Perinatal mortality in preterm births: an analysis of causes, presence of substandard care and avoiding mortality in three Dutch regions

Objective: To analyze the causes and underlying events in cases of perinatal mortality (PNM) in preterm children. Setting: Three regions within the Netherlands. Study design: For this study, we combined data of a PNM audit over a 1-year (2003-2004) with the corresponding data of its source population (n=22,189). In the perinatal audit, all cases of perinatal death have been assessed by multi disciplinary teams of professionals in perinatal care in a consensus model for cause of death and the presence of substandard care factors (SSF). In this article, we restricted our analysis to children born between 22+0 and 37+0 weeks of pregnancy (>= 154 and = 25 weeks] and previous PNM (21.1%). In addition, PPM was substantially increased in mothers of non-Dutch origin (PPM 12.1% vs. 6.6% in children of Dutch mothers relative risk (RR) =1.88, 95% confidence intervals 1.46-2.43) and in mothers in the age group 20-26 years (PPM 13.4% vs.