New Indicators to Guide Action at the Local Level

Through its “Perinatal and Early Childhood” program, Santé publique France contributes to the epidemiological surveillance of perinatal health, based on the analysis of multiple and complementary data sources. The indicators presented in the national bulletin and regional bulletins will also be published shortly as open data on Odissé. Enriched with new indicators on perinatal mental health and congenital anomalies, this work enables public prevention policies to be adapted to the epidemiological reality, starting from the preconception period.

A Public Health Issue with Persistent Challenges 

France is experiencing a decline in births (660,000 in 2024, which is 160,000 fewer births than in 2012) and a rise in the average age of mothers at childbirth (31.1 years on average, with 25% of mothers aged 35 or older). This trend is accompanied by a deterioration in women’s health prior to pregnancy: overweight/obesity (38%), pre-existing diabetes (1%), and chronic hypertension (1.63%)—factors that contribute to the rise in gestational diabetes (15%, compared to 7.5% in 2012) and increase the risk of complications. 

While a moderate decline in preterm births (between 32 and 36 weeks of amenorrhea) is observed between 2012 (6.3%) and 2024 (5.6%), infant mortality is rising, driven by an increase in neonatal deaths between 0 and 27 days of life, often linked to perinatal conditions (51.8% in 2023) or congenital anomalies (19.5%). With 4.08 deaths per 1,000 live births in 2024 (an average annual increase of 1% between 2014 and 2024), France now ranks 21st out of 27 European countries. Furthermore, major congenital anomalies account for 3.5% of all births, which is higher than the European average.

At the same time, prevention efforts remain insufficient: only 27% of women take folic acid before pregnancy, even though this supplementation is recommended to prevent certain birth defects. Only 15.7% of women receive counseling on preventing cytomegalovirus (CMV) infection, which is a risk factor for disability. Early prenatal and postnatal consultations, although mandatory since 2020 and 2022, respectively, are struggling to achieve universal coverage: the former covers 62% of women in 2024, while the latter covers only 25%.

Perinatal mental health: a priority for mother and child

In France, nearly 200,000 women may experience symptoms of depression, anxiety, or suicidal thoughts within two months of giving birth each year.³ These mental health disorders or symptoms, which are often linked, can have serious consequences: obstetric complications, difficulties establishing the mother-infant bond, and increased risks of developmental disorders in the child. Furthermore, since 2013, suicide has been among the top two causes of maternal mortality in France, with nearly 15 suicides per ^year⁴. Findings from Santé publique France indicate that two months postpartum, 17% of women (about 1 in 6) experience depressive symptoms, 27% experience anxiety symptoms (about 1 in 4), and 5.5% (about 1 in 20) have suicidal thoughts. These prevalence rates vary significantly by region, with nearly 30% of women who gave birth in Guadeloupe exhibiting symptoms of depression two months postpartum, compared to 17% in mainland France.

Furthermore, the lack of access to prenatal mental health care is a cause for concern: 73% of women who reported experiencing psychological difficulties during their pregnancy did not receive prenatal mental health care. These are most often women who have developed pregnancy-related conditions (such as gestational diabetes, pregnancy-induced hypertension, or anemia), suggesting that special attention should be given to these women to encourage them to seek mental health care when necessary. Conversely, interventions such as home visits by midwives, consultations with social workers, or childbirth and parenting preparation classes significantly improve access to prenatal mental health care. In the postnatal period, the gradual expansion of early postnatal counseling—which aims in particular to identify women experiencing psychological difficulties within the first two months after childbirth—should help improve access to mental health care.

In light of these findings, it is essential to raise awareness among professionals and the general public about perinatal mental health and to promote support services, with the goal of improving early screening and access to specialized care.  

Lessons to Guide Research on Prevention and Epidemiological Surveillance in Perinatal Health

This scientific research advocates for four priority areas: strengthening existing prevention measures, conducting more in-depth research into the causes of rising infant mortality, collectively mobilizing stakeholders in prevention and epidemiological surveillance to address risks associated with increasing maternal age and the deterioration of women’s preconception health, and continuing and improving epidemiological surveillance. Santé publique France particularly emphasizes the need to optimize the quality of death certificates completed by healthcare professionals, to expand access to SNOOPI (the future birth-related data repository) for public health stakeholders, and to continue population-based surveys (ENP, Epifane, Albane).

Finally, the publication of regional and departmental editions of the bulletins provides, for the first time, a region-specific analysis of the indicators, enabling local stakeholders to tailor their public policies to the specific characteristics of their region.

Helping parents and expectant parents take care of their health and that of their baby

Santé publique France takes action starting in the preconception period and throughout the first 1,000 days to promote the health of parents and children. Through digital tools such as 1000-premiers-jours.fr (2.3 million visitors per year), it provides information on key issues, nutrition, physical activity, and the importance of vaccinations. This preventive approach also includes a focus on early prevention interventions that support parent-child interaction, including the rollout of the Panjo intervention; in addition, its scientific work includes a research component featuring the Evane survey, the first nationally representative study on the determinants of parental experiences and practices. The initial results, to be published this year, will provide insights that complement currently available indicators.

Tailored resources (guides, brochures, apps) address key issues: nutrition, breastfeeding, vitamin B9, and addiction prevention. For migrant populations, bilingual health booklets and a guide for professionals facilitate access to healthcare and rights.