Joke M. Schutte|E.A.P. Steegers|Nico Schuitemaker|Job G. Santema|Karin de Boer|Maria Pel|Guus M. Vermeulen|Willy Visser|Jos van Roosmalen
Rise in maternal mortality in the Netherlands
Isala|Erasmus MC|Diakonessenhuis hospital|Medisch Centrum Leeuwarden|Rijnstate Hospital|Goudappel Coffeng|Erasmus MC|Leiden University Medical Center|Amsterdam UMC Location VUmc
assess causes trends substandard care factors maternal mortality netherlands design confidential enquiry causes maternal mortalitynationwide netherlands2557208 live birthsdata analysis maternal deaths period 19932005maternal mortalitythe overall maternal mortality ratio 121 per 100 000 live births statistically significant rise compared maternal mortality ratio 97 period 19831992 12 95 ci 1015 frequent direct causes preeclampsia thromboembolism sudden death pregnancy sepsis obstetric haemorrhage amniotic fluid embolism number indirect deaths also increased mainly caused increase cardiovascular disorders 25 95 ci 1446 women younger 20 years older 45 years high parity nonwestern immigrant populations higher risk substandard care found women preeclampsia 91 immigrant populations 62maternal mortality netherlands increased since 19831992 preeclampsia remains number one cause groups higher risk complications pregnancy better identified early pregnancy conception order receive preconception advice frequent antenatal visits urgent need better education women professionals concerning danger signs training professionals order improve maternal health care