van Alten D, Eskes M, Treffers P E
Department of Obstetrics and Gynaecology, Academisch Medisch Centrum, Amsterdam, the Netherlands.
Br J Obstet Gynaecol. 1989 Jun;96(6):656-62. doi: 10.1111/j.1471-0528.1989.tb03279.x.
Between 1969 and 1983 a group of 7980 pregnant women, booked consecutively at a practice of freestanding midwives in Wormerveer, the Netherlands, was studied. They gave birth to 8055 children. Perinatal mortality in the total group was low (11.1 per 1000) compared with national figures of 14.5 per 1000 between 1969 and 1983. The highest mortality (51.7 per 1000) was found in the group of 1430 infants born after maternal referral during pregnancy to a specialist obstetrician. The perinatal mortality in the group selected during pregnancy as low-risk cases was very low (2.3 per 1000). The caesarean section rate in the total group was 1.4% and 0.4% in the selected low-risk group. Of the 5985 infants born alive under sole care of a midwife, 3.8% were admitted to hospital. Emergency admission because of birth asphyxia occurred in 0.4%. Convulsions within 48 h of birth at term occurred in seven (0.9 per 1000) in the total group and in five infants born in the selected group (0.8 per 1000). Selection of pregnant women into groups with high and with low risk is possible with the relatively modest means available to the midwife.
1969年至1983年间，对荷兰沃尔默维尔一群连续在独立助产士诊所登记的7980名孕妇进行了研究。她们共生下8055名儿童。与1969年至1983年间全国每1000例14.5的围产期死亡率相比，该组的围产期死亡率较低（每1000例11.1）。在孕期由专科产科医生接诊的1430名婴儿中，死亡率最高（每1000例51.7）。孕期被选为低风险病例组的围产期死亡率非常低（每1000例2.3）。该组的剖宫产率为1.4%，在选定的低风险组中为0.4%。在仅由助产士护理下存活出生的5985名婴儿中，3.8%被送进医院。因出生窒息而急诊入院的比例为0.4%。足月出生后48小时内惊厥在该组中有7例（每1000例0.9），在选定组中出生的5名婴儿中（每1000例0.8）。助产士可用的手段相对有限，但仍有可能将孕妇分为高风险组和低风险组。
