title: Confidential enquiry into maternal deaths in The Netherlands 1983-1992.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Diakonessenhuis Utrecht, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Schuitemaker
authors.forename: J
authors.initials: J
authors.lastname: van Roosmalen
authors.forename: G
authors.initials: G
authors.lastname: Dekker
authors.forename: P
authors.initials: P
authors.lastname: van Dongen
authors.forename: H
authors.initials: H
authors.lastname: van Geijn
authors.forename: J
authors.initials: J
authors.lastname: Bennebroek Gravenhorst
mesh_terms: 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