{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:32:46Z","timestamp":1788867166164,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Preterm birth (PTB) is the leading cause of infant mortality and morbidity worldwide. Rates of PTB in the Netherlands are declining, possibly due to the implementation of preventive strategies. In this study we assessed the overall trend in PTB rates in the Netherlands in recent years, and in more detail in specific subgroups to investigate potential groups that require scrutiny in the near future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Based on the national perinatal registry, we included all pregnancies without severe congenital abnormalities resulting in a birth from 24 to 42 completed weeks of gestation between 2011 and 2019 in the Netherlands. We assessed PTB rates in two different clinical subtypes (spontaneous vs. iatrogenic) and in five gestational age subgroups: 24\u201327<jats:sup>+6<\/jats:sup> weeks (extreme), 28\u201331<jats:sup>+6<\/jats:sup> weeks (very), 32\u201333<jats:sup>+6<\/jats:sup> weeks (moderate, 34\u201336<jats:sup>+6<\/jats:sup> weeks [late] and, in general, 24\u201336<jats:sup>+6<\/jats:sup> weeks [overall PTB]). Trend analysis was performed using the Cochran Armitage test. We also compared PTB rates in different subgroups in the first 2\u2009years compared to the last 2\u2009years. Singleton and multiple gestations were analyzed separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 1\u2009447\u2009689 singleton and 23\u2009250 multiple pregnancies in our study. In singletons, we observed a significant decline in PTB from 5.5% to 5.0% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), mainly due to a decrease in iatrogenic PTBs. When focusing on different gestational age subgroups, there was a decrease in all iatrogenic PTB and in moderate to late spontaneous PTB. However, in spontaneous extreme and very PTB there was an significant increase. When assessing overall PTB risk in different subgroups, the decline was only visible in women with age \u226525\u2009years, nulliparous and primiparous women, women with a medium or high socioeconomic status and hypertensive women. In multiples, the rate of PTB remained fairly stable, from 52.3% in 2011 to 54.1% in 2019 (<jats:italic>p<\/jats:italic>\u2009=\u20090.57).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the Netherlands, between 2011 and 2019, PTB decreased, mainly due to a reduction in late PTB, and more in iatrogenic than in spontaneous PTB. Focus for the near future should be on specific subgroups in which the decline was not visible, such as women with a low socioeconomic status or a young age.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14684","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T06:55:33Z","timestamp":1698735333000},"page":"449-458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Trends in preterm birth in the Netherlands in 2011\u20132019: A\u00a0population\u2010based study among singletons and multiples"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-8557","authenticated-orcid":false,"given":"Job","family":"Klumper","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita C. J.","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of Medical Informatics Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolien","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameen","family":"Abu\u2010Hanna","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn A.","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30451-0"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03010.x"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.02.021"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0268673"},{"key":"e_1_2_13_7_1","unstructured":"Euro\u2010Peristat Project.European Perinatal Health Report \u201cCore indicators of the health and care of pregnant women and babies in Europe in 2015\u20132019\u201d.2022.www.europeristat.com"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30223-1"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04249-8"},{"key":"e_1_2_13_10_1","volume-title":"Perinatal Care in the Netherlands","author":"Perined.","year":"2019"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14273"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000546"},{"key":"e_1_2_13_13_1","unstructured":"March of Dimes.March of Dimes report card.2022.https:\/\/www.marchofdimes.org\/sites\/default\/files\/2022\u201011\/March\u2010of\u2010Dimes\u20102022\u2010Full\u2010Report\u2010Card.pdf"},{"key":"e_1_2_13_14_1","first-page":"1","article-title":"Births: final data for 2019","volume":"70","author":"Martin JA","year":"2021","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_13_15_1","volume-title":"Monitor on Substance Use and Pregnancy","author":"Scheffers\u2010van Schayck T","year":"2018"},{"key":"e_1_2_13_16_1","unstructured":"Nederlandse Vereniging voor Obstetrie en Gynaecologie.NVOG module acetylsalicylzuur.2019.https:\/\/www.nvog.nl\/wp\u2010content\/uploads\/2019\/10\/NVOG\u2010module\u2010Acetylsalicylzuur\u2010okt\u20102019.pdf"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30144-5"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61998-X"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurox.2020.100109"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13438-9"},{"issue":"30","key":"e_1_2_13_21_1","first-page":"A5962","article-title":"Multiple births in the Netherlands","volume":"157","author":"Glasner TJ","year":"2013","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13227"},{"key":"e_1_2_13_23_1","unstructured":"Nederlandse vereniging voor obstetrie en gynaecologie. 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