Key Points

• French Guiana has the highest birth rate after Mayotte, making perinatal care a major public health issue.
• The proportion of women under 20 among those giving birth is six times higher than the national average (12% versus 2%): early pregnancies, particularly among adolescents, pose a risk of complications for the unborn child (low birth weight, prematurity, congenital anomalies, etc.) but also a risk of social isolation and dropping out of school for the mother, thereby exacerbating gender-based inequalities.
• In French Guiana, pregnancies are less often desired, planned, and monitored, even though taking folic acid before conception, proper preparation, and regular, high-quality prenatal care during pregnancy are two key strategies for reducing maternal and neonatal risks:
  • In French Guiana, 29% of women who gave birth reported that they did not want or plan their pregnancy, compared to 17% nationally;
  • In French Guiana, folic acid intake during the preconception phase is one-third as common as at the national level (8% versus 27%);
  • Pregnant women attend prenatal education sessions half as often in French Guiana as they do nationally (43% among first-time mothers versus 80%) and French Guiana is the region where early prenatal care is least commonly provided (39% versus 62%). However, the rate of such care has been increasing for several years.
• In French Guiana, women report smoking less frequently in the year prior to their pregnancy than at the national level (10% versus 27%): tobacco use during pregnancy poses a significant risk of maternal and fetal morbidity.
• In French Guiana, only 61% of pregnant women were screened for gestational diabetes, even though such screening should be routine regardless of whether the pregnant woman has risk factors: this low proportion reflects the lack of prenatal care in French Guiana. Screening for gestational diabetes ensures that this condition is managed as early as possible, particularly through lifestyle and dietary interventions to reduce the risk of complications during pregnancy.
• Hypertensive disorders during pregnancy are twice as common in French Guiana as at the national level (11% versus 6%): they pose a risk of complications during pregnancy and require early screening and monitoring.
• In French Guiana, cesarean sections are less common, and there are fewer complications related to childbirth (postpartum hemorrhage and tears): this can be partly explained by a lower average age of women at delivery and a higher proportion of multiparous women.
• Birth indicators are cause for concern:
  • Preterm birth is more common in French Guiana than at the national level (11% versus 7%), even though it increases the risk of neurodevelopmental disorders and disability. However, a slight downward trend in preterm birth has been observed in French Guiana since 2012;
  • All mortality indicators are worse in French Guiana than at the national level: perinatal mortality rates (stillbirths and deaths within the first 6 days of life; 19 ‰ in French Guiana versus 11 ‰ nationally) and infant mortality (deaths during the first year of life; 10 ‰ in French Guiana and 4 ‰ nationally) are higher in French Guiana.
• Screening for rare and serious diseases is less frequently refused in French Guiana (0.3‰ refusal rate in French Guiana versus 0.6‰ nationally). The results show a lower incidence of diseases, with the exception of sickle cell disease, which is four times more common.
• Breastfeeding is more widespread in French Guiana than at the national level: nearly 9 out of 10 women (88.9%) breastfeed (either exclusively or in combination with other feeding methods) during the postpartum period in French Guiana, compared to 70% nationally.