Maternal mortality and serious maternal morbidity in Jehovah's witnesses in The Netherlands.
OBJECTIVE
To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in The Netherlands.


METHODS
A retrospective study of case notes.


METHODS
All tertiary care centres, general teaching hospitals and other general hospitals in The Netherlands.


METHODS
All cases of maternal mortality in The Netherlands between 1983 and 2006 and all cases of serious maternal morbidity in The Netherlands between 2004 and 2006.


METHODS
Study of case notes using two different nationwide enquiries over two different time periods.


METHODS
Maternal mortality ratio (MMR) and risk of serious maternal mortality.


RESULTS
The MMR for Jehovah's witnesses was 68 per 100,000 live births. We found a risk of 14 per 1000 for Jehovah's witnesses to experience serious maternal morbidity because of obstetric haemorrhage while the risk for the total pregnant population was 4.5 per 1000.


CONCLUSIONS
Women who are Jehovah's witnesses are at a six times increased risk for maternal death, at a 130 times increased risk for maternal death because of major obstetric haemorrhage and at a 3.1 times increased risk for serious maternal morbidity because of obstetric haemorrhage, compared to the general Dutch population.
Van Wolfswinkel
M E
ME
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Zwart
J J
JJ
Schutte
J M
JM
Duvekot
J J
JJ
Pel
M
M
Van Roosmalen
J
J
D000328:Adult; D001803:Blood Transfusion; D002423:Cause of Death; D005260:Female; D006470:Hemorrhage / Q000401:mortality* / Q000628:therapy; D006801:Humans; D033221:Jehovah's Witnesses; D008428:Maternal Mortality; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality* / Q000628:therapy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000592:standards; D012189:Retrospective Studies; D016312:Treatment Refusal