Perinatal death beyond 41 weeks pregnancy: an evaluation of causes and substandard care factors as identified in perinatal audit in the Netherlands

Kortekaas, Joep C.; Scheuer, Anke C.; Miranda, Esteriek de; Dijk, Aimée E. van; Bruinsma, Aafke; Mol, Ben Willem J.; Vandenbussche, Frank P.H.A.; Dillen, Jeroen van

doi:10.1186/s12884-018-1973-0

Cited by 17 publications

(14 citation statements)

References 43 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, follow-up on improvement actions was not documented, and definitions of diagnoses and many laboratory tests were not recorded in the PAA database. Using International Classification of Disease (ICD) codes and addition of few more obligatory characteristics will probably increase the appropriateness of this database for future studies 17. Inherent to the retrospective nature of the analyses, some data were missing.…”

Section: Discussionmentioning

confidence: 99%

Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit

Geest

Rosman

Bergman

et al. 2022

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

ObjectivesTo describe characteristics of neonates with severe neonatal hyperbilirubinaemia (SNH) and to gain more insight in improvable factors that may have contributed to the development of SNH.Design and settingDescriptive study, based on national Dutch perinatal audit data on SNH from 2017 to 2019.PatientsNeonates, born ≥35 weeks of gestation and without antenatally known severe blood group incompatibility, who developed hyperbilirubinaemia above the exchange transfusion threshold.Main outcome measuresCharacteristics of neonates having SNH and corresponding improvable factors.ResultsDuring the 3-year period, 109 neonates met the eligibility criteria. ABO antagonism was the most frequent cause (43%). All neonates received intensive phototherapy and 30 neonates (28%) received an exchange transfusion. Improvable factors were mainly related to lack of knowledge, poor adherence to the national hyperbilirubinaemia guideline, and to incomplete documentation and insufficient communication of the a priori hyperbilirubinaemia risk assessment among healthcare providers. A priori risk assessment, a key recommendation in the national hyperbilirubinaemia guideline, was documented in only six neonates (6%).ConclusionsSNH remains a serious threat to neonatal health in the Netherlands. ABO antagonism frequently underlies SNH. Lack of compliance to the national guideline including insufficient a priori hyperbilirubinaemia risk assessment, and communication among healthcare providers are important improvable factors. Implementation of universal bilirubin screening and better documentation of the risk of hyperbilirubinaemia may enhance early recognition of potentially dangerous neonatal jaundice.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit

Geest

Rosman

Bergman

et al. 2022

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

show abstract

“…18 In the present study, we focused on singleton births and excluded postterm births (gestational age, ≥42 weeks and 0 days [5.6%]), considering that infant deaths in postterm pregnancies are mainly due to utero-placental insufficiency, meconium aspiration, intrauterine infection, or intrapartum and neonatal asphyxia, rather than inappropriate GWG. 19 , 20 We also excluded incomplete records (12.8%) missing on GWG or BMI (eFigure in the Supplement ). This study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline for cohort studies.…”

Section: Methodsmentioning

confidence: 99%

Association of Gestational Weight Gain With Infant Morbidity and Mortality in the United States

et al. 2021

View full text Add to dashboard Cite

IMPORTANCEThe associations of gestational weight gain (GWG) with infant morbidity and mortality are unclear, and the existing recommendations for GWG have not been stratified by the severity of obesity.OBJECTIVES To identify optimal GWG ranges associated with reduced risks of infant morbidity and mortality across maternal body mass index (BMI) categories. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study used US nationwide, linked birth and infant death data between 2011 and 2015 to assess the associations of GWG in 2.0-kg groups with infant morbidity and mortality and identified optimal GWG ranges associated with reduced risks of both outcomes, using multivariable logistic regression models. Statistical analysis was performed from February 11 to October 14, 2021.EXPOSURE Gestational weight gain equivalent to 40 weeks. MAIN OUTCOMES AND MEASURESThe 2 main outcomes were (1) significant morbidity of the newborn infant, defined as any presence of assisted ventilation, admission to the neonatal intensive care unit, surfactant therapy, antibiotic therapy, or seizures; and (2) infant mortality younger than 1 year of age (<1 hour, 1-23 hours, 1-6 days, 7-27 days, or 28-365 days after birth). RESULTSIn this study of 15 759 945 mother-infant dyads, the mean (SD) age of the women was 28.1 (5.9) years. Women gained a mean (SD) of 14.1 (7.3) kg during pregnancy, and the mean (SD) GWG decreased with BMI categories (underweight, 15.

show abstract

“…National audit programs should be implemented in other high-income countries to further reduce perinatal mortalities. Deliveries of 42 weeks or more, which is a risk factor for perinatal mortality, is reduced in the Netherlands by more referral and active management [12,30].…”

Section: Interpretation/clinical Implications and Future Researchmentioning

confidence: 99%

“…This resulted in a reduction in serious congenital abnormalities after 24 weeks [11]. Pregnant women with gestational age > 41 weeks are earlier referred from a midwife to an obstetrician for foetal condition assessment and possible induction of labour [12][13][14]. To improve perinatal health inequalities "Healthy pregnancy for all" programmes were funded for several municipalities with increased perinatal mortality risk [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Decreasing trend in preterm birth and perinatal mortality, do disparities also decline?

et al. 2020

View full text Add to dashboard Cite

Background: In the Netherlands, several initiatives started after the publication of the PERISTAT findings that showed the perinatal mortality risk was higher than in other European countries. The objective of this study is 1) to report recent trends in perinatal mortality and in intermediate risk groups (preterm birth, congenital anomalies and small for gestational age (SGA)), 2) describing perinatal mortality risk among children born preterm, with congenital anomalies or SGA, and born in maternal high risk groups (parity, age, ethnicity and socioeconomic status (SES)). Methods: A nationwide cohort study in the Netherlands among 996,423 singleton births in 2010-2015 with a gestational age between 24.0 and 42.6 weeks. Trend tests, univariate and multivariable logistic regression analyses were used. We did separate analyses for gestational age subgroups and line of care. Results: The perinatal mortality rate was 5.0 per 1000 and it decreased significantly from 5.6 in 2010 to 4.6 per 1000 in 2015. Preterm birth significantly declined (6.1% in 2010 to 5.6% in 2015). Analysis by gestational age groups showed that the largest decline in perinatal mortality of 32% was seen at 24-27 weeks of gestation where the risk declined from 497 to 339 per 1000. At term, the decline was 23% from 2.2 to 1.7 per 1000. The smallest decline was 3% between 32 and 36 weeks. In children with preterm birth, congenital anomalies or SGA, the perinatal mortality risk significantly declined. Main risk factors for perinatal mortality were African ethnicity (adjusted odds ratio (aOR) 2.1 95%CI [1.9-2.4]), maternal age ≥ 40 years (aOR1.9 95%CI [1.7-2.2]) and parity 2 + (aOR 1.4 95%CI [1.3-1.5]). Among the (post)term born neonates, there was no significant decline in perinatal mortality in women with low age, low or high SES, non-Western ethnicity and among women who started or delivered under primary care. Conclusions: There is a decline in preterm birth and in perinatal mortality between 2010 and 2015. The decline in perinatal mortality is both in stillbirths and in neonatal mortality, most prominently among 24-27 weeks and among (post)term births. A possible future target could be deliveries among 32-36 weeks, women with high maternal age or non-Western ethnicity.

show abstract

Perinatal death beyond 41 weeks pregnancy: an evaluation of causes and substandard care factors as identified in perinatal audit in the Netherlands

Cited by 17 publications

References 43 publications

Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit

Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit

Association of Gestational Weight Gain With Infant Morbidity and Mortality in the United States

Decreasing trend in preterm birth and perinatal mortality, do disparities also decline?

Contact Info

Product

Resources

About