[Perinatal mortality in the Netherlands: everyone's problem and yet no one's problem]

Area of Science:

• Public Health
• Perinatal Medicine
• Epidemiology

Context:

• The Netherlands has experienced a decline in its global ranking for low perinatal mortality rates since 1986.
• Studies indicate that higher perinatal mortality rates are not due to data errors but potentially lower quality of care.
• A significant portion of the disparity with countries like Sweden and Finland is attributed to specific risk factors.

Purpose:

• To analyze the contributing factors to the elevated perinatal mortality rate in the Netherlands.
• To compare the Netherlands' perinatal mortality situation with other European countries.
• To highlight the lack of effective policy interventions over the past two decades.

Summary:

• Perinatal mortality rates in the Netherlands are higher than in comparable European countries.
• Key contributing factors include increased multiple pregnancies (linked to IVF), maternal smoking, immigrant demographics, inadequate congenital disorder screening, and substandard perinatal care.
• An estimated 20-25% of the difference in rates between the Netherlands and countries like Sweden and Finland is explained by these factors.

Impact:

• Identifies specific, modifiable factors contributing to higher infant mortality.
• Underscores the need for a coordinated, policy-driven approach to improve perinatal care and outcomes.
• Suggests that current strategies relying on voluntary participation have been insufficient to achieve desired reductions in perinatal mortality.