Intended for healthcare professionals

Letters Dutch perinatal mortality

Too early to question effectiveness of Dutch system

BMJ 2010; 341 doi: (Published 07 December 2010) Cite this as: BMJ 2010;341:c7020
  1. Ank de Jonge, senior midwife researcher1,
  2. Ben Willem Mol, professor of obstetrics and gynaecology2,
  3. Birgit Y van der Goes, midwife researcher2,
  4. Jan G Nijhuis, professor of obstetrics3,
  5. Joris A van der Post, professor of obstetrics2,
  6. Simone E Buitendijk, professor of maternal and child health4
  1. 1Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands
  2. 2Department of Obstetrics and Gynaecology, Amsterdam Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
  3. 3Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, P Debyelaan 25, 6229 HX Maastricht, Netherlands
  4. 4TNO Quality of Life, PO Box 2215, 2301 CE Leiden, Netherlands
  1. ank.dejonge{at}

The study by Evers et al is the first to show a higher mortality among births that started in primary care compared with secondary care.1 We have concerns about the methods used.

Firstly, although the title suggests that it is a prospective cohort study, the entire population at risk was defined retrospectively and based on postal codes of …

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