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. 2024 Aug 20;16(8):e67295.
doi: 10.7759/cureus.67295. eCollection 2024 Aug.

Secular Trends in Preterm Birth Rates: Uncovering the Primary Challenge for Perinatal Medicine in Greece

Nikolaos Vlachadis  1 , Dionysios N Vrachnis  2 , Nikolaos Loukas  3 , Nikolaos Antonakopoulos  4 , Alexandros Fotiou  5 , Theodoros Karampitsakos  2 , Panagiotis Anastasopoulos  6 , Georgios Maroudias  7 , Zoi Iliodromiti  8 , Nikolaos Vrachnis  2
Affiliations

Secular Trends in Preterm Birth Rates: Uncovering the Primary Challenge for Perinatal Medicine in Greece

Nikolaos Vlachadis et al. Cureus. .

Abstract

Introduction: Preterm labour is a serious pregnancy complication that is the primary cause of infant mortality, with detrimental impacts on the offspring and the mother in the short as well as the long term. This study aims to comprehensively present the time trends of national preterm birth rates (PBRs) in Greece.

Methods: Official national data regarding live births in Greece were acquired from the Hellenic Statistical Authority, and the annual total PBR and rates for gestational age groups were computed per 100 total live births spanning from 1980 to 2022. Time trends were analyzed through joinpoint regression analysis, and annual percent changes (APC) and average annual percent change (AAPC) were calculated with a 95% confidence interval (95% CI).

Results: Following a steady decline from 4.66% in 1980 to a historic low of 2.77% in 1991 with an APC of -5.1 (-6.2 to -4.2), the PBR exhibited a dramatic increase during 1991-2011 with an APC of 7.3 (6.9 to 7.8). Subsequently, between 2011 and 2022, the rise in PBR was attenuated, showing a slight statistically non-significant upward trend (APC = 0.5, 95% CI: -0.6 to 1.5). This led to a historical high of 12.07% in 2018, 4.4 times higher than that in 1991, and eventually, the PBR reached 11.90% in 2022. From 1991 to 2022, there were sharper increases in the rates of moderate (32-33 weeks) and late (34-36 weeks) preterm births, with AAPCs of 4.9 (3.5-6.4) and 5.8 (5.3-6.3), respectively. In contrast, the rates of extremely (<28 weeks) and very (28-31 weeks) preterm births saw slower growth, with AAPCs of 2.2 (1.7-2.7) and 0.7 (0.5-1.0), respectively.

Conclusion: The PBR in Greece more than quadrupled during 1991-2022, mainly due to increases in moderate and late preterm births. Although its rise has markedly decelerated since 2011, amidst the country's economic recession, the PBR is alarmingly higher than those in all other European and developed nations. More than one in nine neonates is born prematurely in the Greek population, posing challenges in implementing evidence-based prevention strategies and perinatal care.

Keywords: births; duration of gestation; economic crisis; greece; perinatal medicine; pregnancy; premature birth; preterm birth; preterm birth rate; trend analysis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preterm birth rate (per 100 live births) in Greece, 1980-2022.
Figure 2
Figure 2. Time trends in preterm birth rates (per 100 live births) in Greece, 1980-2022.
Figure 3
Figure 3. Preterm births in Greece, 1980-2022.
Figure 4
Figure 4. Preterm birth rates (per 100 live births) by gestational age sub-groups in Greece, 1980-2022.
EPBR: extremely preterm birth rate (<28 weeks); VPBR: very preterm birth rate (28-31 weeks); MPBR: moderately preterm birth rate (32-33 weeks); LPBR: late preterm birth rate (34-36 weeks).
Figure 5
Figure 5. Time trends in extremely preterm birth rates (<28 weeks) and very preterm birth rates (28-31 weeks) (per 100 live births) in Greece, 1980-2022.
Figure 6
Figure 6. Time trends in moderately preterm birth rates (32-33 weeks) and late preterm birth rates (34-36 weeks) (per 100 live births) in Greece, 1980-2022.
Figure 7
Figure 7. Relative contribution of different gestational age sub-groups in preterm births in Greece, 1991-2022.
Figure 8
Figure 8. Preterm birth rates by gestational week (per 100 live births) (32-36 weeks) in Greece, 1991-2022.
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References

    1. World Health Organization. Born too soon: the global action report on preterm birth. [ Aug; 2024 ]. 2012. https://iris.who.int/handle/10665/44864 https://iris.who.int/handle/10665/44864
    1. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Chawanpaiboon S, Vogel JP, Moller AB, et al. Lancet Glob Health. 2019;7:0–46. - PMC - PubMed
    1. Prediction and prevention of spontaneous preterm birth: ACOG practice bulletin, number 234. Obstet Gynecol. 2021;138:0–90. - PMC - PubMed
    1. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Blencowe H, Cousens S, Oestergaard MZ, et al. Lancet. 2012;379:2162–2172. - PubMed
    1. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Chang HH, Larson J, Blencowe H, et al. Lancet. 2013;381:223–234. - PMC - PubMed

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