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data in Guadeloupe remains worrying

According to studies, in , 1 baby is born premature every 8 minutes. Whether in France or Guadeloupe, the rate of prematurity has increased in recent years. In 2021, it was 10% in Guadeloupe.

The results of the 2021 National Perinatal Survey (ENP) in the DROMs conducted by Orsag, the Guadeloupe Regional Health Observatory, the ARS, the Regional Health Agency, and Public Health France, indicate that the rate of premature births remains high.

In Guadeloupe and Saint-Martin, 690 and 93 births were recorded in the ENP-DROM 2021.

The results of the survey show that perinatal health indicators in Guadeloupe remain worrying.

Prematurity, corresponding to a gestational age less than 37 weeks (week of amenorrhea). The trend seems to show that prematurity more often concerns births in Guadeloupe (10.2% vs. 7.0% in mainland France, without significant difference).

The rate of prematurity and the proportion of births of low weight babies (< 2,500 g) are high (10.2% and 10.8% respectively).

This rate was 6.6% in 2022, in France.

Injections of antenatal corticosteroid therapy, allowing fetal maturation have been recommended in women at risk of premature delivery. These injections were administered to 7.1% of women in Guadeloupe, mainly before 34 weeks (between 95.0 and 99.9% of cases).

A threat of premature birth requiring hospitalization occurred in 6.4% of women in Guadeloupe.

In Guadeloupe and Saint-Martin, the rate of premature births (among live births) increased from 11.4% in 2010 to 9.6% in 2019. In mainland France, the rate was 6.1% in 2019. In 2019, the rate of premature births in Guadeloupe is significantly higher than in France.

In mainland France as in the overseas territories, prematurity affects more than one in two multiple pregnancies, according tohe Department of Research, Studies, Evaluation and Statistics.

According to the ENP 2021, medical factors known to be associated with prematurity (obesity, high blood pressure or even preeclampsia) were found in higher proportions than in France.

In 2014, the Timoun study conducted by Inserm, the National Institute of Health and Medical Research, between 2004 and 2007, revealed that chlordecone, as well as other medical and sociodemographic factors, could explain that in Guadeloupe the rate of prematurity is higher than in France.

The study highlighted the known risk factors that favor premature births:Pathologies linked or not to pregnancy such as hypertension, gestational diabetes, urinary infections, as well as asthma.
High maternal age would also favor premature births. The risk is also increased for obese or overweight women.

More surprisingly, women who live without their partner in their family are more exposed than others. However, to the extent that single-parent families are more numerous in Guadeloupe than in France, this would partially explain the almost three times higher rate of premature births.

Finally, the Inserm study indicated having “highlighted a relationship between the category of exposure to chlordecone and the duration of gestation (…) The risk of premature birth was significantly increased with increasing categories of exposure“.
According to the authors of the study, this could be explained by “the action of chlordecone on estrogen and/or progesterone receptors in vitro and in vivo, which play a determining role in the initiation of childbirth“.
The conclusion of the study did not necessarily encourage optimism, specifying that the rate of prematurity could continue to increase in the years to come.

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