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Aims  Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and foetal morbidity and mortality. We aimed to estimate the impact of HDP on the onset of chronic hypertension in primiparous women in the first years following childbirth. Methods and results  This nationwide cohort study used data from the French National Health Data System (SNDS). All eligible primiparous women without pre-existing chronic hypertension who delivered between 2010 and 2018 were included. Women were followed up from six weeks post-partum until onset of hypertension, a cardiovascular event, death, or the study end date (31 December 2018). The main outcome was a diagnosis of chronic hypertension. We used Cox models to estimate hazard ratios (HRs) of chronic hypertension for all types of HDP. Overall, 2 663 573 women were included with a mean follow-up time of 3.0 years. Among them, 180 063 (6.73%) had an HDP. Specifically 66 260 (2.16%) had pre-eclampsia (PE) and 113 803 (4.27%) had gestational hypertension (GH). Compared with women who had no HDP, the fully adjusted HRs of chronic hypertension were 6.03 [95% confidence interval (CI) 5.89–6.17] for GH, 8.10 (95% CI 7.88–8.33) for PE (all sorts), 12.95 (95% CI 12.29–13.65) for early PE, 9.90 (95% CI 9.53–10.28) for severe PE, and 13.17 (95% CI 12.74–13.60) for PE following GH. Hypertensive disorders of pregnancy exposure duration was an additional risk factor of chronic hypertension for all PE subgroups. Women with HDP consulted a general practitioner or cardiologist more frequently and earlier. Conclusion  Hypertensive disorders of pregnancy exposure greatly increased the risk of chronic hypertension in the first years following delivery. [ABSTRACT FROM AUTHOR]

Context: The increase in the incidence of congenital hypothyroidism (CH) reported worldwide may partly be explained by an increase in the transient form of CH. Objective: We aimed to estimate the proportion of transient CH (TCH) in France, and to identify associated neonatal and young child characteristics. Methods: We used probabilistic record linkage to link children with eutopic gland born between 2006 and 2012 recorded in the national French CH registry and the French national health data system (SNDS). Of the 703 children recorded, 484 (68.8%) were linked. We retrospectively examined reimbursement for oral levothyroxine (LT4) between January 1, 2006, and December 31, 2017. Children who had discontinued treatment for 6 months or more before December 31, 2017, were classified as having TCH. We used a Cox model to examine the factors associated with TCH. Results: Among the main study sample (n = 471), 53.5% were female, 14.2% were preterm, and 13.8% had low birth weight. One-quarter (n = 111, 24.3%) had mild CH (thyroid-stimulating hormone [TSH] < 50 mU/L, serum) at diagnosis and a median LT4 dose at treatment initiation of 30 μg/day. One-third (n = 155, 32.9%) had TCH. Premature birth (adjusted hazard ratio = 2.1 [1.0–4.2]), a TSH < 50 mU/L at CH screening (7.4 [3.2– 17.1]), LT4 dose received at 12 months of age (0.98 [0.97–0.99, P = 0.003]), congenital cardiac malformations (6.6 [1.5–29.0]), and year of birth (1.2 [1.1–1.4]) were all associated with TCH. Conclusion: One-third of the children had TCH, and it was associated with several characteristics at birth and postpartum. These data are useful for CH medical management and epidemiological surveillance. [ABSTRACT FROM AUTHOR]

Résumé: Dès le lendemain de l'incendie survenu sur les sites des entreprises Lubrizol et NL Logistique à Rouen, Santé publique France (SpF) a réfléchi à un dispositif d'études visant à évaluer de manière globale l'impact sanitaire de l'incendie industriel, pour la population générale ou la population des travailleurs exposés. Ce dispositif a été déployé suite à une saisine du ministère de la Santé en date du 8 octobre 2019 et permet d'appréhender les impacts sanitaires de l'accident industriel pour la population riveraine et les travailleurs exposés, en prenant en compte l'ensemble des expositions des populations exposées, la santé mentale et la qualité de vie. Plus particulièrement, il comprend une enquête transversale sur la santé perçue réalisée sur un échantillon représentatif de la population exposée et un suivi épidémiologique longitudinal de l'état de santé de la population exposée. Le dispositif inclut également une réflexion relative à la meilleure stratégie de surveillance épidémiologique possible pour les professionnels exposés. Enfin, une réflexion sur la pertinence et la faisabilité de mener une enquête de biosurveillance afin d'identifier les éventuelles surexpositions humaines aux composés émis par l'incendie a été conduite. The French public health agency developed and implemented a project to assess the overall health impact of a major industrial fire at a chemical plant. The aim was to describe all of the fire's health impacts on the general population and exposed workers, including those affecting their mental health and quality of life. The project includes a cross-sectional survey on perceived health based on a representative sample of the exposed population and a longitudinal follow-up of the exposed population's health status. It also includes an epidemiological surveillance strategy for exposed workers and a study of the relevance and feasibility of conducting a biomonitoring survey to identify possible human overexposure to the compounds emitted during the factory fire. [ABSTRACT FROM AUTHOR]

Pertussis vaccination in young mothers aims to protect neonates through cocooning. We estimated pertussis vaccination coverage (VC) in women at two months postpartum in France in 2021, and the proportion of women who got vaccinated in the first two months postpartum; associated determinants were studied. We used data from the 2021 National Perinatal Surveys conducted in metropolitan France (ENP 2021) and French overseas territories (ENP-DROM 2021). Multivariate poisson regressions were employed to study the following determinants: age, educational level, monthly household income, socio-professional situation, birth country, parity, health professional who monitored pregnancy, influenza vaccination during pregnancy, region of residence, prenatal care consultations, having health insurance, having a partner, and having a chronic pathology. Results were weighted. The study sample comprised 7999 women. Estimated pertussis VC at two months postpartum was 66.8 % (95 %CI [65.5–68.0]). VC was significantly lower in i) unemployed women (vs. executives/managers, intermediate and higher intellectual professionals), ii) those on low income (vs. high), and iii) those with two or more children (vs. primiparous). It was significantly higher in i) women born in France, ii) those vaccinated against influenza during pregnancy, iii) those who received pre-natal care from a private midwife, and iv) those with more prenatal consultations. The proportion of women vaccinated against pertussis in the two-month postpartum period (33.4 % [31.7–35.9]) was significantly lower in i) women on low incomes, ii) unemployed women, iii) women with health insurance, and iv) multiparous women. It was significantly higher in those vaccinated against influenza during pregnancy. Pertussis VC in women at two months postpartum in 2021 was insufficient and was marked by social and territorial inequalities in health. Vaccination for pregnant women has been recommended in France since 2022. A study monitoring the impact of this new recommendation is essential. • 2021 pertussis vaccination coverage in postpartum mothers in France was 66.8 % [65.5–68.0]. • Social and territorial inequalities in health impact vaccination against pertussis. • The postpartum period is an ideal time to reduce health inequalities. [ABSTRACT FROM AUTHOR]

Background: Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother-infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care., Methods: Among the 12,723 women included in the representative French national perinatal survey 2021ENP, 7,133 completed the Edinburgh Postnatal Depression Scale (EPDS) self-administered questionnaire - including three anxiety-specific items (EPDS-3A) - at 2 months postpartum. We estimated the adjusted prevalence ratios (aPR) of PPA symptoms using Poisson regression models with robust variance., Results: PPA symptom prevalence at 2 months was 27.6% (95% CI [26.5-28.8]). Associated risk factors were: age ≤ 34 years (maximum aPR = 1.38 [1.22-1.58] obtained for persons aged 25-29 years vs. 35-39 years), poorer health literacy (1.15 [1.07-1.23]), a history of medical termination of pregnancy (1.32 [1.05-1.68]), psychological (1.31 [1.17-1.47]) or psychiatric (1.42 [1.24-1.63]) care history since adolescence, nulliparity (1.23 [1.12-1.35]), no weight gain or loss (1.29 [1.03-1.61] vs. 9-15 kg gain) or gain ≥23 kg (1.20 [1.00-1.43]) during pregnancy, ≥3 pregnancy-related emergency consultations (1.16 [1.03-1.31] vs. none), poor/good support during pregnancy, (1.16 [1.00-1.34] and 1.15 [1.05-1.26], respectively, vs. very good), sadness (1.52 [1.36-1.69]), anhedonia (1.48 [1.27-1.72]), or both (1.99 [1.79-2.21]) during pregnancy, not at all/not very satisfied with pain management during childbirth (1.16 [1.01-1.32] vs. quite/very satisfied). Similar risk factors were found in the 'no PPD symptoms' and 'no history of mental health care' subgroups., Conclusions: Estimated PPA symptom prevalence at 2 months in our study sample was 27.6%. The risk factors we identified may guide future prevention policies.

Background: To date, most large surveys on the mental health of children under 11 years old have relied exclusively on data collected from parents and teachers, with no information from children themselves. However, these children are valuable informants despite their young age., Objective: To evaluate the effects of adding young children's self-evaluation of internalizing disorders to a combined teacher/parent-based algorithm using data from a European survey carried out in Italy, Bulgaria, and in the Netherlands., Method: Comparing concordances with the Development and Well-Being Assessment (DAWBA; considered as the gold standard) of a Strengths and Difficulties Questionnaire's (SDQ) parent/teacher-based predictive algorithm, with and without integrating a child self-evaluation. The child self-evaluation was using the Dominic Interactive (DI), a computerized, pictorial, self-administered questionnaire for young children, which followed DSM 5 diagnoses definitions for internalized disorders. The concordance comparisons concerned 238 children, 5 to 12 years old from out-patient clinics, double evaluated, using kappa concordance test . Subsequent variations in disorder prevalence were evaluated in cross-sectional surveys in the general populations of the three study countries ( n  = 3,442)., Results: Adding self-evaluated child DI-based 'probable' internalizing disorder diagnoses to the SDQ parent/teacher algorithm increased concordance with gold standard: kappa increased from .25 (.14-.37) to .36 (.23-.49). In terms of population-based data, this addition increased the prevalence of 'probable' emotional disorders from 2.00 % (1.56-2.53) to 3.63 % (3.03-4.31) and revealed an expected gender difference., Conclusion: The inclusion of young children's self-reported data on internalizing disorders is a valuable addition to the generally used combined parent/teacher-based SDQ algorithm, and therefore better reflects the true prevalence of these disorders in these children. Further evaluation on larger validation samples is required.

Background: Assessing the risk of subsequent self-harm after hospitalisation for COVID-19 is critical for mental health care planning during and after the pandemic., Aims: This study aims to compare the risk of admission to hospital for self-harm within 12 months following a COVID-19 hospitalisation during the first half of 2020, with the risk following hospitalisations for other reasons., Method: Using the French administrative healthcare database, logistic regression models were employed to analyse data from patients admitted to hospitals in metropolitan France between January and June 2020. The analysis included adjustments for sociodemographic factors, psychiatric history and the level of care received during the initial hospital stay., Results: Of the 96 313 patients hospitalised for COVID-19, 336 (0.35%) were subsequently admitted for self-harm within 12 months, compared to 20 135 (0.72%) of 2 797 775 patients admitted for other reasons. This difference remained significant after adjusting for sociodemographic factors (adjusted odds ratio (aOR) = 0.66, 95% CI: 0.59-0.73), psychiatric disorder history (aOR = 0.65, 95% CI: 0.58-0.73) and the level of care received during the initial hospital stay (aOR = 0.70, 95% CI: 0.63-0.78). History of psychiatric disorders and intensive care were strongly correlated with increased risk, while older age was inversely associated with self-harm admissions., Conclusions: Hospitalisation for COVID-19 during the early pandemic was linked to a lower risk of subsequent self-harm than hospitalisation for other reasons. Clinicians should consider psychiatric history and intensive care factors in evaluating the risk of future suicide.

Background: Children's mental health, including their well-being, is a major public health concern, as the burden of related disorders may last throughout one's life. Although epidemiological mental health surveillance systems for children and adolescents have been implemented in several countries, they are sorely lacking in France., Objective: This study aims to describe the first step of the implementation of a novel surveillance system in France called Enabee (Etude nationale sur le bien-être des enfants), which focuses on the issue of mental health in children. The system aims to (1) describe the temporal trends in the population-based prevalence of the main mental health disorders and well-being in children aged 3 to 11 years, (2) explore their major determinants, and (3) assess mental health care use by this population. To do this, Enabee will rely on results from a recurrent national cross-sectional homonymous study. This paper presents the protocol for the first edition of this study (called Enabee 2022), as well as initial results regarding participation., Methods: Enabee 2022 is a national cross-sectional study that was implemented in French schools in 2022. It used a probabilistic, multistage, stratified, and balanced sampling plan as follows: first, schools were randomly drawn and stratified according to the type of school. Up to 4 classes per school were then randomly drawn, and finally, all the pupils within each class were selected. The study covered children from preschool and kindergarten (aged 3 to 6 years, US grading system) to fifth grade (aged 6 to 11 years). Children from first to fifth grades provided a self-assessment of their mental health using 2 validated self-administered questionnaires: the Dominic Interactive (DI) and the KINDL. Parents and teachers completed a web-based questionnaire, including the Strengths and Difficulties Questionnaire. Parents also answered additional questions about their parenting attitudes; their own mental health; known social, economic, and environmental determinants of mental health in children; and their child's life habits. Health, education, and family stakeholders were involved in designing and implementing the study as part of a large consultation group., Results: Data were collected from May 2, 2022, to July 31, 2022, in 399 schools across metropolitan France. Teachers completed questionnaires for 5721 pupils in preschool and kindergarten and for 15,263 pupils from first to fifth grades. Parents completed questionnaires for 3785 children in preschool and kindergarten and for 9227 children from first to fifth grades. Finally, 15,206 children from first to fifth grades completed the self-administered questionnaire., Conclusions: Enabee 2022 constitutes the first milestone in the development of a novel national epidemiological surveillance system, paving the way for improved children's mental health policies in France., (©Yvon Motreff, Maude Marillier, Abdessattar Saoudi, Charlotte Verdot, Louise Seconda, Damien Pognon, Imane Khireddine-Medouni, Jean-Baptiste Richard, Viviane Kovess-Masfety, Richard Delorme, Valentina Decio, Anne-Laure Perrine, Maria El Haddad, Anne Gallay, Stéphanie Monnier-Besnard, Nolwenn Regnault, Enabee Study Group. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.08.2024.)