Regionale verschillen moedersterfte in Nederland*

Objective

To study regional differences in maternal mortality in the Netherlands.

Design

Retrospective observational study.

Method

We used existing data from the Netherlands Maternal Mortality Committee and analysed all maternal deaths in the period 1993-2008.

Results

During this period, 337 maternal deaths were reported. The overall maternal mortality ratio (MMR) in the Netherlands was 10.8 per 100.000 live births. In the 12 provinces of the Netherlands, the MMR ranged from 6.2 in North Brabant to 16.3 in Zeeland. In the four largest cities, the MMR varied from 9.3 in Amsterdam to 21.0 in Rotterdam. At the national level, the most frequent direct cause of maternal death was pre-eclampsia. A significant increased risk of maternal mortality was found in women older than 35 years (relative risk (RR): 1.61) and in women of non-Western origin (RR: 1.59).

Conclusion

There were substantial differences in maternal mortality between neighbourhoods, cities and provinces in the Netherlands. In addition, a higher maternal mortality was observed in women of non-Western origin and in women older than 35 years. This should be taken into account in the current discussion on the quality of obstetric care.

Conflict of interest: none declared. Financial support: none declared.