Master Theses UMCG - University of Groningen
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Perinatale sterfte Verloskundig Samenwerkingsverband Martini Ziekenhuis 2010-2016 - Kan de zorg beter?

(2017) Dam, W.H.J. van

Introduction Perinatal mortality is an important indicator for the health of pregnant women and their children, as well as health care quality, and was significantly different per province in the Netherlands from 2000 till 2006. Highest mortality rates were found in the province of Groningen with an uncorrected mortality rate of 1,13 (95%-CI: 1,02-1,26).
Objective To examine whether there were additional, antenatal risk factors besides the standard risk factors that could be correlated to perinatal mortality in the VSV Martini from 2010 till 2016.
Material and Methods A total of 57 cases of perinatal mortality were included. As a control group, each case was matched with three cases of women with similar parity that gave birth to a living child in the same period. Study groups were compared based on medical, biological, behavioural and environmental factors.
Results Smoking (18% versus 8,0%, p = 0,048), pregnancy counselling from a health care worker with a solo practice (14% versus 5,0%, p = 0,049), and foetal growth restriction (FGR) (26% versus 8,0%, p ≤ 0,001) each correlated significantly to perinatal mortality. Of the cases with FGR, no biometry was performed in 39% of cases in the perinatal mortality group versus 8,0% in the control group. Perinatal mortality occurred more frequently in non-Western women who started prenatal care after the 12th week of their pregnancy. Socio-economic status and travel distance were not different between groups.
Conclusion In agreement with previous studies, this study shows that smoking increases the risk of perinatal mortality. Additionally, identification of FGR might be essential in the prevention of perinatal mortality. It is desirable to limit the number of obstetric health care workers per case (while maintaining at least two) to ensure quality and continuity of health care.

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