Increasing maternal age at first pregnancy planning: Health outcomes and associated costs

Objectives: To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design: Decision model based on data from perinatal registries and the literature. Setting: The Netherlands. Population: 3 hypothetical cohorts of 100 000 women aged 23, 29 and 36 years, planning a first pregnancy. Main outcome measures: Live birth, pregnancy complications for mother and child and associated healthcare costs. Results: For the three cohorts of 23-, 29- and 36-yearold women, 1.6%, 4.6% and 14% of women would not succeed in an ongoing pregnancy (spontaneous or after assisted reproductive technolo

Decrease in foetal and neonatal mortality in the Netherlands; comparison with other Euro-Peristat countries in 2004, 2010 and 2015

OBJECTIVE: To compare changes in foetal, neonatal and perinatal mortality in the Netherlands in 2015, relative to 2004 and 2010, with changes in other European countries and regions. DESIGN: Descriptive population-wide study. METHOD: Data from 32 European countries and regions within the Euro-Peristat registration area were analysed. These countries and regions were grouped into: the Netherlands, Scandinavia, Western Europe and Eastern Europe. International differences in registration and policies were taken into account by using rates from 28 weeks gestation for foetal mortality and for 24 weeks gestation and beyond for neonatal mortality. Ranking was based on individual countries and regions. RESULTS: Foetal mortality decreased by 24% in the Netherlands, from 2.9 per 1,000 births in 2010 to 2.2 per 1,000 births in 2015; neonatal mortality decreased by 9%, from 2.2 to 2.0 per 1,000 live births. Perinatal mortality (the sum of foetal mortality and neonatal mortality) decreased by 18% from 5.1 to 4.2 per 1,000 births. The Netherlands moved from the 18th place in the European ranking in 2004 to the 10th place in 2015. CONCLUSION: Foetal, neonatal and perinatal mortality in the Netherlands decreased in 2015 when compared with 2004 and 2010. The country's position in the European ranking also improved. Explanations for this decrease are related to changes in the areas of organisation of care, population and risk factors. When mortality rates in other European countries and regions - particularly Scandinavia - are considered there is room for further improvement

Differences in perinatal mortality in Amsterdam

__Doel__ In Amsterdam werd onderzocht of er per stadsdeel verschillen waren in perinatale sterfte en of deze verklaard konden worden door risicofactoren zoals etniciteit en sociaaleconomische status (SES). __Opzet__ Cohortonderzoek. __Methode__ Het onderzoek had betrekking op 73.661 eenlinggeboorten in Amsterdam, Diemen en Ouder-Amstel, vastgelegd in de Perinatale Registratie Nederland over de jaren 2000-2006. Met logistische regressieanalyse werd bepaald of perinatale sterfte verschilde per stadsdeel, waarbij rekening werd gehouden met risicofactoren.