General Department, University of Thessaly, 41100 Larissa, Greece.
Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece.
Int J Environ Res Public Health. 2020 Sep 11;17(18):6606. doi: 10.3390/ijerph17186606.
(1) Background: To explore the effects of the 2008 economic crisis on maternal, perinatal and infant mortality in Greece and the socio-economic determinants associated with them; (2) Methods: The annual rates of stillbirth (SBR), perinatal mortality (PMR), infant mortality (IMR), neonatal mortality (NNMR), post-neonatal mortality (PNMR), low birth weight (LBW), and maternal mortality (MMR) were calculated for the years 2000-2016. Average Annual Percent Changes (AAPC) were calculated by the period before and after 2008. The expected rates of 2009-2016 and the observed-to-expected rate ratios (RR) were calculated. Correlation and multiple linear regression analyses were used to test the impact of socio-economic variables on health outcomes; (3) Results: A reverse in downwards trends of PNM, IMR, and NNMR is observed since 2009. All observed values of 2009-2016 were found significantly higher than the expected ones by 12-34%. All indicators except SBR were found negatively correlated with GDP and DHI. A positive correlation was found between IMR, NNMR, and LBW and long-term unemployment, and no association with public health expenditure; (4) Conclusions: Economic crisis was associated with remarkable adverse effects on perinatal outcomes and infant mortality, mainly determined by long-term unemployment and income reduction. The findings stress a need for interventions to protect maternity and child health during crises.
（1）背景：探讨 2008 年经济危机对希腊母婴和婴儿死亡率的影响，以及与之相关的社会经济决定因素；（2）方法：计算了 2000-2016 年的死产率（SBR）、围产儿死亡率（PMR）、婴儿死亡率（IMR）、新生儿死亡率（NNMR）、后期新生儿死亡率（PNMR）、低出生体重（LBW）和孕产妇死亡率（MMR）的年率。通过 2008 年前后的时间段计算平均年百分比变化（AAPC）。计算了 2009-2016 年的预期率和观察到的与预期比率（RR）。使用相关和多元线性回归分析来检验社会经济变量对健康结果的影响；（3）结果：自 2009 年以来，PNM、IMR 和 NNMR 的下降趋势出现逆转。发现 2009-2016 年的所有观察值都比预期值高出 12-34%。除 SBR 外，所有指标均与 GDP 和 DHI 呈负相关。IMR、NNMR 和 LBW 与长期失业呈正相关，与公共卫生支出无关；（4）结论：经济危机对围产儿结局和婴儿死亡率产生了显著的不利影响，主要由长期失业和收入减少决定。研究结果强调需要在危机期间采取干预措施保护母婴健康。
