Perinatal mortality in the Netherlands

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b1491 (Published 22 April 2009) Cite this as: BMJ 2009;338:b1491
  1. Marc J N C Keirse, professor of obstetrics and gynaecology
  1. 1Flinders University, Adelaide, SA 5042, Australia
  1. marc.keirse{at}flinders.edu.au

    Consistently poor performance indicates that it is time for change

    The Netherlands’ consistently poor performance in the European perinatal mortality league is a cause for concern. Neither the concern nor the performance are new. They culminated in the late 1970s and mid-1980s when home births were erroneously put forward as the explanation.1 A new height was reached when the Peristat project showed that at the turn of this century the Netherlands had the highest perinatal mortality in the European Union.1 Five years on, nine new EU members have expanded the league from 15 to 24, but this has brought little change.2 In 2004, perinatal mortality was 10 per 1000 in the Netherlands, higher than in all but one of the new EU members,2 and still 9.8 per 1000 in 2006.3

    Admittedly, the European perinatal mortality league is a poor relation of the European football league, not just because it takes four years before the results are announced.2 Not all teams play by the same rules. Some nations register births for babies ≥500 g; others from 22, 24, or 28 weeks’ gestation; and some have …

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