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Decreasing perinatal mortality in The Netherlands, 2000-2006: a record linkage study
A C J Ravelli1, M Tromp, M van Huis
1Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands. a.c.ravelli@amc.uva.nl
Journal of Epidemiology and Community Health
|May 7, 2009
Summary
Dutch perinatal mortality decreased from 2000-2006, with significant declines observed across most risk groups. However, overall levels remain high compared to European benchmarks, indicating ongoing challenges in reducing infant and fetal mortality rates.
Area of Science:
- Perinatal health research
- Public health surveillance
- Epidemiology
Background:
- Previous studies indicated higher perinatal mortality in The Netherlands compared to other European nations.
- This study aimed to analyze recent trends and influencing risk factors in Dutch perinatal mortality.
Purpose of the Study:
- To investigate the trend in perinatal mortality in The Netherlands between 2000 and 2006.
- To identify the impact of various risk factors on this trend.
Main Methods:
- A retrospective cohort study analyzed 1,246,440 singleton births from 2000-2006.
- Data were linked from midwifery, obstetrics, and neonatology registries.
- Perinatal mortality (fetal and early neonatal) was the primary outcome measure, with trend analysis performed with and without risk adjustment.
Main Results:
- A significant decline in perinatal mortality was observed, from 10.5 to 9.1 per 1000 births.
- This downward trend persisted after risk adjustment and was evident in both fetal and neonatal mortality.
- The decline was most notable in births with congenital anomalies, premature births (32.0-36.6 weeks), and term births; home births had the lowest mortality risk.
Conclusions:
- Dutch perinatal mortality showed a steady decline between 2000-2006, independent of known risk factors like advanced maternal age or non-western ethnicity.
- The reduction was observed across most risk groups, excluding very premature births.
- Despite the decline, Dutch perinatal mortality rates remain comparatively high by European standards.
