Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study

BMJ : British Medical Journal
Annemieke Cc EversAnneke Kwee

Abstract

To compare incidences of perinatal mortality and severe perinatal morbidity between low risk term pregnancies supervised in primary care by a midwife and high risk pregnancies supervised in secondary care by an obstetrician. Prospective cohort study using aggregated data from a national perinatal register. Catchment area of the neonatal intensive care unit (NICU) of the University Medical Center in Utrecht, a region in the centre of the Netherlands covering 13% of the Dutch population. Pregnant women at 37 weeks' gestation or later with a singleton or twin pregnancy without congenital malformations. Perinatal death (antepartum, intrapartum, and neonatal) or admission to a level 3 NICU. During the study period 37 735 normally formed infants were delivered at 37 weeks' gestation or later. Sixty antepartum stillbirths (1.59 (95% confidence interval 1.19 to 1.99) per 1000 babies delivered), 22 intrapartum stillbirths (0.58 (0.34 to 0.83) per 1000 babies delivered), and 210 NICU admissions (5.58 (4.83 to 6.33) per 1000 live births) occurred, of which 17 neonates died (0.45 (0.24 to 0.67) per 1000 live births). The overall perinatal death rate was 2.62 (2.11 to 3.14) per 1000 babies delivered and was significantly higher for nullipar...Continue Reading

Citations

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Related Concepts

Home Childbirth
Hospitalization
Midwifery
Primiparity
Primary Health Care
Patient Referral
Neonatal Intensive Care
High-Risk Pregnancy
Obstetric Delivery
Congenital Abnormality

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