[Psychosocial evaluation: can prematurity in a primipara be prevented?]

Consideration of psycho-social factors in monitoring pregnancy, especially in a gravida I patient, permits predicting an increased risk of unfavorable results. Research conducted in the Rhone-Alpes region concerns specifically the risk factors for prematurity related to the psycho-social environment of the woman, for the purpose of long-term prevention, i.e., from the beginning of the pregnancy. The prematurity rate remains much higher in women under 20, in foreign or French women living overseas, in unmarried women living with someone or alone, and in women of low socio-cultural level. A profession does not, per se, constitute an increased risk factor for prematurity, since women staying at home present a higher prematurity rate than that of working women. However, tiresome working conditions constitute an increased factor for prematurity. Several factors related to living habits are evaluated. Finally, the role of psychological modifications related to the pregnancy is also considered, and appears to be important, especially in women without any other known medical risk factor. In view of these results, the authors present a number of suggestions for a better prevention of prematurity.