Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study

Erik Jonge*, Jacky Lagendijk, Unnati Saha, Jasper Been, Lex Burdorf

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
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Abstract

Objectives To study the effect of an urban perinatal health programme in Rotterdam, the Netherlands, on perinatal outcomes.Design A retrospective cohort study with differencein-differences analysis using individual-level perinatal outcome data from the Dutch Perinatal Registry 2003-2014 linked to Central Bureau of Statistics data of migration background and individual disposable household income.Intervention The programme consisted of perinatal health promotion, risk selection and risk-guided pregnancy care, and a new primary care child birth centre. The programme was implemented during 2009-2012.Primary outcome measures We compared trends in perinatal mortality, preterm delivery and small-for-gestational-age births between targeted urban neighbourhoods in Rotterdam (n=61 415) and all other urban neighbourhoods in the Netherlands (n=881 202). The effect of the programme was modelled as a change in trend of each perinatal outcome in the treatment group post intervention compared with the control population from January 2010 onwards. All analyses were adjusted for maternal age, parity, ethnicity and individual-level low socioeconomic status (SES). We also conducted a stratified analysis by SES.Results During 2003-2014, downward trends in perinatal mortality (adjusted OR (aOR) 0.9439 per year, 95% CI 0.9362 to 0.9517), preterm birth (aOR 0.9970 per year, 95% CI 0.9944 to 0.9997) and small-for-gestationalage births (aOR 0.9809 per year, 95% CI 0.9787 to 0.9831) in the entire study population were observed. No demonstrable changes in these trends were found in the intervention group after the programme had started. The stratified analyses by SES showed no changes in trends post intervention in both strata either.Conclusions The programme had no demonstrable effects on perinatal outcomes. The intervention may not have reached a sufficient proportion of the population or has provided too little contrast to the widespread attention for inequalities in pregnancy outcomes occurring simultaneously in the Netherlands.
Original languageEnglish
Article numbere031357
Number of pages9
JournalBMJ Open
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 2019

Bibliographical note

Funding;
JVB is supported by a personal fellowship from the Netherlands Lung
Foundation.

Research programs

  • EMC MM-03-54-04-A
  • EMC NIHES-02-65-01

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