Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study
Objectives To study the effect of an urban perinatal health programme in Rotterdam, the Netherlands, on perinatal outcomes.Design A retrospective cohort study with difference-in-differences analysis using individual-level perinatal outcome data from the Dutch Perinatal Registry 2003–2014 linked to C...
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open |
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| author | Alex Burdorf Jasper V Been Hendrik CC de Jonge Jacqueline Lagendijk Unnati Saha |
| author_facet | Alex Burdorf Jasper V Been Hendrik CC de Jonge Jacqueline Lagendijk Unnati Saha |
| author_sort | Alex Burdorf |
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| description | Objectives To study the effect of an urban perinatal health programme in Rotterdam, the Netherlands, on perinatal outcomes.Design A retrospective cohort study with difference-in-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-gestational-age 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. |
| format | Article |
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| issn | 2044-6055 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-0bc4f59232d14891a26dbadd186b87db2025-08-20T01:55:45ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-031357Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort studyAlex Burdorf0Jasper V Been1Hendrik CC de Jonge2Jacqueline Lagendijk3Unnati Saha41 Department of Public Health, Erasmus University Medical Center, Rotterdam, The NetherlandsDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands1 Department of Public Health, Erasmus MC, Rotterdam, The NetherlandsDepartment of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, The Netherlands1 Department of Public Health, Erasmus MC, Rotterdam, The NetherlandsObjectives To study the effect of an urban perinatal health programme in Rotterdam, the Netherlands, on perinatal outcomes.Design A retrospective cohort study with difference-in-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-gestational-age 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.https://bmjopen.bmj.com/content/9/10/e031357.full |
| spellingShingle | Alex Burdorf Jasper V Been Hendrik CC de Jonge Jacqueline Lagendijk Unnati Saha Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study BMJ Open |
| title | Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study |
| title_full | Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study |
| title_fullStr | Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study |
| title_full_unstemmed | Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study |
| title_short | Did an urban perinatal health programme in Rotterdam, the Netherlands, reduce adverse perinatal outcomes? Register-based retrospective cohort study |
| title_sort | did an urban perinatal health programme in rotterdam the netherlands reduce adverse perinatal outcomes register based retrospective cohort study |
| url | https://bmjopen.bmj.com/content/9/10/e031357.full |
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