Rise in maternal mortality in the Netherlands
- 8 February 2010
- journal article
- research article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 117 (4), 399-406
- https://doi.org/10.1111/j.1471-0528.2009.02382.x
Abstract
To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. Nationwide in the Netherlands. 2,557,208 live births. Data analysis of all maternal deaths in the period 1993-2005. Maternal mortality. The overall maternal mortality ratio was 12.1 per 100 000 live births, which was a statistically significant rise compared with the maternal mortality ratio of 9.7 in the period 1983-1992 (OR 1.2, 95% CI 1.0-1.5). The most frequent direct causes were (pre-)eclampsia, thromboembolism, sudden death in pregnancy, sepsis, obstetric haemorrhage and amniotic fluid embolism. The number of indirect deaths also increased, mainly caused by an increase in cardiovascular disorders (OR 2.5, 95% CI 1.4-4.6). Women younger than 20 years and older than 45 years, those with high parity or from nonwestern immigrant populations were at higher risk. Most substandard care was found in women with pre-eclampsia (91%) and in immigrant populations (62%). Maternal mortality in the Netherlands has increased since 1983-1992. Pre-eclampsia remains the number one cause. Groups at higher risk for complications during pregnancy should be better identified early in pregnancy or before conception, in order to receive preconception advice and more frequent antenatal visits. There is an urgent need for the better education of women and professionals concerning the danger signs, and for the training of professionals in order to improve maternal health carKeywords
This publication has 12 references indexed in Scilit:
- Substandard care in maternal mortality due to hypertensive disease in pregnancy in the NetherlandsBJOG: An International Journal of Obstetrics and Gynaecology, 2008
- A prospective national study of acute fatty liver of pregnancy in the UKGut, 2008
- Maternal mortality due to psychiatric disorders in the NetherlandsJournal of Psychosomatic Obstetrics & Gynecology, 2008
- Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available dataThe Lancet, 2007
- Trends in obstetric interventions in the Dutch obstetrical care system in the period 1993–2002European Journal of Obstetrics & Gynecology and Reproductive Biology, 2007
- Suicide: the leading cause of maternal deathThe British Journal of Psychiatry, 2003
- Mortality in a cohort of IVF patients.Human Reproduction, 2001
- Risk factors for preeclampsia in nulliparous women in distinct ethnic groups: a prospective cohort studyPublished by Ovid Technologies (Wolters Kluwer Health) ,1998
- Confidential enquiry into maternal deaths in The Netherlands 1983–1992European Journal of Obstetrics & Gynecology and Reproductive Biology, 1998
- Underreporting of maternal mortality in The NetherlandsObstetrics & Gynecology, 1997