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To compare changes in foetal, neonatal and perinatal mortality in the Netherlands in 2015, relative to 2004 and 2010, with changes in other European countries and regions.Descriptive population-wide study.Data from 32 European countries and regions within the Euro-Peristat registration area were analysed. These countries and regions were grouped into: the Netherlands, Scandinavia, Western Europe and Eastern Europe. International differences in registration and policies were taken into account by using rates from 28 weeks gestation for foetal mortality and for 24 weeks gestation and beyond for neonatal mortality. Ranking was based on individual countries and regions.Foetal mortality decreased by 24% in the Netherlands, from 2.9 per 1,000 births in 2010 to 2.2 per 1,000 births in 2015; neonatal mortality decreased by 9%, from 2.2 to 2.0 per 1,000 live births. Perinatal mortality (the sum of foetal mortality and neonatal mortality) decreased by 18% from 5.1 to 4.2 per 1,000 births. The Netherlands moved from the 18th place in the European ranking in 2004 to the 10th place in 2015.Foetal, neonatal and perinatal mortality in the Netherlands decreased in 2015 when compared with 2004 and 2010. The country's position in the European ranking also improved. Explanations for this decrease are related to changes in the areas of organisation of care, population and risk factors. When mortality rates in other European countries and regions - particularly Scandinavia - are considered there is room for further improvement.

To compare the change in foetal and neonatal mortality in the Netherlands between 2004 and 2010 with the change in other European countries.Descriptive, population-based study.Data from the Euro-Peristat project on foetal and neonatal mortality in European countries were analysed for changes between 2004 and 2010. The Netherlands was compared with 26 other European countries and regions. International differences in registration and policy were taken into account using figures on foetal mortality starting at 28 weeks of pregnancy and neonatal mortality starting at 24 weeks of pregnancy.Foetal mortality in the Netherlands declined by 33%, from 4.3 per 1000 births in 2004 to 2.9 per 1000 births in 2010 while neonatal mortality declined by 21%, from 2.8 per 1000 live births in 2004 to 2.2 per 1000 live births in 2010. Perinatal mortality (the sum of foetal mortality and neonatal mortality) declined by 27%, from 7.0 to 5.1 per 1000. In the European ranking, the Netherlands shifted from 23rd to 13th place for foetal mortality; it remained the same for neonatal mortality (15th of 22 countries) and virtually the same for perinatal mortality (from 15th to 13th of 22 countries).Both foetal mortality at 28+ weeks and neonatal mortality at 24+ weeks declined in the Netherlands between 2004 and 2010. However, the relatively unfavourable position of the Netherlands in the European ranking for foetal and neonatal mortality improved only for foetal mortality. In that respect, the Netherlands holds an average position.

Results from the Euro-Peristat project in 2000 and 2004 showed the Netherlands to have higher perinatal mortality rates and a slower rate of decline than in other European countries. Recent results from the 2010 Euro-Peristat project have shown a substantial decline in both foetal and neonatal mortality rates and an improved position in the European ranking. However, the comparison of the Netherlands to countries with similar population characteristics and healthcare systems puts this position in a different perspective. Continuing effort will be necessary to improve perinatal health and care in the Netherlands.

To gain insight in recent perinatal mortality figures in The Netherlands and their relation with important risk factors, risk groups and risk selection among pregnant women.Retrospective cohort study.The National Obstetrical Registrations and the National Neonatal Registration were linked into The Netherlands Perinatal Registry to prevent double counting. From this database, data on 1.3 million births in the years 2000-2006 were analysed with perinatal mortality as outcome measure.In 2006, perinatal mortality was 9.8 per 1000 total births (foetal mortality 6.8 per 1000 births and early neonatal mortality 3.1 per 1000 live births). Maternal age (20 andor = 40 years) and high multiparity (or = 4) were risk factors for perinatal mortality but showed low prevalence (3%). Non-Western ethnicity and nulliparity were important risk factors (relative risk of both 1.4) with a prevalence of 16% and 46%, respectively. The very preterm births (22.0-25.6 weeks of gestation) provided 29% ofall perinatal mortality with a mortality risk of 935 per 1000 births. Full-term births (or = 37.0 weeks) accounted for 26% of all perinatal mortality with a mortality risk of 2.8 per 1000 births. In the full-term born group, perinatal mortality was 0.4 per 1000 births in home births, 2.7 per 1000 births in outpatient clinics and 4.5 per 1000 births when the women were referred to the gynaecologist before start of labour.At a population level, low or high maternal age and high parity are less important risk factors than expected. More detailed research is indicated into the mortality ofvery preterm births but also offull-term born children.

Doel. Vergelijking van de perinatale sterfte in Nederland met die in andere Europese landen (Peristat-II) en met gegevens van vijf jaar eerder (Peristat-I). Opzet. Beschrijvend onderzoek. Methode. Indicatoren voor perinatale sterfte die ontwikkeld waren voor Peristat-I werden in Peristat-II opnieuw gebruikt. Gegevens over perinatale sterfte in het jaar 2004 werden aangeleverd door 26 Europese landen. De Nederlandse gegevens waren afkomstig uit de Landelijke Verloskunde Registratie van verloskundigen en gynaecologen en uit de Landelijke Neonatologie Registratie. Resultaten. In Peristat-I had Nederland vanaf 22 weken zwangerschapsduur het hoogste foetale sterftecijfer (7,4 per 1000 in totaal geborenen). Op Griekenland na had Nederland bovendien het hoogste vroege neonatale sterftecijfer (3,5 per 1000 levendgeborenen). In Peristat-II heeft Nederland vanaf 22 weken zwangerschapsduur na Frankrijk het hoogste foetale sterftecijfer (7,0 per 1000 in totaal geborenen). Van alle West-Europese landen heeft Nederland het hoogste vroege neonatale sterftecijfer (3,0 per 1000 levendgeborenen). De Nederlandse perinatale sterfte is in 5 jaar afgenomen van 10,9 naar 10,0 per 1000 in totaal geborenen, maar de afname is sneller in andere landen. Conclusie. Nederland heeft relatief veel oudere moeders en meerlingzwangerschappen, maar dit kan slechts een deel van de hoge perinatale sterfte verklaren. De Nederlandse perinatale sterfte neemt nog steeds een ongunstige positie in de Europese rangorde in. Er is meer onderzoek nodig om inzicht te krijgen in de Nederlandse prevalentie van risicofactoren voor perinatale sterfte ten opzichte van andere Europese landen. Daarnaast verdienen de perinatale gezondheid en de kwaliteit van de perinatale gezondheidszorg een prominentere plaats in Nederlandse onderzoeksprogramma’s.

Doel. Vergelijking van de perinatale sterfte in Nederland met die in andere Europese landen (Peristat-II) en met gegevens van vijf jaar eerder (Peristat-I). Opzet. Beschrijvend onderzoek. Methode. Indicatoren voor perinatale sterfte die ontwikkeld waren voor Peristat-I werden in Peristat-II opnieuw gebruikt. Gegevens over perinatale sterfte in het jaar 2004 werden aangeleverd door 26 Europese landen. De Nederlandse gegevens waren afkomstig uit de Landelijke Verloskunde Registratie van verloskundigen en gynaecologen en uit de Landelijke Neonatologie Registratie. Resultaten. In Peristat-I had Nederland vanaf 22 weken zwangerschapsduur het hoogste foetale sterftecijfer (7,4 per 1000 in totaal geborenen). Op Griekenland na had Nederland bovendien het hoogste vroege neonatale sterftecijfer (3,5 per 1000 levendgeborenen). In Peristat-II heeft Nederland vanaf 22 weken zwangerschapsduur na Frankrijk het hoogste foetale sterftecijfer (7,0 per 1000 in totaal geborenen). Van alle West-Europese landen heeft Nederland het hoogste vroege neonatale sterftecijfer (3,0 per 1000 levendgeborenen). De Nederlandse perinatale sterfte is in 5 jaar afgenomen van 10,9 naar 10,0 per 1000 in totaal geborenen, maar de afname is sneller in andere landen. Conclusie. Nederland heeft relatief veel oudere moeders en meerlingzwangerschappen, maar dit kan slechts een deel van de hoge perinatale sterfte verklaren. De Nederlandse perinatale sterfte neemt nog steeds een ongunstige positie in de Europese rangorde in. Er is meer onderzoek nodig om inzicht te krijgen in de Nederlandse prevalentie van risicofactoren voor perinatale sterfte ten opzichte van andere Europese landen. Daarnaast verdienen de perinatale gezondheid en de kwaliteit van de perinatale gezondheidszorg een prominentere plaats in Nederlandse onderzoeksprogramma’s.