Trends in preterm birth in the Netherlands in 2011–2019: a population-based study

Looking back on preterm birth – The successes and failures

“…Considering that late‐onset preterm birth (delivery between 34 and 36 weeks of gestation) constitutes roughly 70% of all iatrogenic preterm deliveries, this shift in practice is likely to have had a significant impact on preterm birth rates in the Netherlands. 2 …”

“…have shown no difference in the preterm birth rates of small‐for‐gestational‐age fetuses over the last decade. 2 A multicenter randomized control trial addressing optimal timing of delivery in late preterm small‐for‐gestational‐age fetuses is currently underway and we remain optimistic that the results will help to address preterm birth rates within this specific population group. 7 In the setting of HDP, emerging evidence now supports the use of prediction models for preeclampsia with prescription of low‐dose aspirin in those at high risk reducing the rates of preterm disease by 62%.…”

“…demonstrated a mere 0.06% decline in spontaneous preterm birth rates over the last decade. 2 This could be caused by (a) the poor performance of prediction models, (b) the limited effectiveness of preventive treatments, or (c) the lack of implementation of good‐quality evidence. The two main tenets of predicting spontaneous preterm birth are maternal characteristics and transvaginal cervical length.…”

“…In the Netherlands, the progress made in reducing preterm birth in singleton pregnancies does not seem to extend to multiple gestations. 2 This reflects the scarcity of evidence regarding the prediction of preterm birth in multiple pregnancies and the lack of interventions to prevent this outcome. Therefore, the opportunity to reduce preterm birth rates in this population group involves reducing the incidence of multiple pregnancies in the first place.…”

“…have explored trends in preterm birth in the Netherlands between 2011 and 2019. 2 They demonstrated an encouraging decline in overall preterm birth from 5.45% to 5.08% in singleton pregnancies over the course of 10 years with no change to the preterm birth rates among multiple gestations. This decline was predominantly driven by iatrogenic preterm birth (from 1.77% to 1.34%) with a modest fall in the spontaneous preterm birth rates (from 3.68% to 3.62%).…”