{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:57:51Z","timestamp":1770911871407,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,11]],"date-time":"2019-12-11T00:00:00Z","timestamp":1576022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Midwife\u2010led models of care have been the subject of debate for many years. We conducted a study to compare intrapartum and neonatal mortality rates in midwife\u2010led (primary) vs obstetrician\u2010led (secondary) care at the onset of labor in low\u2010risk term women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We performed an unmatched and a propensity score matched cohort study using data from the national perinatal audit registry (PAN) and from the national perinatal registry (PERINED) of the Netherlands. We included women with singleton pregnancies (without congenital anomalies or antepartum fetal death) who gave birth at term between 2010 and 2012. We excluded the following major risk factors: non\u2010vertex position of the fetus, previous cesarean birth, hypertension, diabetes mellitus, prolonged rupture of membranes (\u226524\u00a0hours), vaginal bleeding in the second half of pregnancy, nonspontaneous start of labor and post\u2010term pregnancy (\u226542\u00a0weeks). The primary outcome was intrapartum or neonatal mortality up to 28\u00a0days after birth. Secondary outcome measures were mode of delivery and a 5\u2010minute Apgar score &lt;7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 259\u00a0211 women. There were 100\/206\u00a0642 (0.48\u2030) intrapartum and neonatal deaths in the midwife group and 23\/52\u00a0569 (0.44\u2030) in the obstetrician group (odds ratio [OR] 1.11, 95% CI 0.70\u20101.74). Propensity score matched analysis showed mortality rates of 0.49\u2030 (26\/52\u00a0569) among women in midwife\u2010led care and 0.44\u2030 (23\/52\u00a0569) for women in obstetrician\u2010led care (OR 1.13, 95% CI 0.65\u20101.98). In the midwife group there were significantly lower rates of vaginal instrumental deliveries (8.4% vs 13.0%; matched OR 0.65, 95% CI 0.62\u20100.67) and intrapartum cesarean sections (2.6% vs 8.2%; matched OR 0.32, 95% CI 0.30\u20100.34), and fewer neonates with low Apgar scores (&lt;7 after 5\u00a0minutes) (0.69% vs 1.11%; matched OR 0.61, 95% CI 0.53\u20100.69).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among low\u2010risk term women, there were comparable intrapartum and neonatal mortality rates for women starting labor in midwife\u2010led vs obstetrician\u2010led care, with lower intervention rates and fewer low Apgar scores in the midwife group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13767","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T06:10:39Z","timestamp":1573539039000},"page":"546-554","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Intrapartum and neonatal mortality in low\u2010risk term women in midwife\u2010led care and obstetrician\u2010led care at the onset of labor: A national matched cohort study"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-6400","authenticated-orcid":false,"given":"Melanie M. J.","family":"Wiegerinck","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Center Amsterdam The Netherlands"},{"name":"Department of Obstetrics and Gynecology OLVG hospital Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7181-8665","authenticated-orcid":false,"given":"Martine","family":"Eskes","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Amsterdam University Medical Center Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-2116","authenticated-orcid":false,"given":"Joris A. M.","family":"van der Post","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Center Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Monash University Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3447-8286","authenticated-orcid":false,"given":"Anita C. J.","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Center Amsterdam The Netherlands"},{"name":"Department of Medical Informatics Amsterdam University Medical Center Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,11]]},"reference":[{"issue":"50","key":"e_1_2_10_2_1","first-page":"2718","article-title":"Higher perinatal mortality in The Netherlands than in other European countries: the Peristat\u2010II study","volume":"152","author":"Mohangoo AD","year":"2008","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5639"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7020"},{"key":"e_1_2_10_5_1","unstructured":"EURO\u2010PERISTAT European Perinatal Health report. 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