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Biomedical subjects

S E Buitendijk

Publications and source records attributed to S E Buitendijk.

At least 19 recordsLinked to original sources

GP-initiated preconception counselling in a randomised controlled trial does not induce anxiety.

BACKGROUND: Preconception counselling (PCC) can reduce adverse pregnancy outcome by addressing risk factors prior to pregnancy. This study explores whether anxiety is induced in women either by the offer of PCC or by participation with GP-initiated PCC. METHODS: Randomised trial of usual care versus GP-initiated PCC for women aged 18-40, in 54 GP practices in the Netherlands. Women completed the six-item Spielberger State Trait Anxiety Inventory (STAI) before PCC (STAI-1) and after (STAI-2). After pregnancy women completed a STAI focusing on the first trimester of pregnancy (STAI-3). RESULTS: The mean STAI-1-score (n = 466) was 36.4 (95% CI 35.4-37.3). Following PCC there was an average decrease of 3.6 points in anxiety-levels (95% CI, 2.4-4.8). Mean scores of the STAI-3 were 38.5 (95% CI 37.7-39.3) in the control group (n = 1090) and 38.7 (95% CI 37.9-39.5) in the intervention group (n = 1186). CONCLUSION: PCC from one's own GP reduced anxiety after participation, without leading to an increase in anxiety among the intervention group during pregnancy. We therefore conclude that GPs can offer PCC to the general population without fear of causing anxiety.

Adolescent↗

Ethnic differences in congenital malformations in the Netherlands: analyses of a 5-year birth cohort.

Congenital malformations are among the major causes of perinatal mortality and morbidity at present. Research into the ethnic diversity of congenital malformations can form a basis both for aetiological studies and for health care advice and planning. This study compared the overall prevalence of congenital malformations, the prevalence in different organ systems and of several specific malformations between different maternal ethnic groups in the Netherlands using a 5-year national birth cohort (1996-2000) containing 881 800 births. Maternal ethnic groups considered were Dutch; Mediterranean (Moroccan/Turkish); other European; Black; Hindu and Asian. Mediterranean women had a 20% higher risk of having a child with a congenital malformation than Dutch women (age-adjusted OR = 1.21 [95% CI 1.16, 1.27]). They showed an increased risk of malformations in several organ systems such as the central nervous system and sensory organs, the urogenital system and skin and abdominal wall. Further, they had an increased risk of the group of chromosomal malformations/multiple malformations/syndromes. For the specific group of multiple malformations the maternal age adjusted OR was 1.80 [95% CI 1.47, 2.20]. The Black group showed a significantly increased risk of skeletal and muscular malformations (age adjusted OR = 1.76 [95% CI 1.53, 2.02]) with a sixfold increased risk of polydactyly compared with the Dutch group. For Mediterranean women, the largest and fastest growing group of immigrants in the Netherlands, this study demonstrated an increased risk of congenital malformations.

Abdominal Wall↗

Maternal factors and the probability of a planned home birth.

OBJECTIVES: In the Netherlands, approximately one-third of births are planned home births, mostly supervised by a midwife. The relationship between maternal demographic factors and home births supervised by midwives was examined. DESIGN: Cross-sectional study. Setting Dutch national perinatal registries of the year 2000. POPULATION: All women starting their pregnancy care under the supervision of a midwife, because these women have the possibility of having a planned home birth. METHODS: The possible groups of birth were as follows: planned home birth or short stay hospital birth, both under the supervision of a midwife, or hospital birth under the supervision of an obstetrician after referral from the midwife during pregnancy or birth. The studied demographic factors were maternal age, parity, ethnicity and degree of urbanisation. Probabilities of having a planned home birth were calculated for women with different demographic profiles. MAIN OUTCOME MEASURE: Place of birth. RESULTS: In all age groups, the planned home birth percentage in primiparous women was lower than in multiparous women (23.5%vs 42.8%). A low home birth percentage was observed in women younger than 25 years. Dutch and non-Dutch women showed almost similar percentages of obstetrician-supervised hospital births but large differences in percentage of planned home births (36.5%vs 17.3%). Fewer home births were observed in large cities (30.5%) compared with small cities (35.7%) and rural areas (35.8%). CONCLUSIONS: This study demonstrates a clear relationship between maternal demographic factors and the place of birth and type of caregiver and therefore the probability of a planned home birth.

Adult↗

[High perinatal mortality in the Netherlands compared to the rest of Europe].

In the Peristat-project, a European collaborative study, a set of indicators has been defined for monitoring perinatal health outcomes. For a group of 10 core indicators, with variables for subgroup analysis, national registry data from 15 European member states were collected and compared. The Netherlands was found to have the highest perinatal mortality in Europe: the foetal and neonatal mortality amounted to 7.4 and 3.5 per 1000 births, respectively. European countries differ in registration practices. Some countries do not register perinatal deaths occurring before a duration of amenorrhoea of 28 weeks. Therefore, the Peristat mortality data should be compared with 28 weeks of gestation as a cut-off point. With this cut-off point, The Netherlands has the second highest perinatal mortality. A number of factors may have contributed to this relatively high mortality, such as differences in registration practices, the profile of the Dutch childbearing population and the characteristics of Dutch perinatal care. The Netherlands has a relatively high proportion of older mothers, multiple births and mothers belonging to an ethnic minority. Also, Dutch neonatologists are known to be conservative in their treatment of premature newborns, which reduces their chances of survival. There is also less prenatal screening for congenital abnormalities in The Netherlands than in many other European countries. Further analysis of the Dutch data, as well as continued monitoring at the European level, can serve as a basis for future policy decisions to enhance the health of Dutch mothers and newborns.

Data Collection↗

Health-related quality of life in relation to gender and age in couples planning IVF treatment.

BACKGROUND: Specific subgroups of people planning IVF might be at risk of having more psychological or health-related problems. Identification of subgroups at risk may better enable allocation of appropriate counselling. METHODS: A group of 425 men and 447 women planning to undergo IVF treatment filled out a questionnaire. Four domains of health-related quality of life were measured, namely perceived emotional, physical, cognitive and social functioning. RESULTS: Young men and women (aged 21-30 years) planning IVF had more short-term social and emotional problems than people of the same age group in the general population. No substantial differences were found in cognitive and physical functioning for all age groups of men nor women planning IVF compared with the general population. A high level of irrational parenthood cognitions substantially accounted for a less optimal score on all the different domains of quality of life. These cognitions ('needing a child in order to live a happy life') were especially prevalent among younger women. CONCLUSIONS: Patients with high levels of irrational parenthood cognitions are at risk of a less optimal quality of life. A short cognitive counselling therapy is advised for patients with high levels of these cognitions.

Adult↗

Congenital malformations in 4224 children conceived after IVF.

BACKGROUND: The percentage of children born after IVF will continue to increase due to demographic changes such as increasing maternal age and new developments in assisted reproduction techniques. IVF conceptions may carry an increased risk of congenital malformations. METHODS: We compared overall and specific congenital malformation rates calculated for IVF children (n = 4224) and naturally conceived children (n = 314 605), using records from the same Dutch national database for the years 1995 and 1996 and controlling for confounding maternal factors. RESULTS: The overall crude odds ratio (OR) for the risk of any malformation for IVF children compared with naturally conceived children was 1.20 [95% confidence interval (CI): 1.01-1.43]. After correction for differences in maternal age, parity and ethnicity between the IVF and control population the OR was 1.03 (95% CI: 0.86-1.23). The crude OR for IVF children appeared higher for the cardiovascular organ system and for several specific minor congenital malformations. However, these could be chance findings due to comparison of many malformation categories or may result from remaining differences in ascertaining malformations between IVF and naturally conceived children. CONCLUSIONS: The small increase in overall congenital malformations observed in the IVF children appears to be attributable to differences in maternal characteristics and not to any aspect of the IVF procedure.

Adult↗

[Erythromycin for premature rupture of membranes is beneficial for infant].

In the 'Overview of the role of antibiotics in curtailing labour and early delivery' (ORACLE I)-trial in women with premature rupture of membranes, the use of erythromycin was found to be associated with a decrease in the primary composite outcome (neonatal death, chronic lung disease or major cerebral abnormality on ultrasound; p = 0.08) and in single adverse neonatal outcomes (p = 0.02) when compared to placebo. The positive results were more significant in the singleton group (p = 0.02 for the composite outcome), while no effects were found in twin pregnancies. The combination of amoxycillin and clavulanic acid, with or without erythromycin, was associated with some improvements in outcome, but was also accompanied by a higher rate of neonatal necrotising enterocolitis. Another trial (ORACLE II) found no effects of antibiotic use in women with premature labour with intact membranes. Although both trials were of good quality, the stratification into singleton and twin pregnancies should have been done more consistently. Because premature rupture of membranes in singleton pregnancies is more likely to be associated with a pre-existing infection than in multiple pregnancies, the potential benefit of treatment with antibiotics is larger in singleton pregnancies.

Amoxicillin-Potassium Clavulanate Combination↗

[Prevalence of neural tube defects in births before and after promotion of periconceptional folic acid supplementation].

OBJECTIVE: To describe the incidence and the expected clinical picture of neural tube defects (NTD) in years when periconceptional folic acid use increased. DESIGN: Descriptive. METHOD: Data on the prevalence of NTD in the Netherlands in 1994-1998 and on the prognosis at the time of the report obtained from the Nederlands Signalerings Centrum Kindergeneeskunde (Netherlands Paediatric Spotting Centre), where all practising physicians in the Netherlands monthly report children in whom a rare disease has been diagnosed. Prevalence figures from before and after 1996 were compared, because periconceptional use of folic acid increased since late 1996. RESULTS: In 1994-1998, 414 children with NTD were reported, 164 boys, 191 girls and 59 unreported. The prevalence of NTD was 4.6 per 10,000 live births (95% confidence interval (CI): 3.7-5.6) compared with 3.8 per 10,000 live births (95% CI: 2.9-4.6) in the period 1997-1998. Of the 414 children, 257 had a meningomyelocele; the early mortality in this group amounted to 37%. Hydrocephalus was found in 84.8% of the infants, 40.9% of the infants were believed never be able to sit, stand, and walk. CONCLUSION: The prevalence of NTD was lower in the period 1997-1998 than in the period 1994-1996 although the difference was not statistically significant.

Female↗

The Dutch 'Folic Acid Campaign'--have the goals been achieved?

Periconceptional folic acid use considerably reduces the risk of neural tube defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Before (1995 survey) and 1 year after the campaign (1996 survey), the awareness and use of folic acid was measured among pregnant women in four regions of the Netherlands. To this end, pregnant women who visited the midwife, general practitioner or obstetrician for the first or second prenatal visit were asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) increased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the local Folic Acid Campaign was found (adjusted odds ratio= 1.0; 95% confidence interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.

Adolescent↗

Children after in vitro fertilization. An overview of the literature.

This paper provides an overview of the effects of in vitro fertilization (IVF) on the children born from it. One of the main problems with IVF to date remains the high incidence of multiple pregnancies, which carry an inherent higher risk of preterm delivery and, therefore, of increased morbidity and mortality in newborns. Further, singleton pregnancies and twin pregnancies from IVF compared to control singleton or twin pregnancies appear to be at higher risk of preterm birth and low birth weight. Whether this is an effect of the procedure per se or is related to maternal factors, or a combination of both, remains to be studied. The risk of congenital malformations does not, with the available data, seem to be elevated. As of now, it remains unclear whether embryo freezing is a safe procedure. Psychomotor development of children born through IVF does not seem to be disturbed. Until further and more extensive studies are conducted, it remains unclear whether IVF poses long-term risks for the children.

Congenital Abnormalities↗

Increasing awareness of and behaviour towards periconceptional folic acid consumption in The Netherlands from 1994 to 1995.

OBJECTIVE: In November 1993, Dutch health authorities advised that women planning a pregnancy should take folic acid in the periconceptional period to reduce the risk of fetal neural tube defects. In the autumn of 1995 a national campaign was organized to inform women and health care professionals in a systematic way. METHODS: We assessed the awareness and behaviour of women at their first or second antenatal visit in two surveys in the spring of 1994 and the autumn of 1995, in order to evaluate the impact of non-systematic information during that period, and to collect baseline data to evaluate the effect of the national folic acid campaign. The two surveys were carried out in the north and the west of The Netherlands. RESULTS: The proportion of women who had heard of folic acid increased from 28% to 78%. The proportion that used folic acid during any period in pregnancy increased from 7.8% to 26%. The proportion that took folic acid tablets during the whole of the recommended period increased from 0.8 to 4.4%. In the group of women who did not take folic acid, the proportion who did "not like to use anything during pregnancy" decreased, as did the proportion who did "not think it is useful". CONCLUSION: In the Netherlands, non-systemic information about periconceptional folic acid use has already led to significant changes in awareness and behaviour before the start of the national folic acid campaign.

Adult↗

Perinatal death in ethnic minorities in The Netherlands.

OBJECTIVES: To investigate differences in perinatal death rate and associated obstetric risk factors between ethnic groups in the Netherlands. DESIGN: Retrospective cohort study based on the 1990-1993 birth cohorts in the National Obstetric Registry. SUBJECTS: 569,743 births of which 85,527 were for women belonging to ethnic minorities. MAIN OUTCOME MEASURES: Perinatal death occurring between 16th week of pregnancy and 24 hours after birth. METHOD: Bivariate and multivariate analysis of perinatal death rate per ethnic group. A total of 42,282 women living in the three main cities of the Netherlands were classified on the basis of postal code districts into four socioeconomic (SES) classes for analysis of the relation between SES, perinatal death, and preterm birth. RESULTS: Black mothers had the highest perinatal death rate compared with indigenous Dutch (odds ratio 2.2, 95% CI 1.9, 2.4) followed by a group "others", consisting of women of mixed or unknown ethnicity (odds ratio 1.8, 95% CI 1.5, 2.0), Hindustani (odds ratio 1.4, 95% CI 1.2, 1.6), and Mediterraneans (odds ratio 1.3, 95% CI 1.2, 1.4). Asians (excluding West Indian Asians) and non-Dutch Europeans did not have higher rates than Dutch women. The increased rates of black and Hindustani women could be explained fully and that of the group "others" partially by higher rates of preterm birth. Controlling for age and parity lowered the odds ratio of the Mediterraneans slightly. The risk of ethnicity was independent of SES. CONCLUSION: Ethnic minorities in the Netherlands except immigrants from Asia and other European countries have higher rates of perinatal death than indigenous Dutch women. With a twofold increase, black women had the highest rate, which was related to an equally large increased rate of preterm birth.

Adolescent↗

[Folic acid use for women desiring offspring: the family physician's response].

OBJECTIVE: To establish to what extent general practitioners (GP's) are familiar with the folic acid campaign of the Netherlands Bureau for Food and Nutrition Education, display a positive attitude regarding use of folic acid tablets by women who would like to become pregnant and factually provide information on folic acid. DESIGN: Cross-sectional, descriptive. SETTING: Regions: Central Brabant, Achterhoek, Randstad and Northern Netherlands. METHOD: In 1996 a printed questionnaire was sent to 300 GP's selected at random. It contained questions about knowledge, attitude and management regarding the use of folic acid by women who would like to become pregnant and with a normal risk to have a child with a neural tube defect. RESULTS: The response was high (81%). Most GP's were familiar with the national campaign on folic acid (87%), but 18% considered themselves insufficiently informed about the education campaign and/or the folic acid recommendations. Half the GP's considered use of folic acid tablets by women who would like to become pregnant as important, while two-thirds were of the opinion that it contributed to medicalization of the pregnancy. Most GP's (82%) thought that pregnant women who had not used folic acid tablets might develop feelings of guilt. Nevertheless, 64% recommended use of folic acid tablets and 63% were willing to write a prescription if the woman asked for it. Seventy-five per cent of the GP's reported that they themselves suggested use of folic acid tablets to women who they assumed would like to become pregnant, although most stated they sometimes forgot (58%). The percentages of GP's who sometimes or always suggested folic acid tablets during a contraception advice after delivery or who advised women who would like to become pregnant to switch to a diet rich in folic acid, were much smaller (29 and 37%, respectively). CONCLUSION: Although a large number of the GP's mentioned potential problems, the majority actively cooperated in promoting use of folic acid by women who would like to become pregnant.

Cross-Sectional Studies↗

[Prevalence, clinical aspects and prognosis of neural tube defects in The Netherlands].

OBJECTIVE: To determine the live birth prevalence of neural tube defects (NTD) in the Netherlands and describe the clinical picture. DESIGN: Descriptive. SETTING: TNO Prevention and Health, Leiden, the Netherlands. METHOD: Data collected through active surveillance of NTD on a monthly basis by paediatricians throughout the country. RESULTS: From October 1993 to September 1995, 203 infants with NTD were registered. Six were diagnosed with anencephaly, 10 with encephalocele and 157 with spina bifida. On 30 children no further information was available. Seventy-nine per cent of children with spina bifida had a myelomeningocele and 11% had a meningocele. Hydrocephalus was found in 75% of all registered infants and in 81% of infants with myelomeningocele. In 18% of the latter group a kyphosis was diagnosed. In 45% of 131 children prognosis of ambulation fair: they were expected to learn to walk. In 32% prognosis for motor disorder was very poor, and unsupported sitting was considered to be unlikely. At the time of registration, when most children were less than a month old, 55 (27%) had died; in infants with a myelomeningocele this was 35%. In many children treatment had not been started, probably because the prognosis was poor. Some had not been referred to a multidisciplinary team and only one of them received a hydrocephalus valve. CONCLUSION: The prevalence of spina bifida in the Netherlands is at least 100 live-born children per year among 195,000 total births. Mortality in the first month is high and for many surviving infants a severe handicap can be expected. Preventive strategies (such as folic acid supplementation) are urgently needed.

Activities of Daily Living↗