According to the DoHad concept, many chronic diseases in adulthood (diabetes, cancer, cardiovascular disease, reproductive health, mental and behavioural disorders, etc.) may have their origins in the prenatal period, linked to exposure to environmental factors. The intrauterine period, particularly early during embryogenesis, is a period of high sensitivity to these factors. Environmental factors also affect gametogenesis, particularly sperm quality, which can lead to developmental abnormalities that may be passed on to future children. Promoting preconception health therefore represents a major opportunity for population health. However, professionals lack the resources to address environmental and preconception health.The aim of this project is to develop a communication tool to promote overall health and environmental health among adults who are likely to have children.A multidisciplinary team (geneticist, midwife and general practitioner) led this project, which was part of an interventional research programme. The stages consisted of: reviewing the literature, developing an initial framework for the support material, setting up a committee of experts from other disciplines (occupational physicians, paediatricians, gynaecologists, public health specialists) as well as associations and patients, who were involved in developing the support material through iterative reviews and proposals during various consultation rounds. The FALC (easy to read and understand) guide was used to develop the material.This inter-professional collaboration with patients resulted in the production of a leaflet based on the concept of the exposome, addressing the various relevant exposure factors: diet, air quality, cosmetics, toxins, medical factors, occupational exposure and stress. It takes a positive approach, focusing on resources.It is intended for distribution to healthcare professionals who are in contact with the relevant population in order to encourage open dialogue about overall health in the pre-conception period, during dedicated consultations or otherwise. It is suitable for those planning to become parents, but the overall health aspect also applies to people who are not planning to become parents or are undecided. Accessibility is not sufficient for people with difficulties accessing written language in particular.Additional work is planned to adapt teaching materials and methods in particular to the level of health literacy.

Fetal alcohol spectrum disorder (FASD) represents the leading cause of non-genetic neurodevelopmental disability worldwide and remains a major challenge for primary healthcare systems. While maternal alcohol exposure has been extensively studied, paternal factors have received far less attention. Fathers may influence alcohol-related behaviors during pregnancy, family functioning, and long-term child outcomes. A better understanding of paternal characteristics, perceptions, and involvement is therefore essential to inform more inclusive prevention and support strategies in family medicine.This study aimed to characterize the sociodemographic profiles, alcohol and substance use patterns, levels of involvement, and perceptions of fathers of children diagnosed with FASD.A cross-sectional descriptive study was conducted among fathers of children diagnosed with FASD on Reunion Island. Eligible participants were biological fathers who agreed to take part in the study. Data were collected using semi-structured, interviewer-administered questionnaires covering sociodemographic characteristics, health status, substance use, paternal involvement, and perceptions of fatherhood and FASD. Quantitative data were analyzed using descriptive statistics, and qualitative data were examined through thematic analysis to identify recurring patterns and perceptions.Ten fathers were included. Most participants experienced social vulnerability, characterized by low educational attainment, unstable employment, and limited access to health information. Alcohol consumption prior to pregnancy was frequent, with several fathers reporting regular use. Following the child’s birth, many fathers described a reduction in alcohol consumption, often linked to increased parental responsibility. Paternal involvement during pregnancy and child-rearing varied according to relationship status and family context; however, a strong willingness to support both the child and the mother was consistently expressed. Although general awareness of the risks associated with alcohol use during pregnancy was high, knowledge of FASD as a clinical entity, including its diagnosis and long-term consequences, remained limited.These findings suggested a discrepancy between general prevention messages and fathers’ understanding of FASD, highlighting an unmet need for targeted paternal education in primary care settings.Fathers of children with FASD demonstrate both social vulnerability and adaptive behavioral changes following parenthood. Integrating fathers more systematically into prevention, counseling, and support interventions may strengthen family-centered approaches to fetal alcohol exposure and improve equity in primary healthcare.

In France, a prenatal consultation for the co-parent is provided for in the Public Health Code, yet it remains poorly known. No study has evaluated the feasibility or acceptability of a consultation dedicated to first-time expectant fathers in general practiceTo determine whether this consultation meets first-time expectant fathers needs and to identify areas for improvement to optimize its implementation and disseminationA multicentric quantitative descriptive cross-sectional observational study was conducted among French-speaking adult expectant fathers. After a consultation enriched by our DES work and delivered by a volunteer general practitioner, participants completed a questionnaire assessing the content, their satisfaction, and their suggestions for improvement.Sixteen men participated. None were aware of the existence of such a consultation. It was considered relevant, ideally offered early in pregnancy and conducted by a general practitioner. The most relevant topics concerned the partner and the unborn child. Physical health topics generated less interest, while mental health, although positively perceived, remained secondary.Recruitment difficulties highlight the low visibility of this service and the challenge of mobilizing expectant fathers. The results confirm the feasibility and value of a dedicated space for expectant fathers, and stress the need to raise awareness among men and healthcare professionalsThis study supports the relevance of a prenatal consultation for first-time expectant fathers in general practice, highlights the general practitioner’s key role in including them in perinatal care pathway and paves the way for further studies evaluating its impact.

In France, the Public Health Code provides for a consultation dedicated to the co-parent during pregnancy. In practice, its feasibility remains unknown, and no study has assessed the opinions of general practitioners after implementing it.To evaluate the opinions and experiences of general practitioners who participated in a pilot consultation dedicated to first-time fathers during pregnancy, as well as their perception of a consultation guide.This was a quantitative, cross-sectional, multicenter observational and descriptive study involving general practitioners. The questionnary assessed their opinions and experiences regarding the consultation and the guide, as well as their suggestions for improvement.Fourteen general practitioners conducted 16 consultations with future first-time fathers. All the topics addressed received favorable feedback, particularly those related to mental health, childbirth, physical health, and sexuality. General practitioners reported feeling comfortable and legitimate in conducting the consultation but emphasized its time-consuming nature and the absence of financial compensationThese results confirm general practitioners’ interest in providing a consultation dedicated to fathers and its practical feasibility. The consultation guide appears to be a valuable tool to further develop to support practitioners. This pilot experiment, unprecedented in France, warrants further investigation on a larger scale.This work highlights the central role of the general practitioner in the comprehensive support of parenthood. The consultation with the expectant father represents a key opportunity for screening, prevention, parental support, and fostering greater paternal involvement with the future child.

The demand for gamete donation is increasing, notably due to new laws regulating it. The number of donors remains stable and insufficient, leading to prolonged waiting times. The main barrier to donation appears to be a lack of information among patients, but also among physicians, who should be key providers of this information.The main objective is to study, on one hand, the knowledge of patients eligible for gamete donation (women aged 18 to 37 and men aged 18 to 44) on the topic, and on the other hand, the knowledge of practicing general practitioners regarding the subjectThis is a descriptive quantitative study based on two knowledge questionnaires addressed to physicians and patients of gamete-donation age. The distribution was carried out through the departmental Medical Councils as well as via social mediaA total of 68 patient responses and 95 physician responses were analyzed. Patients and physicians achieved overall mean scores that were not significantly different, 6.95/15 and 7.63/15, respectively. Physicians performed better regarding the practical aspects of donation and the regulations compared to patients. Physicians who had previously discussed the topic with their patients had a statistically higher mean score than those who had not. Ninety-six percent of patients indicated they would not be uncomfortable if their physician raised the issue of gamete donation during a consultation. Nearly 43% of patients said they might consider donating in the future. Ninety-three percent of physicians considered an informational document useful, preferably in the form of a brochure.Since the 2011 decree, the general practitioner has been at the center of providing information on gamete donation. The sample size is insufficient to generalize the results nationally. It appears necessary to strengthen initial medical training, offer continuing education to those who wish, and consider creating a mixed informational resource aimed at both physicians and patients to meet their needs.Gamete donation is a topic at the heart of current concerns, requiring the enhancement of healthcare professionals’ knowledge in order to meet the growing demand from patients.

Smoking during pregnancy (SDP) is an important source of preventable morbidity and mortality for both mother and child.The aim of this study was to describe changes in the prevalence of SDP between 1995 and 2020, in developed countries (Human Development Index >0.8 in 2020) and associated social inequalities.A systematic review was conducted based on a search in PubMed, Embase and PsycInfo databases and government sources. Study selection and data extraction: Published studies between January 1995 and March 2020, for which the primary outcome was to assess the national prevalence of SDP and the secondary outcome was to describe related socio-economic data were included in the analysis. The selected articles had to be written in English, Spanish, French or Italian. The articles were selected after successive reading of the titles, abstracts and full-length text. An independent double reading with intervention of a third reader in case of disagreement allowed including 35 articles from 14 countries in the analysis.The prevalence of SDP differed across the countries studied despite com-parable levels of development. After 2015, the prevalence of SDP ranged between 4.2% in Sweden and 16.6% in France. It was associated with socio-economic factors. The prevalence of SDP slowly decreased over time, but this overall trend masked in-equalities within populations. In Canada, France and the United States, the prevalence decreased more rapidly in women of higher socio-economic status, and inequalities in maternal smoking were more marked in these countries. In the other countries, inequalities tended to decrease but remained significant.The study was conducted using rigorous methodology (PROSPERO registration, diverse databases, validation of the search equation by a methodologist) and reported according to PRISMA Equity 2021 guidelines. However, the articles included in the analysis were compared while they sometimes used different methodologies and timeframes. Furthermore, smoking status was most often self-reported, which may lead to an underestimation of prevalence rates.During pregnancy, that is a period described as a window of opportunity, smoking and social vulnerability factors need to be detected to implement targeted prevention strategies aiming at reducing related social inequalities

Most pregnant women are followed by a gynecologist while only a minority of them are followed by their general practitioners (GP). However, those are allowed to manage antenatal care in case of low risk pregnancy.The aim of this study is to explore the different barriers and facilitators to antenatal care by GP.A narrative literature review was conducted using a methodology borrowed from the Scoping review. Five databases were explored : Pubmed, Cochrane, ScienceDirect, PsycINFO and Cismef. Inclusion and exclusion criteria were established. Studies dated from 2015 to 2025, written in English or French, addressing antenatal care and involving management by GP, were included. Studies were excluded if they focused exclusively on management by the gynecologist or midwife, or if they focused exclusively on childbirth, high risk pregnancies, or abortions.Twenty-four studies were included in our review. Key barriers included the link between the discontinuation of childbirth practice by GP and the decrease in pregnancy follow-ups, the lack of training, the lack of interprofessional coordination and collaboration, insufficient time, inadequate remuneration, and weak continuity of care. Main facilitators included the exposure to training, positive interprofessional collaboration experiences and practice in rural areas or shared-care programs.Five main categories of barriers and facilitators were identified : organizational, institutional, interpersonal, individual, and professional. The main barriers appeared at the organizational and institutional levels. The professional environment influences clinical practice, with GP providing more antenatal care in rural than in urban areas. Differences between healthcare systems across countries can also be observed, influencing the involvement of GP in pregnancy care. Moreover, eight studies emphasized the important role of GP in addressing perinatal mental health and vulnerability, highlighting the benefits and centrality of their role in antenatal care.To encourage and support physicians in providing more antenatal care, it would be essential to strengthen care coordination with other professionals, enhance medical training, and encourage policymakers to improve funding for pregnancy follow-up consultations. Further research on patients’ perceptions of antenatal care by GP would be valuable to complement our study.