noticeable decline in prevalence between 2000 and 2014; first-week mortality rates were particularly high for multiple and syndromic cases, especially among cases from Latin America lacking elective termination options.
- The findings emphasize the importance of monitoring prevalence trends and addressing the elevated mortality risks in affected individuals, particularly in specific regions and among certain case
Article Synopsis
- Congenital hydrocephalus (CH) is a diverse set of birth defects with varying prevalence, and this study aimed to analyze the early neonatal case fatality rate (CFR) and total birth prevalence (BPR) among newborns with CH using data from 25 international registries from 2000 to 2014.
- The study found that the early neonatal CFR was 5.9 per 100 liveborn CH cases, with syndromic cases having a significantly higher CFR than non-syndromic cases (10.4% vs. 4.4%).
- Although there were substantial differences in CFR and BPR across registries, higher CFR often correlated with higher BPR; however, most
Background: Congenital anomalies are the leading cause of perinatal, neonatal and infant mortality in developed countries. Large long-term follow-up studies investigating survival beyond the first year of life in children with rare congenital anomalies are costly and sufficiently large standardized cohorts are difficult to obtain due to the rarity of some anomalies. This study aimed to investigate the survival up to 10 years of age of children born with a rare structural congenital anomaly in the period 1995-2014 in Western Europe.
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- - The study analyzed infant mortality rates (IMR) in France from 2001 to 2019 using data on births and deaths in the first year of life, finding an average IMR of 3.63/1000, with higher rates for males compared to females.
- - Key findings included a sharp decrease in IMR until 2005, a slower decrease until 2012, and a notable increase thereafter, particularly among early neonatal deaths.
- - The authors emphasize the need for urgent investigation into the recent uptick in IMR since 2012 to identify causes and implement corrective measures.