Pregnancy and labour in the dutch maternity care system: What is normal? The role division between midwives and obstetricians

Introduction: In the Dutch maternity care system, the role division between independently practising midwives (who take care of normal pregnancy and childbirth) and obstetricians (who care for pathologic pregnancy and childbirth) has been established in the so-called " List of Obstetric Indications" (LOI). The LOI designates the most appropriate...

Etnische verschillen in de voorkeur voor thuisbevallingen en het zorgtraject dat zwangeren doorlopen [Ethnic differences in preference for home delivery and in pregnancy care received by pregnant women]

Objective. To investigate differences among pregnant women from various ethnic groups in terms of pregnancy care and the place of delivery. Design. Descriptive, retrospective study. Method. Data from the Dutch Perinatal Registries during the period 1995-2002, representing a total of 1,401,892 pregnancies, were linked and analysed for perinatal...

Evaluation of 280 000 cases in Dutch midwifery practices: A descriptive study

Objective: To assess the nature and outcome of intrapartum referrals from primary to secondary care within the Dutch obstetric system. Design: Descriptive study. Setting: Dutch midwifery database (LVR1), covering 95% of all midwifery care and 80% of all Dutch pregnancies (2001-03). Population: Low-risk women (280 097) under exclusive care of a...

Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands

Background: Little research has been conducted to date on women's postnatal emotional well-being and satisfaction with the care received in the Netherlands. The aim of this study was to investigate Dutch women's views of their birth experience 3 years after the event. Methods: A questionnaire was mailed to all women who had given birth in 2001...

Hoge perinatale sterfte in Nederland vergeleken met andere Europese landen: De Peristat-II-studie [Higher perinatal mortality in the Netherlands than in other European countries: The Peristat-II study]

Objective. Comparison of perinatal mortality in the Netherlands with that in other European countries (Peristat-II), and with data collected 5 years previously (Peristat-I). Design. Descriptive study. Method. Indicators of perinatal mortality which were developed for Peristat-I were used again in Peristat-II. Data on perinatal mortality in 2004...

Outcome of perinatal care for very preterm infants at 5 years of age: A comparison between 1983 and 1993

Perinatal mortality in very preterm infants has decreased by up to 50% during the last decades. Studies of changes of long-term outcome are inconclusive. We studied the visual, auditory, neuromotor, cognitive and behavioural development of two geographically defined populations of very preterm, singleton infants, born in 1983 and in 1993, and...

Lower mortality but higher neonatal morbidity over a decade in very preterm infants

Better perinatal care has led to better survival of very preterm children, but may or may not have increased the number of children with cerebral and pulmonary morbidity. We therefore investigated the relationship between changes in perinatal care during one decade, and short-term outcome in very preterm infants. Perinatal risk factors and their...

Changes in perinatal care and survival in very preterm and extremely preterm infants in the Netherlands between 1983 and 1995

Objective: To evaluate changes in obstetrical and neonatal care for very preterm and extremely preterm infants between 1983 and 1995 in The Netherlands and to evaluate the effect of those changes. Study design: Data on all very preterm or VLBW infants from the linked national obstetrical and neonatal databases of 1995 (N=2066) were compared to...

Suboptimal care and perinatal mortality in ten European regions: Methodology and evaluation of an international audit

Background: A European concerted action (the EuroNatal study) investigated differences in perinatal mortality between countries of Europe. This report describes the methods used in the EuroNatal international audit and discusses the validity of the results. Methods: Perinatal deaths between 1993 and 1998 in regions of ten European countries were...

Selecting an indicator set for monitoring and evaluating perinatal health in Europe: Criteria, methods and results from the PERISTAT project

The PERISTAT project was charged with developing an indicator set for monitoring and describing perinatal health in Europe as part of the European Commission's Health Monitoring Programme, run by the Directorate General for Health and Consumer Protection (DG-SANCO), which is working towards the establishment of a comprehensive health monitoring...

PERISTAT: Indicators for monitoring and evaluating perinatal health in Europe

Background: The PERISTAT project aimed to develop an indicator set for monitoring and describing perinatal health in Europe. The challenge was to define indicators that cover common concerns and have the same meaning within the different European health care systems. Methods: PERISTAT included i) a review of existing recommendations on perinatal...

Evaluatie en validatie van perinatale-sterfte-audit door terugkoppeling naar zorgverleners [Evaluation and validation of a perinatal death audit by means of feedback to the caregivers]

Objective. To evaluate a perinatal audit procedure by communicating the results to the caregivers (midwives and obstetricians) involved, in order to determine whether the audit led to specific suggestions for improving practice and whether evaluation of the panel assessments by caregivers leads to a different evaluation of the audit process....

Substandard factors in perinatal care in The Netherlands: A regional audit of perinatal deaths

Background. To determine: 1) whether substandard factors were present in cases of perinatal death, and to what extent another course of action might have resulted in a better outcome, and 2) whether there were differences in the frequency of substandard factors by level of care, particularly between midwives and gynecologists/obstetricians and...

Quality of life in preschool children born preterm

The relationship of preterm birth to health-related quality of life (HRQoL) was examined for children aged 1 to 4 years. Three gestational age groups with a NICU history were selected, <32 weeks (n=65), 32 to 36 weeks (n=41),≥37 weeks (n=54), and a reference group from the open population (n=50). The main instrument was the TNO-AZL Preschool...

Looking back in time: Outcome of a national cohort of very preterm infants born in The Netherlands in 1983

In 1983, Dutch pediatricians collaborated on a national level and collected perinatal data on 1338 liveborn infants with a gestational age <32 weeks and/or a birthweight <1500 g (project on preterm and small for gestational age infants, POPS). Their outcome was assessed at 2 years of age by their pediatricians, at 5 years by a team of...

Toename van perinatale verwijzing naar regionale centra bij vroeggeboorte in Nederland : Vergelijking van 1983 en 1993 [Increased perinatal referral to regional centres of premature infants in the Netherlands : Comparison of 1983 and 1993]

Objective. To determine changes in referral of preterm newborns. Design. Descriptive. Setting. Foundation for Perinatal Epidemiology the Netherlands, Leiden. Methods. Data regarding hospital of birth, referral, need of intensive care and mortality of the infants < 32 weeks and (or) < 1500 g birth weight born in 1993 from the National Neonatology...

An European concerted action investigating the validity of perinatal mortality as an outcome indicator for the quality of antenatal and perinatal care

In this paper the concepts, objectives, design, and data analysis procedures of the EuroNatal study are described. This sutdy started in 1996 and is a concerted action including 14 countries in Europe. The EuroNatal study aims at determining the validity of national perinatal mortality rates as an outcome indicator for the quality of antenatal...

Perinatale registratie: Een proefonderzoek naar koppeling gegevens uit de Landelijke Verloskunde Registratie en de Landelijke Neonatalogie Registratie [Linking Dutch Perinatal Registration Systems]