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Tony Sheldon highlighted the recent news that the Netherlands had the
third worst perinatal mortality rate out of 26 European countries in 2004
[1]. The news item listed some of the possible explanations, for example
lifestyle factors (Dutch women have their babies late); obstetric factors
(Dutch women have more multiple pregnancies); and social inequalities
(Dutch women of non-western origin are 40% more likely to experience
perinatal mortality).
When the Peristat II results were published earlier this month the
Dutch media suggested a number of other possible explanations, some of
which might be worth some further investigation. For example:
paediatricians in the Netherlands were less interventionist in 2004 and
may have not have started treatment in extremely premature babies, which
may explain the higher than expected death rate immediately after birth
(early neonatal mortality). The media also reported that the Dutch were
less likely to use prenatal screening for congenital deformities than many
other countries in Europe. While several newspapers mentioned
specifically that the high percentage of home births was not a causal
factor.
Reference
1. Sheldon T, Perinatal mortality in Netherlands third worst in
Europe, Brit Med J 2008; 337: a3118
Competing interests:
None declared
Competing interests:
No competing interests
04 January 2009
Edwin R. van Teijlingen
Reader in Public Health
University of Aberdeen, Aberdeen, AB25 2ZD, Scotland
Need for further research into high Dutch perinatal mortality rate
Tony Sheldon highlighted the recent news that the Netherlands had the
third worst perinatal mortality rate out of 26 European countries in 2004
[1]. The news item listed some of the possible explanations, for example
lifestyle factors (Dutch women have their babies late); obstetric factors
(Dutch women have more multiple pregnancies); and social inequalities
(Dutch women of non-western origin are 40% more likely to experience
perinatal mortality).
When the Peristat II results were published earlier this month the
Dutch media suggested a number of other possible explanations, some of
which might be worth some further investigation. For example:
paediatricians in the Netherlands were less interventionist in 2004 and
may have not have started treatment in extremely premature babies, which
may explain the higher than expected death rate immediately after birth
(early neonatal mortality). The media also reported that the Dutch were
less likely to use prenatal screening for congenital deformities than many
other countries in Europe. While several newspapers mentioned
specifically that the high percentage of home births was not a causal
factor.
Reference
1. Sheldon T, Perinatal mortality in Netherlands third worst in
Europe, Brit Med J 2008; 337: a3118
Competing interests:
None declared
Competing interests: No competing interests