Document Detail


Rise in maternal mortality in the Netherlands.
MedLine Citation:
PMID:  19943828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. SETTING: Nationwide in the Netherlands. POPULATION: 2,557,208 live births. METHODS: Data analysis of all maternal deaths in the period 1993-2005. MAIN OUTCOME MEASURES: Maternal mortality. RESULTS: 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%). CONCLUSIONS: 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 care.
Authors:
J M Schutte; E A P Steegers; N W E Schuitemaker; J G Santema; K de Boer; M Pel; G Vermeulen; W Visser; J van Roosmalen;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-11-26
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  399-406     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, Isala Klinieken Zwolle, Dr Van Heesweg 2, Zwolle, the Netherlands. jokeschutte@yahoo.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Female
Humans
Maternal Mortality / ethnology,  trends
Middle Aged
Netherlands / epidemiology
Parity
Pregnancy
Pregnancy Complications / ethnology,  mortality*,  therapy
Prenatal Care / standards*
Quality of Health Care
Young Adult
Comments/Corrections
Comment In:
BJOG. 2010 Mar;117(4):379-81   [PMID:  20374577 ]
BJOG. 2010 Jun;117(7):894-5; author reply 895   [PMID:  20482544 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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