title: Maternal mortality and serious maternal morbidity in Jehovah's witnesses in The Netherlands.
abstract: 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.
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Van Wolfswinkel
authors.forename: J J
authors.initials: JJ
authors.lastname: Zwart
authors.forename: J M
authors.initials: JM
authors.lastname: Schutte
authors.forename: J J
authors.initials: JJ
authors.lastname: Duvekot
authors.forename: M
authors.initials: M
authors.lastname: Pel
authors.forename: J
authors.initials: J
authors.lastname: Van Roosmalen
mesh_terms: 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