The reliability of perinatal and neonatal mortality rates: Differential under-reporting in linked professional registers vs. Dutch civil registers

Official Dutch perinatal mortality rates are based on birth and death certificates. These civil registration data are not detailed enough for international comparisons or extensive epidemiological research. In this study, we linked and extrapolated three national incomplete, professional registers from midwives, obstetricians and paediatricians, containing detailed perinatal information. This linkage and extrapolation resulted in one detailed professional database which is representative of all Dutch births and from which gestational age-specific perinatal mortality rates could be calculated. The reliability of these calculated mortality rates was established by comparing them with the rates derived from the national civil registers. The professional database reported more perinatal deaths and fewer late neonatal deaths than the civil registers. The underreporting in the civil registers amounted to 1.2 fewer perinatal deaths per 1000 births and was most apparent in immature newborns. We concluded that under-reporting of perinatal and neonatal deaths depends on the data source used. Mortality rates for the purpose of national and international comparison should, therefore, be defined with caution. This study also demonstrated that combining different incomplete professional registers can result in a more reliable database containing detailed perinatal information. Such databases can be used as the basis for extensive perinatal epidemiological research

No association between glucocorticoid receptor polymorphisms and long-term respiratory outcome after very preterm birth

Developmen

Gender differences in respiratory symptoms in 19-year-old adults born preterm

Objective: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. Methods: Design: Prospective cohort study. Setting: Nation wide follow-up study, the Netherlands. Participants: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). Main outcome measures: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire

Opzetten van een landelijk bestand van kinderen met congenitale afwijkingen uit de Landelijke Verloskunde Registratie en de Landelijke Neonatologie registratie [Registration of congenital anomalies in the national perinatal registries]

Objective. To determine if the birth prevalence data on congenital malformations in the national perinatal registries, the Landelijke Verloskunde Registratie (LVR) (National Obstetrical Registry) and the Landelijke Neonatologie Registratie (LNR) (National Neonatological Registry), can be combined into one nationwide database, and if so to determine the validity of this database. Design. Descriptive. Setting. TNO Prevention and Health, Leiden, the Netherlands. Methods. Investigation of the registered number of congenital malformations in the LVR/LNR, the amount of overlapping and the possibility of combining the LVR and LNR into one nationwide database. The validity of this database was evaluated by comparing the total number of registered children with the total number expected in the Netherlands. Furthermore the total number of children registered in the nationwide database was compared with children registered by the European registration of congenital anomalies and twins (EUROCAT) in the Northern Netherlands. Results. The LVR and LNR were mostly complementary with respect to the registration of congenital anomalies and could be combined to one nationwide database. For sixteen important diagnoses this nationwide database contained approximately 87% of the total number expected in the Netherlands. Comparing this database with the data of EUROCAT in the Northern Netherlands showed that one-third of these congenital malformations (n = 229 in 217 children) were registered in both systems, while 99 (43%) were only registered by EUROCAT and 50 (22%) only by the nationwide database. Conclusion. It was possible to create a nationwide database, which can supplement the regional EUROCAT data with nationwide data on sixteen important diagnoses of congenital malformations

De levensloop van te vroeg geboren kinderen

Zal ons kind het overleven? En hoe zal het dan verder gaan? Zal het iets overhouden aan de veel te vroege start? Dat zijn de kwesties die de ouders van een te vroeg geboren kind de eerste weken en maanden na de geboorte sterk bezig houden. Maar ook als het kind ouder wordt, blijven er vragen. Veel kinderen uit deze groep worden op latere leeftijd nog geconfronteerd met uiteenlopende gezondheidsproblemen. Om een antwoord op die vragen te vinden, werd in 1983 het POPS-onderzoek opgezet, waarin bijna alle kinderen die in dat jaar te vroeg ter wereld kwamen, konden worden betrokke

Cultural paradigm shifts in socio-technical transitions towards sustainable cities: A case study of the transportation system of São Paulo

Transportation is a key component of the urban realm due to its high fossil fuel consumption, GHG emissions and pollution generation (among other negative externalities) that have been aggravated by an individual motor vehicle-driven society. In order to achieve a balanced urban growth for the future, the transportation paradigm requires a complete shift that will depend upon a change on people’s behaviors and perceptions about mobility. Being the biggest, most populous city of Brazil and the western hemisphere, as well as the financial motor behind the country’s economy, São Paulo currently faces a very serious transportation problem: an extremely high car per capita ratio in conjunction with a deficient public transport network. Furthermore, socioeconomic disparities exert an additional pressure to this dilemma, limiting the access to mobility and deeply embedding the car from a cultural standpoint. Given its prominence, São Paulo is the ideal city to evaluate how specific cultural and socio- spatial niches can steer a cultural paradigm shift that could ultimately trigger a socio-technical transition towards sustainability. In this case study, the role of policies, technology, and infrastructure as policymaking instruments are analyzed in the context of urban spaces in emergent nations, where political and economic structures are strong social determinants. Moreover, this study has shown how these instruments could not only produce a new set of mobility practices (or a new transportation culture) but also the creation of an equitable and thriving urban environment.

Beleid van Nederlandse gynaecologen en kinderartsen bij (dreigende) extreme vroeggeboorte wisselt sterk.

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