Abstract
BackgroundResearch in maternity care is often conducted in mixed low and high-risk or solely high-risk populations. This limits generalizability to the low-risk population of pregnant women receiving care from Dutch midwives. To address this limitation, 24 midwifery practices in the Netherlands bring together routinely collected data from medical records of pregnant women and their offspring in the VeCaS database. This database offers possibilities for research of physiological pregnancy and childbirth. This study explores if the pregnant women in VeCaS are a representative sample for the national population of women who receive primary midwife-led care in the Netherlands.MethodsIn VeCaS we selected a low risk population in midwife-led care who gave birth in 2015. We compared population characteristics and birth outcomes in this study cohort with a similarly defined national cohort, using Chi Square and two side t-test statistics. Additionally, we describe some birth outcomes and lifestyle factors.ResultsMidwifery practices contributing to VeCaS are spread over the Netherlands, although the western region is underrepresented. For population characteristics, the VeCaS cohort is similar to the national cohort in maternal age (mean 30.4 years) and parity (nulliparous women: 47.1% versus 45.9%). Less often, women in the VeCaS cohort have a non-Dutch background (15.7% vs 24.4%), a higher SES (9.9% vs 23.7%) and live in an urbanised surrounding (4.9% vs 24.8%). Birth outcomes were similar to the national cohort, most women gave birth at term (94.9% vs 94.5% between 37 + 0–41+ 6 weeks), started labour spontaneously (74.5% vs 75.5%) and had a spontaneous vaginal birth (77.4% vs 77.6%), 16.9% had a home birth. Furthermore, 61.1% had a normal pre-pregnancy BMI, and 81.0% did not smoke in pregnancy.ConclusionsThe VeCaS database contains data of a population that is mostly comparable to the national population in primary midwife-led care in the Netherlands. Therefore, the VeCaS database is suitable for research in a healthy pregnant population and is valuable to improve knowledge of the physiological course of pregnancy and birth. Representativeness of maternal characteristics may be improved by including midwifery practices from the urbanised western region in the Netherlands.
Highlights
Research in maternity care is often conducted in mixed low and high-risk or solely high-risk populations
The aim of this study is to examine if pregnant women registered in Verloskundig Casusregistratie Systeem (VeCaS) offer a representative reflection of the national population of women who receive primary care in midwifery practices in the Netherlands, considering maternal and pregnancy characteristics
We excluded women who gave birth before 28 weeks or at an unknown gestational age, women who were transferred to obstetrician-led care before 28 weeks, women who had a multiple pregnancy and women whose antenatal care in the midwifery practice ended for non-medical reasons such as moving out of the practice area
Summary
Research in maternity care is often conducted in mixed low and high-risk or solely high-risk populations. This limits generalizability to the low-risk population of pregnant women receiving care from Dutch midwives To address this limitation, 24 midwifery practices in the Netherlands bring together routinely collected data from medical records of pregnant women and their offspring in the VeCaS database. 24 midwifery practices in the Netherlands bring together routinely collected data from medical records of pregnant women and their offspring in the VeCaS database This database offers possibilities for research of physiological pregnancy and childbirth. Midwives are ‘gatekeepers’ and refer women to a secondary care obstetric team if risk factors or complications arise during pregnancy, labour or after birth Interventions such as augmentation of labour, pharmacological pain relief, continuous foetal monitoring or instrumental birth are only accessible in secondary care [1,2,3].
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