Abstract 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). We estimated the FGM/C prevalence using (i) the diagnosed cases and (ii) the indirect prevalence estimated by UNICEF in each source country. We compared population characteristics and perinatal outcomes between women diagnosed with FGM/C and two groups: (i) women originating in source countries and diagnosed as without FGM/C and (ii) all women without diagnosis of FGM/C whatever the country of birth. Results Diagnosed prevalence of FGM/C was 95% (95% CI: 0.78–1.14 and the indirect computed estimation prevalence was estimated at 1.53% (95% CI: 1.31–1.77) in 113 and 183 women, respectively. Labor and delivery outcomes were globally similar in women with FGM/C and the other two groups. Only episiotomy was more frequently performed in women with FGM/C than in the other two groups. Conclusion In receiving countries, obstetric outcomes of women with FGM/C can be similar to those of other women, which does not preclude need of further research and training to provide the most appropriate care, including enhanced attention to diagnosis.
Synopsis In receiving countries, obstetric outcomes of women with genital mutilation/cutting can be similar to those of other women.
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.
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. Comparisons between surveys showed trends over time.
Between 1995 and 2021, maternal characteristics changed. Maternal age and the frequency of women with obesity rose: in 2021, 24.6% of women were 35 years or older (21.1% in 2016, 19.2% in 2010, 15.9% in 2003 and 12.4% in 1995) and 14.4% were obese (11.8% in 2016, 9.9% in 2010 and 7.4% in 2003). Some antenatal prevention behaviors that improved in 2021 were not smoking during the third trimester, acid folic administration before pregnancy, and vaccination against influenza. The percentage of women with an early prenatal appointment ("4
month appointment"), implemented to facilitate screening of maternal vulnerability during pregnancy, has continued to rise. The percentage of women receiving prenatal care by midwives has risen markedly (39.0% in 2021 versus 11.7% in 2016). Serum screening for Down syndrome continues to increase (91.8% of women in 2021). The rate of induction of labor has risen significantly (20.2% in 1995 and 25.8% in 2021). The mode of delivery has not varied significantly since 2003; in 2021, the cesarean rate was 21.4% and the instrumental vaginal delivery rate 12.4%. Episiotomy was increasingly rare, among both primiparous and multiparous women (16.5% and 2.9% in 2021, respectively). The prevalence of coronavirus (SARS-CoV2) infection during pregnancy was 5.7%. Preterm live births increased regularly, slightly but significantly over the 1995-2016 period and then remained stable between 2016 and 2021 (7.0%). In 2021, 56.3% of women exclusively breastfed during their hospital stay, a modest increase in comparison with 2016 (54.6%).
Routine national perinatal surveys highlight positive trends over time in some preventive practices, decreases in some medical interventions consistent with national guidelines, and the increasing role of midwives in prenatal care. Nonetheless, some indicators remain less than optimal and require more detailed analyses.
Several series reported obstetric complications among pregnant women hospitalized for COVID. These data, because they focused on women with the most severe presentations or with specific ...immunosuppression, were likely to overestimate the risks associated with the infection at a global level. To date, population-based studies, most of which collected data from registers of women hospitalized during pregnancy for COVID-19, remain sparse. Neither the prevalence of COVID-19 in pregnant women nor the overall extent of obstetric complications worldwide, compared with uninfected pregnant women is clear. The impact of COVID-19 on perinatal care and obstetric management is thus difficult to evaluate.
To evaluate the prevalence and determinants of COVID-19 diagnosis during pregnancy and assess related obstetric practices and perinatal outcomes.
Used data collected at childbirth in France from women included in the 2021 national perinatal survey, we compared women with and without a COVID-19 diagnosis (for sociodemographic characteristics) and then women with no COVID-19 diagnosis during pregnancy, women diagnosed more than 15 days preceding childbirth, and those diagnosed within those 15 days for outcomes.
The COVID-19 prevalence during pregnancy was 5.7 % (95 %CI 5.3–6.1) (678/11 930). The aOR for COVID-19 diagnosis associated with non-French nationality was 1.27 (95 %CI 1.03–1.58), with non-smoking 0.63 (95 %CI 0.55–0.81) and with multiparity 1.21 (95 %CI 1.02–1.45). Diagnosis occurred in the third trimester for 49 % —28.5 % in the 15 days before childbirth. Women with COVID-19 diagnosed during pregnancy had preterm births more often (9.6 %) than women without this diagnosis (6.9 %) (P = 0.007). Women with COVID-19 diagnosed within the 15 days preceding childbirth had more cesarean deliveries (28.3 %) than those diagnosed earlier (17.4 %) (P = 0.02).
COVID-19 diagnosis during pregnancy was associated with an increased risk of preterm birth. Obstetric outcomes were poorer in women with a COVID-19 diagnosis in the 15 days preceding childbirth.
•Tested collision avoidance strategies between young (YA) and older adults (OA).•Initially OA act cautiously with greater threshold for motion adaptation.•Over time, YA contributed more to collision ...avoidance behaviours than OA.•At time of crossing, two OA interacting led to smallest clearance distance.•Age-related changes in visuomotor processing appear to be emphasised.
Collision avoidance between two walkers requires a mutual adaptation based on visual information in order to be successful. Age-related changes to visuomotor processing, kinesthetic input, and intersegmental dynamics increases the risk of collision and falls in older adults. However, few studies examine behavioural strategies in older adults during collision avoidance tasks with another pedestrian.
Is there a difference between older adults’ and young adults’ collision avoidance behaviours with another pedestrian?
Seventeen older adults (x¯ = 68 ± 3 years) and seventeen young adults (x¯ = 23 ± 2 years) walked at a comfortable walking speed along a 12.6 m pathway while avoiding another walker. Trials were randomized equally to include 20 interactions with the same age group and 21 interactions with the opposite age group. Minimum predicted distance (mpd) was used to characterize collision avoidance behaviours between older adults and young adults.
Older adults had riskier avoidance behaviours, passing closer to the other pedestrian (0.79 m ± 0.18 m) compared to when two young adults were on a collision course (0.93 m ± 0.17 m) (χ²(3) = 35.94, p < .0001). Whenever an older adult was on a collision course with a young adult, the young adult contributed more to the avoidance regardless of passing order.
The results from the current study highlight age-related effects during a collision avoidance task in older adults resulting in risky behaviour and a potential collision. Future studies should further investigate age-related visuomotor deficits during collision avoidance tasks in cluttered environments using virtual reality in order to tease out factors that contribute most to avoidance behaviours in older adults.
Individuals who have sustained a concussion often display associated balance control deficits and visuomotor impairments despite being cleared by a physician to return to sport. Such visuomotor ...impairments can be highlighted in collision avoidance tasks that involves a mutual adaptation between two walkers. However, studies have yet to challenged athletes with a previous concussion during an everyday collision avoidance task, following return to sport.
Do athletes with a previous concussion display associated behavioural changes during a 90°-collision avoidance task with an approaching pedestrian?
Thirteen athletes (ATH; 9 females, 23 ± 4years) and 13 athletes with a previous concussion (CONC; 9 females, 22 ± 3 years, concussion <6 months) walked at a comfortable walking speed along a 12.6 m pathway while avoiding another athlete on a 90º-collision course. Each participant randomly interacted with individuals from the same group 20 times and interacted with individuals from the opposite group 21 times. Minimum predicted distance (mpd) was used to examine collision avoidance behaviours between ATH and CONC groups.
The overall progression of mpd(t) did not differ between groups (p > .05). During the collision avoidance task, previously concussed athletes contributed less when passing second compared to their peers(p < .001). When two previously concussed athletes were on a collision course, there was a greater amount of variability resulting in inappropriate adaptive behaviours.
Although successful at avoiding a collision with an approaching athlete, previously concussed athletes exhibit behavioural changes manifesting in riskier behaviours. The current findings suggest that previously concussed athletes possess behavioural changes even after being cleared to returned to sport, which may increase their risk of a subsequent injury when playing.
•Safe collision avoidance requires a mutual adaptation using visuomotor processing.•Previously concussed athletes contribute less to mutual avoidance of collisions.•Two previously concussed athletes on collision courses yield highly variable actions.•Previously concussed athletes possess behavioral changes beyond return to sport.
Gait patterns provide a rich source of person-specific information such as age, sex, identity, and vulnerability. However, it is unknown to what extent person-specific gait information can affect ...collision avoidance behaviours with an approaching “person”. We sought to determine whether young adults’ spatiotemporal avoidance behaviours were affected by changes to a virtual agent’s gait parameters (i.e., speed or trunk sway). In a virtual environment (FOVE head-mounted display; 70Hz), young adults (n=21) walked along an 18m pathway towards a goal while avoiding an approaching virtual agent. The agent’s walking speed and trunk sway magnitude were a multiples of each participant’s average speed or sway: fast (x1.5m/s), normal (matched), or slow (x0.8m/s); large (2x), normal (matched), or small (0x) respectively. The agent was non-reactive and walked straight forward at a constant speed. Participants’ kinematics were recorded (Qualisys; 120Hz) to examine avoidance behaviours of initiation of path deviation and medial-lateral clearance at the time of crossing. Statistical analysis revealed that participants initiated a path deviation (i.e., estimate of time-to-contact, TTC) significantly earlier (F(2,40)=11.31, p<.001, f=.69) when the agent was walking fast (M=3.93s, SD=.56) as opposed to normal (M=4.31s, SD=.33) and slow (M=4.41s, SD=.44) walking speeds. However, the agent’s trunk sway magnitudes did not affect participants’ initiation of path deviation or medial-lateral clearance at crossing. Participants appear not to use temporal information to initiate an avoidance, but rather a point in space (i.e., TTC was affected by approach speed) due to awareness that the agent was non-reactive and always approaching. The agent’s sway magnitude did not affect medial-lateral avoidance behaviours most likely because there was little observable difference between conditions (i.e., ~3° normal sway). Conceivably, the study’s environmental conditions may underrepresent people’s behaviours in real-world. Future work is needed to understand the perception of an approaching person’s gait characteristics on collision avoidance.
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