27 Regional variations in childbirth interventions in the Netherlands for clinically significant correlations are arbitrary, we considered a correlation of ρ ≥ 0.60 or ≤ - 0.60 as strong (50), and only these correlations were discussed in the text and indicated in bold in the tables. Statistical analyses were performed using SPSS Statistics 22 (SPSS Inc, Chicago, IL, USA). First, overall results and remarkable associations between subgroups of women or between interventions were described. Second, results for each intervention were described, starting with those that showed most variation. Results Baseline characteristics Figure 1 shows the number of births eligible for inclusion in this study and table 1 describes the maternal and neonatal characteristics. Of the 276,701 births in nulliparous women, 153,091 were in midwife-led care at the onset of labour, 121,612 in obstetrician-led care, and for the remainder, the care setting was unknown. For births in multiparous women, these numbers were 174,918 and 161,286 respectively. In the regions, the proportion of mothers younger than 20 years of age ranged from between 0.8% to 2.2%, and of 40 years or older from between 2.4% to 4.5%. The lowest proportion of mothers with a non-Dutch ethnicity was 9.3% and the highest 34.6%. In three regions, there were no urban areas, whereas in all regions there were mothers living in rural areas, with a range of between 11.1% and 48.5%. Proportions of mothers with a low socioeconomic status varied from between 24.1% to 59.2%. Regions with the lowest number of births after 42 weeks (varying from between 0.8% to 2.5%), had higher numbers of births at 37-38 weeks (varying from between 5.8% to 9.2%), and vice versa. We found a similar pattern for birth weight below the 2.3rd, 10th or above the 90th or 97.7th percentile, with rates varying from between 1.4% to 2.1% for birth weight below the 2.3rd percentile, and from between 2.3% to 3.5% for birth weight above the 97.7th. 2
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