Differences in maternal and perinatal outcomes between Dutch and non-Western women in a midwife-led care setting: a retrospective cohort study

• Published in: BMC pregnancy and childbirth 2024-11, Vol.24 (1), p.803-11, Article 803
• Main Authors: Ali, F, Horvat-Gitsels, L A, Bakker, P C A M, Verhoeven, C J M, van der Wal, J T Gitsels
• Format: Article
• Language: English
• Subjects: Adult; Apgar Score; Birth Weight; Birthweight; Body Mass Index; Cesarean section; Cohort analysis; Cultural differences; Data collection; Delivery, Obstetric - statistics & numerical data; Ethnicity; Ethnicity - statistics & numerical data; Female; Gestational Age; Hemorrhage; Hospitals; Humans; Infant, Newborn; Midwifery; Midwifery - statistics & numerical data; Netherlands - epidemiology; Obstetrics; Parity; Perinatal outcomes; Perineum; Postpartum Hemorrhage - epidemiology; Postpartum period; Pregnancy; Pregnancy Outcome - epidemiology; Premature birth; Prenatal care; Prenatal Care - statistics & numerical data; Retrospective Studies; Sociodemographics; Socioeconomic factors; Womens health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-024-06982-2

Previous research has shown that genetics and maternal medical, sociodemographic, lifestyle and psychosocial factors affect maternal and perinatal outcomes. Substantial research has been done on ethnic differences and maternal and perinatal outcomes in hospital settings. To our knowledge there are no studies about the associations between ethnicity and maternal and perinatal outcomes in a midwife-led care setting among low-risk women. Therefore, our study aimed to investigate possible ethnic associations between non-Western and Dutch women, and maternal and perinatal outcomes in a midwife-led care setting. A retrospective cohort study was performed of low-risk pregnant women (n = 977) in midwife-led care. Data was collected from a medium-sized midwifery practice in an urban region near Amsterdam, the Netherlands. Regression analyses were performed to examine the effect of ethnicity on maternal and perinatal outcomes. Outcomes of interest were gestational age, mode of birth, perineal status, postpartum hemorrhage, birthweight, perinatal death and low Apgar score. Associations were corrected for deprived areas, body mass index (BMI), parity and maternal educational level. Potential effect modification for prenatal referral to obstetrician and parity were assessed. The study included 977 women, of whom 483 were non-Western, and 494 were Dutch. Regarding characteristics, compared to Dutch women, non-Western women were more likely to be multiparous (respectively 58.6% versus 49.2%; p = 0.003), live in a deprived area (34.0% versus 8.1%; p