Responses

Download PDFPDF

Intrapartum and neonatal mortality among low-risk women in midwife-led versus obstetrician-led care in the Amsterdam region of the Netherlands: a propensity score matched study
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses [https://authors.bmj.com/after-submitting/rapid-responses/].
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses [https://www.bmj.com/company/journals-terms-and-conditions-for-rapid-responses/] and understand that your personal data will be processed in accordance with those terms and our privacy notice [https://www.bmj.com/company/your-privacy/].
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Lack of reliable data confuses discussion on safety of midwife-led and obstetrician-led care
    • Ank De Jonge, Associate professor Midwifery Science Department of Midwifery Science AVAG/ Amsterdam Public Health research institute VU University Medical Center Amsterdam.
    • Other Contributors:
      • Francois Schellevis, Professor of General Practice

    With interest we read the article of Wiegerinck et al. on intrapartum and neonatal mortality among low-risk women in midwife-led versus obstetrician-led care based on case notes and data from the Dutch national perinatal database (PRN, nowadays called ‘Perined’). In a recent commentary we addressed some important pitfalls associated with the use of register-based data.1 Although the authors acknowledge the methodological challenges of their study, and the limitations of the Perined database, it is important to specify these issues in more detail. Secondly, we want to challenge the interpretation of the findings.
    In this study clinical information regarding the women and babies in the numerators and denominators for intrapartum and neonatal mortality rates were derived from different sources. For the numerators information on women and their babies who died was taken from case notes. For the denominators information was taken from the Perined database, in which information on risk factors is often missing. The authors show in their supplementary file that in a sample of 100 women who started labour in obstetrician-led care no information was recorded for 13% of women on one or more of the eight risk factors which were defined as exclusion criteria in this study. Most women with risk factors will have been removed from the numerator, because information was available in their case notes. On the other hand, an unknown number of women with risk factors were not removed f...

    Show More
    Conflict of Interest:
    None declared.