Abstract

Compared to previous years the Dutch perinatal mortality rates, as registered by CBS (Statistics Netherlands), showed a sudden decline in 2004. Despite a slight increase in 2005, a small decline in perinatal mortality is noticeable in the course of a slightly longer period (2000-2004/2005). The relatively strong decline in perinatal mortality in the year 2004 may have been caused by a statistical fluctuation. Trends in underlying risk factors were analysed for possible other explanations. In the period 2000 the share of births to older mothers (35+) and to mothers belonging to non western ethnic minority groups has increased slightly. The prevalence of pregnant women with obesity probably increased as well, but proper data are lacking. These are all unfavourable influences on the perinatal mortality risk. Some aspects of healthcare and prevention with a possible beneficial effect on perinatal mortality appear to have been improved, however. Earlier shortages in admission capacity for neonatal intensive care have decreased over the period 2000 2005, policies on term breech presentation have been changed and in IVF single instead of multiple embryo transfer has been used more often. Research has indicated that recently Dutch pregnant women smoke less frequently. In addition, the uptake of folic acid by pregnant women might have improved. For the time being the observed improvements in healthcare, prevention and lifestyle have compensated the increased occurrence in the mentioned risk factors. But a further decrease in perinatal mortality will require further improvements in quality of perinatal care and prevention.