Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study.

Abstract:

OBJECTIVE:To compare incidences of perinatal mortality and severe perinatal morbidity between low risk term pregnancies supervised in primary care by a midwife and high risk pregnancies supervised in secondary care by an obstetrician. DESIGN:Prospective cohort study using aggregated data from a national perinatal register. SETTING:Catchment area of the neonatal intensive care unit (NICU) of the University Medical Center in Utrecht, a region in the centre of the Netherlands covering 13% of the Dutch population. PARTICIPANTS:Pregnant women at 37 weeks' gestation or later with a singleton or twin pregnancy without congenital malformations. MAIN OUTCOME MEASURES:Perinatal death (antepartum, intrapartum, and neonatal) or admission to a level 3 NICU. RESULTS:During the study period 37 735 normally formed infants were delivered at 37 weeks' gestation or later. Sixty antepartum stillbirths (1.59 (95% confidence interval 1.19 to 1.99) per 1000 babies delivered), 22 intrapartum stillbirths (0.58 (0.34 to 0.83) per 1000 babies delivered), and 210 NICU admissions (5.58 (4.83 to 6.33) per 1000 live births) occurred, of which 17 neonates died (0.45 (0.24 to 0.67) per 1000 live births). The overall perinatal death rate was 2.62 (2.11 to 3.14) per 1000 babies delivered and was significantly higher for nulliparous women compared with multiparous women (relative risk 1.65, 95% confidence interval 1.11 to 2.45). Infants of pregnant women at low risk whose labour started in primary care under the supervision of a midwife had a significant higher risk of delivery related perinatal death than did infants of pregnant women at high risk whose labour started in secondary care under the supervision of an obstetrician (relative risk 2.33, 1.12 to 4.83). NICU admission rates did not differ between pregnancies supervised by a midwife and those supervised by an obstetrician. Infants of women who were referred by a midwife to an obstetrician during labour had a 3.66 times higher risk of delivery related perinatal death than did infants of women who started labour supervised by an obstetrician (relative risk 3.66, 1.58 to 8.46) and a 2.5-fold higher risk of NICU admission (2.51, 1.87 to 3.37). CONCLUSIONS:Infants of pregnant women at low risk whose labour started in primary care under the supervision of a midwife in the Netherlands had a higher risk of delivery related perinatal death and the same risk of admission to the NICU compared with infants of pregnant women at high risk whose labour started in secondary care under the supervision of an obstetrician. An important limitation of the study is that aggregated data of a large birth registry database were used and adjustment for confounders and clustering was not possible. However, the findings are unexpected and the obstetric care system of the Netherlands needs further evaluation.

journal_name

BMJ

authors

Evers AC,Brouwers HA,Hukkelhoven CW,Nikkels PG,Boon J,van Egmond-Linden A,Hillegersberg J,Snuif YS,Sterken-Hooisma S,Bruinse HW,Kwee A

doi

10.1136/bmj.c5639

subject

Has Abstract

pub_date

2010-11-02 00:00:00

pages

c5639

eissn

0959-8138

issn

1756-1833

journal_volume

341

pub_type

杂志文章
  • Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial.

    abstract:OBJECTIVE:To compare the effectiveness of corticosteroid injections with physiotherapy for the treatment of painful stiff shoulder. DESIGN:Randomised trial. SETTING:40 general practices. SUBJECTS:109 patients consulting general practitioners for shoulder pain were enrolled in the trial. INTERVENTIONS:Patients were ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.317.7168.1292

    authors: van der Windt DA,Koes BW,Devillé W,Boeke AJ,de Jong BA,Bouter LM

    更新日期:1998-11-07 00:00:00

  • The World Health Organisation. WHO in Europe: does it have a role?

    abstract::WHO is under pressure from all sides to justify its existence. Donors want to know what they are getting for their money, and health professionals question the relevance of the organisation's work. The pressure to justify itself is perhaps strongest of all in Europe, where most member countries have fully fledged heal...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6976.389

    authors: Godlee F

    更新日期:1995-02-11 00:00:00

  • Waiting times for carotid endarterectomy in UK: observational study.

    abstract:OBJECTIVES:To assess timeliness of carotid endarterectomy services in the United Kingdom. DESIGN:Observational study with follow-up to March 2008. SETTING:UK hospitals performing carotid endarterectomy. PARTICIPANTS:UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007. MAIN OUTCOME MEA...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b1847

    authors: Halliday AW,Lees T,Kamugasha D,Grant R,Hoffman A,Rothwell PM,Potter JF,Horrocks M,Naylor R,Rudd AG,Carotid Endarterectomy Steering Group.,Clinical Effectiveness and Evaluation Unit, Royal College of Physicians.,Vascular Society o

    更新日期:2009-06-04 00:00:00

  • Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial.

    abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.e3086

    authors: Meeuwsen EJ,Melis RJ,Van Der Aa GC,Golüke-Willemse GA,De Leest BJ,Van Raak FH,Schölzel-Dorenbos CJ,Verheijen DC,Verhey FR,Visser MC,Wolfs CA,Adang EM,Olde Rikkert MG

    更新日期:2012-05-15 00:00:00

  • Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants' data from seven trials.

    abstract:OBJECTIVE:To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. DESIGN:Pooled analysis of in...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.d3036

    authors: Boutitie F,Pinede L,Schulman S,Agnelli G,Raskob G,Julian J,Hirsh J,Kearon C

    更新日期:2011-05-24 00:00:00

  • Negative extrathoracic pressure in treatment of respiratory failure in infants and young children.

    abstract:OBJECTIVE:To assess the efficacy of a newly developed system for applying continuous or intermittent negative (subatmospheric) extrathoracic pressure in respiratory failure. DESIGN:Uncontrolled clinical trials in infants deteriorating or failing to improve despite standard medical treatment. SETTING:Paediatric and ne...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.299.6710.1253

    authors: Samuels MP,Southall DP

    更新日期:1989-11-18 00:00:00

  • Influence of data display formats on physician investigators' decisions to stop clinical trials: prospective trial with repeated measures.

    abstract:OBJECTIVE:To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN:Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING:Comprehensive cancer c...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.318.7197.1527

    authors: Elting LS,Martin CG,Cantor SB,Rubenstein EB

    更新日期:1999-06-05 00:00:00

  • Influenza A/H1N1 MF59 adjuvanted vaccine in pregnant women and adverse perinatal outcomes: multicentre study.

    abstract:OBJECTIVE:To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. DESIGN:Cross sectional multicentre study. SETTING:49 public hospitals in major cities in Argentina, from September 2010 to May 2011. PARTICIPANTS:30,448 mothers (7293 vaccinated) and their 30,76...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.f393

    authors: Rubinstein F,Micone P,Bonotti A,Wainer V,Schwarcz A,Augustovski F,Pichon Riviere A,Karolinski A,EVA Study Research Group Estudio Embarazo y Vacuna Antigripal.

    更新日期:2013-02-04 00:00:00

  • Cardiac rehabilitation for heart failure can improve quality of life and fitness.

    abstract::The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.l5456

    authors: Cook R,Davidson P,Martin R,NIHR Dissemination Centre.

    更新日期:2019-10-01 00:00:00

  • Liver transplantation in patients with alcoholic cirrhosis: selection criteria and rates of survival and relapse.

    abstract:OBJECTIVE:To evaluate the outcome of liver transplantation in patients with alcoholic cirrhosis with respect to selection criteria, survival, and evidence suggesting a return to harmful drinking. DESIGN:Nine year retrospective study. SETTING:Cambridge and King's College Hospital liver transplant programme. SUBJECTS:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6742.15

    authors: Bird GL,O'Grady JG,Harvey FA,Calne RY,Williams R

    更新日期:1990-07-07 00:00:00

  • Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.

    abstract:OBJECTIVE:To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN:Retrospective cohort study. SETTING:Population based birth registry linked with health administrative databases in the pro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.l4151

    authors: Walsh LK,Donelle J,Dodds L,Hawken S,Wilson K,Benchimol EI,Chakraborty P,Guttmann A,Kwong JC,MacDonald NE,Ortiz JR,Sprague AE,Top KA,Walker MC,Wen SW,Fell DB

    更新日期:2019-07-10 00:00:00

  • Drug injection and HIV prevalence in inmates of Glenochil prison.

    abstract:OBJECTIVE:To determine prevalence of HIV infection and drug injecting behaviour among inmates of Glenochil Prison on a specified date a year after an outbreak of hepatitis B and HIV infection. DESIGN:Cross sectional: voluntary, anonymous HIV salivary antibody surveillance and linked self completion questionnaire on ri...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6975.293

    authors: Gore SM,Bird AG,Burns SM,Goldberg DJ,Ross AJ,Macgregor J

    更新日期:1995-02-04 00:00:00

  • Ultrasonography compared with intravenous urography in the investigation of adults with haematuria.

    abstract:OBJECTIVE:To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN:Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.301.6760.1074

    authors: Spencer J,Lindsell D,Mastorakou I

    更新日期:1990-11-10 00:00:00

  • Is London overbedded?

    abstract:OBJECTIVE:To examine whether there are too many hospital beds in London. DESIGN:Analysis of data from the Hospital In-Patient Enquiry, Mental Health Enquiry, health service indicators, and Emergency Bed Service. SETTING:England, London, and inner London. RESULTS:Hospital admission rates for acute plus geriatric serv...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6883.979

    authors: Jarman B

    更新日期:1993-04-10 00:00:00

  • Equity in access to total joint replacement of the hip and knee in England: cross sectional study.

    abstract:OBJECTIVE:To explore geographical and sociodemographic factors associated with variation in equity in access to total hip and knee replacement surgery. DESIGN:Combining small area estimates of need and provision to explore equity in access to care. SETTING:English census wards. SUBJECTS:Patients throughout England w...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c4092

    authors: Judge A,Welton NJ,Sandhu J,Ben-Shlomo Y

    更新日期:2010-08-11 00:00:00

  • Estimating the high risk group for cardiovascular disease in the Norwegian HUNT 2 population according to the 2003 European guidelines: modelling study.

    abstract:OBJECTIVE:To estimate the high risk group for cardiovascular disease in a well defined Norwegian population according to European guidelines and the systematic coronary risk evaluation system. DESIGN:Modelling study. SETTING:Nord-Tröndelag health study 1995-7 (HUNT 2), Norway. PARTICIPANTS:5548 participants of the N...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38555.648623.8F

    authors: Getz L,Sigurdsson JA,Hetlevik I,Kirkengen AL,Romundstad S,Holmen J

    更新日期:2005-09-10 00:00:00

  • Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users and in [correction of who are] carriers of hereditary prothrombotic conditions. The Cerebral Venous Sinus Thrombosis Study Group.

    abstract:OBJECTIVE:To investigate whether users of oral contraceptives and in [corrected] carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis. DESIGN:Comparison of a prospective series of cases of cerebral sinu...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.316.7131.589

    authors: de Bruijn SF,Stam J,Koopman MM,Vandenbroucke JP

    更新日期:1998-02-21 00:00:00

  • Control of defecation in patients with spinal injuries by stimulation of sacral anterior nerve roots.

    abstract:OBJECTIVE:To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN:Prospective study of 12 consecutive patients. SETTING:Spinal injuries unit and university gastrointestinal physiology department. PA...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6738.1494

    authors: MacDonagh RP,Sun WM,Smallwood R,Forster D,Read NW

    更新日期:1990-06-09 00:00:00

  • Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study.

    abstract:OBJECTIVE:To evaluate the impact of the US Air Force suicide prevention programme on risk of suicide and other outcomes that share underlying risk factors. DESIGN:Cohort study with quasi-experimental design and analysis of cohorts before (1990-6) and after (1997-2002) the intervention. PARTICIPANTS:5,260,292 US Air F...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.327.7428.1376

    authors: Knox KL,Litts DA,Talcott GW,Feig JC,Caine ED

    更新日期:2003-12-13 00:00:00

  • Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau.

    abstract:OBJECTIVE:To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). DESIGN:Follow up study of 3 months. SETTING:Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.319.7214.878

    authors: Aaby P,Gomes J,Fernandes M,Djana Q,Lisse I,Jensen H

    更新日期:1999-10-02 00:00:00

  • Effect of mobile telephone reminders on treatment outcome in HIV: evidence from a randomised controlled trial in India.

    abstract:OBJECTIVE:To assess whether customised mobile phone reminders would improve adherence to therapy and thus decrease virological failure among HIV infected patients starting antiretroviral treatment (ART). DESIGN:Randomised controlled trial among HIV infected patients initiating antiretroviral treatment. SETTING:Three ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.g5978

    authors: Shet A,De Costa A,Kumarasamy N,Rodrigues R,Rewari BB,Ashorn P,Eriksson B,Diwan V,HIVIND Study Team.

    更新日期:2014-10-24 00:00:00

  • Wartime evacuation and mortality from childhood leukaemia in England and Wales in 1945-9.

    abstract:OBJECTIVE:To discover whether the wartime government evacuation of children from London and other population centres to rural districts was associated with any increase in childhood leukaemia. DESIGN:Observational study of mortality from leukaemia among the childhood population of England and Wales in relation to the ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6963.1197

    authors: Kinlen LJ,John SM

    更新日期:1994-11-05 00:00:00

  • Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study.

    abstract:OBJECTIVE:To assess the role of rhinoviruses in elderly people living in the community. DESIGN:Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7065.1119

    authors: Nicholson KG,Kent J,Hammersley V,Cancio E

    更新日期:1996-11-02 00:00:00

  • Scenario analysis of the future of medicines.

    abstract::Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples'...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6962.1137

    authors: Leufkens H,Haaijer-Ruskamp F,Bakker A,Dukes G

    更新日期:1994-10-29 00:00:00

  • Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies.

    abstract:OBJECTIVES:To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation. DESIGN:Meta-analysis and systematic review of prospective cohort studies. DATA SOURCES:PubMed and Embase up to December 20...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.f3706

    authors: Zheng JS,Hu XJ,Zhao YM,Yang J,Li D

    更新日期:2013-06-27 00:00:00

  • Hospital admissions for asthma in east London: associations with characteristics of local general practices, prescribing, and population.

    abstract:OBJECTIVE:To determine the relative importance of appropriate prescribing for asthma in explaining high rates of hospital admission for asthma among east London general practices. DESIGN:Poisson regression analysis describing relation of each general practice's admission rates for asthma with prescribing for asthma an...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.314.7079.482

    authors: Griffiths C,Sturdy P,Naish J,Omar R,Dolan S,Feder G

    更新日期:1997-02-15 00:00:00

  • Renal disease, epidermal necrosis, and epithelial cell antibodies.

    abstract:OBJECTIVE:To describe the association between epithelial cell IgM, which has previously been associated with an increased incidence of loss of renal graft in children, with a novel cutaneous eruption and unexplained native renal disease. DESIGN:Observational study on children with epithelial cell antibody presenting w...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.303.6795.161

    authors: Deal JE,Groves RW,Harmer AW,Welsh KI,MacDonald DM,Rigden SP

    更新日期:1991-07-20 00:00:00

  • Graduated compression stockings as adjuvant to pharmaco-thromboprophylaxis in elective surgical patients (GAPS study): randomised controlled trial.

    abstract:OBJECTIVES:To investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery. DESIGN:Open, multicentre, randomised, controlled, non-inferiority trial. SETTING:Seven...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.m1309

    authors: Shalhoub J,Lawton R,Hudson J,Baker C,Bradbury A,Dhillon K,Everington T,Gohel MS,Hamady Z,Hunt BJ,Stansby G,Warwick D,Norrie J,Davies AH,GAPS trial investigators.

    更新日期:2020-05-13 00:00:00

  • Investigation of long term problems after obstetric epidural anaesthesia.

    abstract:OBJECTIVE:To examine the association between obstetric epidural anaesthesia and subsequent long term problems. DESIGN:Postal questionnaire on health problems after childbirth linked to maternity case note data. SETTING:Maternity hospital in Birmingham. SUBJECTS:11701 women who delivered their most recent child durin...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.304.6837.1279

    authors: MacArthur C,Lewis M,Knox EG

    更新日期:1992-05-16 00:00:00

  • Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups.

    abstract:OBJECTIVE:To identify major concerns of national and local importance in the provision, commissioning, research, and use of generalist end of life care. DESIGN:A national consultation and prioritising exercise using a modified form of the nominal group technique. PARTICIPANTS:Healthcare practitioners, commissioners, ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.a1720

    authors: Shipman C,Gysels M,White P,Worth A,Murray SA,Barclay S,Forrest S,Shepherd J,Dale J,Dewar S,Peters M,White S,Richardson A,Lorenz K,Koffman J,Higginson IJ

    更新日期:2008-10-01 00:00:00