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Biomedical subjects

J Bouyer

Publications and source records attributed to J Bouyer.

14 recordsLinked to original sources
PubMed1991

Vaginal infections, cervical ripening and preterm delivery.

A prospective study is presented which addresses the relative effect of cervicovaginal infection and precocious maturation of the uterine cervix on preterm delivery. From April 1981 through December 1983, a total of 5758 pregnant women were checked by means of a vaginal examination at every prenatal visit and a research for bacterial cervicovaginal infection whenever abnormal signs were observed. The study reveals that vaginal infection has no measurable effect when observed during the second trimester of pregnancy, and a small effect during the third trimester. This means that infection of the vagina or/and the cervix may be demonstrated as a risk factor only when the cervix is short before 28 weeks or open before 37 weeks.

Bacterial Infections↗
PubMed1991

Prevention of sexually transmitted diseases: a randomised community trial.

STUDY OBJECTIVE: The aim was to evaluate the effectiveness of a programme for the prevention of sexually transmitted diseases which affect fertility. DESIGN OF THE PREVENTION PROGRAMME: The programme took place in six French geographical departments. Three of these, randomly selected, served as experimental departments while the other three were matched with the first three and served as controls. DESIGN OF THE EVALUATION: Genital discharge was used as the indicator of a sexually transmitted disease. In each department, about 40 voluntarily participating general practitioners (263 in total) gathered information on the frequency of infected patients and on their characteristics, both before and after the campaign. PATIENTS: Before and after the programme respectively, 412 and 288 women and 117 and 94 men with a genital discharge were described. MEASUREMENTS AND MAIN RESULTS: After the programme, tests for chlamydia trachomatis were prescribed more often to both women and men with a discharge in the experimental departments. The characteristics of women having consulted a general practitioner with a discharge differed according to the department group studied. In the experimental departments, the women were younger than those in the control departments and had fewer sexual partners. In contrast to the results obtained for women, no behavioural changes were observed among men with a discharge. CONCLUSIONS: The results may indicate a decreased risk in spread of infection. Methodological problems associated with such a design are discussed. There is a need to develop specific messages aimed at changing male sexual behaviour. The study design has implications for the best strategy in delivering prevention messages to the general population which are relevant to the present AIDS epidemic.

Adolescent↗
PubMed1991

[Logistics regression in epidemiology. II].

The logistic regression is used in epidemiology to study the relationships between a disease in two modalities (diseased or disease free) and risk factors Xi which may be qualitative as quantitative variables. According to this model, the probability of disease knowing Xi's values is written: [formula: see text]. The coefficients satisfy to the equation: ORi = exp(beta i) where ORi is the odds-ratio linked to the variable Xi adjusted on the other variables of the model. The second part of this paper is devoted to the tests of hypothesis in the logistic model and to the choice of the variables to be included in the model. The way of using tests to decide how to code variables is explained. Analysis strategy (choice and selection of variables) is discussed. The rational of goodness of fit tests is shown. At least, we indicate how to use the logistic model in case-controls studies and in studies with matched samples.

Case-Control Studies↗
PubMed1991

[Epidemiological methods in evaluation].

This paper describes different epidemiological methods to evaluate the effect of a public health intervention. The different types of indicators as well as types of evaluative surveys (experimental, quasi-experimental, observational) are presented. Criteria for choosing one type of survey are discussed. Examples of surveys are described.

Cohort Studies↗
PubMed1991

[Logistic regression and epidemiology. I].

The logistic regression is used in epidemiology to study the relationships between a disease in two modalities (diseased or disease free) and risk factors Xi which may be qualitative or quantitative variables. According to this model, the probability of disease knowing Xi's values is written: [formula: see text]. The coefficients beta i satisfy to the equation: ORi = exp(beta i) where ORi is the odds-ratio linked to the variable Xi adjusted on the other variables of the model. The first part of this paper indicates the way to include in the model qualitative variables with more than two modalities, quantitative variables and interaction between variables. At least, the maximum likelihood method to estimate the parameters of the model is presented.

Epidemiologic Methods↗
PubMed1989

[Attempted analysis of the progressive development of prematurity between 1980 and 1985 at the maternity hospital in Haguenau].

The recent increase of premature births has led the authors to conduct an exhaustive, prospective investigation from computerized data, including 8,618 pregnant women who delivered at the Maternity Hospital in Haguenau between January 1980 and December 1985. Their results disclose a significantly increased ratio of premature births in the gravida I group and in women with a primary level of education, who were followed by a general practitioner. On the other hand, the ratio of premature births at 34 weeks and less, is also increased in people followed by a general practitioner, which is not the case for induced prematurity. These results, although preliminary, prompt the consultant to reconsider primary prevention in these groups with particular risks.

France↗
PubMed1988

Secular trend in the rate of small-for-gestational-age infants: Haguenau Study 1971-1985.

Between 1971 and 1985, at the Haguenau Maternity Hospital, a 20% decrease was observed in the rate of small-for-gestational-age infants (birthweight less than 10th centile using figures from all the study births) among 20,101 births between 28 and 42 weeks. This decrease could not be explained by simultaneous changes in socio-demographic and anthropometric characteristics of the pregnant women, nor a recruitment bias. The earliness of prenatal care at the Maternity Hospital may have played a role in the downward trend. Further research is needed to confirm the influence of prenatal care on the rate of small-for-gestational-age babies.

Adult↗
PubMed1988

[Prevention of prematurity: Haguenau perinatal survey, 1971-1985].

A preterm birth prevention program was instituted in France in the early 1970s. Its effectiveness has been assessed through a perinatal study in Haguenau. A relationship between prenatal care improvement and preterm birth rate decrease was noted, but a causal interpretation cannot be derived from such an observational study. However, some arguments do support this interpretation: no satisfactory alternative explanation (such as biases in pregnancy duration measurement, change in the composition of the population of pregnant women, or secular trend), a plausible causal pattern, and a dose-response relationship between prenatal care and preterm birth rate. The Haguenau study results can be applied to other French regions, but extrapolation to other countries would depend on their social, medical and cultural contexts.

Female↗
PubMed1986

Women's acceptance of a preterm birth prevention program.

A major modification in French national perinatal policy was proposed in 1970. Its primary aim was to reduce preterm births, and a specific program has been progressively applied to all pregnant women in France since 1971. Because the policy was introduced at a national level, it was possible to use a district hospital in Haguenau (northeastern France) as an observation site for measuring the effects of the change. A longitudinal study was begun in 1971 and continued for 12 years, during which time a total of 16,004 singleton pregnancies were followed. This article focuses on acceptance by the pregnant women in Haguenau in response to the new prenatal care proposals. A major reduction in preterm births is demonstrated, and the relationship between acceptance and observed changes in preterm birth is discussed. Certain time-related patterns were observed: it took time for the policy modification to be measurable; while the outcomes showed general improvement, results were closely related to the patient's social status; there were significant time-lag differences between social class groups with regard to acceptance of specific interventions.

Birth Weight↗
PubMed1986

Spontaneous abortion and interpregnancy interval.

Analysis of 8972 pregnancies and 5089 interpregnancy intervals, computer-registered over 12 years at the Haguenau Hospital Maternity Department, showed that the length of interpregnancy interval may be considered as a risk factor in spontaneous abortion; this was still true after other important known risk factors, i.e. maternal age, parity, previous spontaneous abortion and contraceptive practice, had been taken into account. However, separate analysis of pregnancies according to whether they occur more or less than 1 year after contraception (if used) had been stopped showed that the relationship between a long interval and spontaneous abortion was only significant for subfertile women who took longer than 1 year to conceive. This supports the hypothesis that the same mechanism is involved in the aetiologies of spontaneous abortion and of difficulty in conceiving.

Abortion, Spontaneous↗
PubMed1986

Maturation signs of the cervix and prediction of preterm birth.

A prospective study was conducted on 7937 pregnancies, 4430 of which had prenatal visits before 37 weeks of gestation. Induced preterm deliveries were excluded (N = 40). Then the data was incorporated from the visits (cervix status, uterine contractions) as well as some common indicators of risk for preterm birth (mother's age, social status, obstetric antecedents, bleeding) into a predictive scoring system for spontaneous preterm labor. Different scores were computed according to both parity and to the timing during pregnancy when the signs were observed. It was found that approximatively 25% of the total preterm births were connected with the presence of at least one of three maturation signs of the uterine cervix (dilation of the internal os to 1 cm, cervical length less than 1 cm, and presence of painful uterine contractions).

Adolescent↗
PubMedDate not supplied

Prevention of preterm birth and perinatal risk reduction.

A reduction in preterm births has been observed in Haguenau, eastern France, during a 12-year intervention study on prevention of preterm deliveries. Between 1971 and 1982 there was also an increase in the proportion of women who attended the prenatal clinic in the first trimester, and an increase in the mean number of visits in the first 6 months of pregnancy. These changes were observed in women of all educational levels. This investigation illustrates the use of time-trend studies in the field of health technology assessment.

Educational Status↗