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Updated: Jun 13, 2026

Induction of Cerebral Arterial Gas Embolism in Rat
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Published on: October 18, 2024

Indirect maternal mortality increases in the Netherlands.

Joke M Schutte1, Layla de Jonge, Nico W E Schuitemaker

  • 1Department of Obstetrics and Gynecology, Isala Klinieken Zwolle, Dr. Van Heesweg 2, Zwolle, The Netherlands. jokeschutte@yahoo.com

Acta Obstetricia Et Gynecologica Scandinavica
|May 11, 2010
PubMed
Summary

Indirect maternal deaths in the Netherlands increased significantly between 1993-2005, driven by cardiovascular issues and risk factors like advanced maternal age. Substandard care was noted in 35% of cases.

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Last Updated: Jun 13, 2026

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06:26

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Published on: October 18, 2024

Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Epidemiology

Background:

  • Indirect maternal mortality presents a complex challenge in healthcare systems.
  • Understanding trends and causes is crucial for targeted interventions.

Purpose of the Study:

  • To analyze the causes, trends, and instances of substandard care in indirect maternal mortality within the Netherlands.
  • To identify risk factors and high-risk populations for improved maternal health outcomes.

Main Methods:

  • A confidential inquiry into maternal deaths was conducted nationwide in the Netherlands.
  • Data from 2,557,208 live births between 1993 and 2005 were analyzed for indirect maternal deaths.

Main Results:

  • Indirect maternal mortality ratio increased from 2.4 to 3.3 per 100,000 live births (1983-1992 vs. 1993-2005).
  • Cardiovascular and cerebrovascular disorders were leading causes; vascular dissection was most frequent.
  • Advanced maternal age, non-indigenous origin, and pre-existing health conditions were key risk factors. Substandard care was identified in 35% of cases.

Conclusions:

  • The rise in indirect maternal mortality reflects demographic shifts and changes in maternal health profiles.
  • Preconception care and identification of high-risk groups are vital for mitigating mortality.
  • A multidisciplinary approach is recommended for managing high-risk pregnancies and improving maternal care.