Confidential enquiry into maternal deaths in The Netherlands 1983-1992.
OBJECTIVE
To determine the causes of maternal death in The Netherlands.


METHODS
Nationwide Confidential Enquiry into the Causes of Maternal Deaths during the period 1983-1992.


RESULTS
Of 192 direct and indirect maternal deaths, 154 (80%) were available for the Enquiry. The most frequent direct causes were (pre-)eclampsia, thrombo-embolism, obstetrical haemorrhage and sepsis. Cerebro- and cardiovascular disorders were the most frequent indirect causes of death. Age above 35 years and parity 3 or more are related to higher maternal mortality. Women from non-caucasian origin are more prone to death in comparison to caucasian women. Autopsy was performed in 88 cases (57%). Of the 24 women where labour started at home, the place of birth played a significant role in delay in four.


CONCLUSIONS
More efforts should be made to have a higher percentage than 80% available for the Confidential Enquiry as in the UK where only 1-4% of deaths are not available for similar purposes. Also, the autopsy rate of 57% is much lower than in the UK (82%). Special strategies should be developed to improve maternal health of populations at higher risk such as women of high age and parity and immigrant populations.
Schuitemaker
N
N
Department of Obstetrics and Gynaecology, Diakonessenhuis Utrecht, The Netherlands.
van Roosmalen
J
J
Dekker
G
G
van Dongen
P
P
van Geijn
H
H
Bennebroek Gravenhorst
J
J
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D003219:Confidentiality; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011795:Surveys and Questionnaires