Perinatal mortality in Netherlands third worst in Europe

BMJ 2008; 337 doi: (Published 23 December 2008) Cite this as: BMJ 2008;337:a3118
  1. Tony Sheldon
  1. 1Utrecht

    Researchers in the Netherlands fear that Dutch babies “may not be getting the start they should” after data have shown that perinatal mortality continues to compare badly with the country’s European neighbours. The comparative study of mothers’ and babies’ health outcomes in 26 European countries, Peristat II, showed that the Netherlands had the third worst figures, after France and Latvia (

    The findings reinforce the findings of the Peristat I study, in which the Netherlands had some of the worst rates among 15 European Union countries. Perinatal mortality has dropped from 10.9 to 10 per 1000 births, but it has fallen faster in other countries, including Greece and Spain.

    Researchers think that the results of Peristat II make it less likely that the Peristat I figures were a result of chance or poor data collection.

    The Dutch researchers are urging more insight into the risks compared with other European countries (Ned Tijdschr Geneeskd 2008;152:2718-27).

    Simone Buitendijk, professor in maternal and child health at Leiden University Medical Centre and one of the leaders of the Dutch Peristat research, said, “It is really high time the Dutch started looking at what kind of care we deliver to pregnant women and babies, in its entire scope. We need at least to know what the causes are. If we knew we could decide what should change and what not.”

    For Peristat II the Netherlands Organisation for Applied Scientific Research analysed data for 2004. The level of fetal mortality, defined as during or before birth after 22 weeks of pregnancy, was 7 per 1000 total births. Only France had more. This compares with 7.4 in 1999, then the worst in Europe.

    Among western European countries the Netherlands has most early neonatal mortality up to a week after birth, at 3 per 1000 live births. This compares with 3.5 in 1999, when the Netherlands was second only to Greece.

    After Denmark, the Netherlands has the lowest percentage of young mothers—1.6% under 20. It is second to only Cyprus and Denmark in the number of multiple pregnancies per 1000 pregnant women, at 20.5. But the researchers argue that these factors cannot fully explain the differences.

    Anita Ravelli, an epidemiologist of the department of medical informatics at Amsterdam’s Academic Medical Centre and part of the Peristat team, also looked separately at risk factors in data from 1.3 million births between 2000 and 2006 (Ned Tijdschr Geneeskd 2008;152:2728-33).

    She concluded that ethnic group is more important than maternal age. The prevalence of older mothers is low, but 16% of pregnant women in the Netherlands are of non-Western origin, and they have a 40% higher chance of perinatal mortality.


    Cite this as: BMJ 2008;337:a3118

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