Vlachadis Nikolaos, Vrachnis Dionysios N, Loukas Nikolaos, Antonakopoulos Nikolaos, Fotiou Alexandros, Karampitsakos Theodoros, Anastasopoulos Panagiotis, Maroudias Georgios, Iliodromiti Zoi, Vrachnis Nikolaos
Department of Obstetrics and Gynecology, General Hospital of Messinia, Kalamata, GRC.
Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attiko Hospital, Athens, GRC.
Cureus. 2024 Aug 20;16(8):e67295. doi: 10.7759/cureus.67295. eCollection 2024 Aug.
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.
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).
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.
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.
早产是一种严重的妊娠并发症，是婴儿死亡的主要原因，对后代和母亲的短期及长期均有不利影响。本研究旨在全面呈现希腊全国早产率（PBR）的时间趋势。
从希腊统计局获取有关希腊活产的官方国家数据，并计算1980年至2022年每100例总活产中的年度总早产率和各孕周组的早产率。通过连接点回归分析对时间趋势进行分析，并计算年度百分比变化（APC）和平均年度百分比变化（AAPC）及其95%置信区间（95%CI）。
早产率从1980年的4.66%稳步下降至1991年的历史低点2.77%，APC为-5.1（-6.2至-4.2），随后在1991 - 2011年期间急剧上升，APC为7.3（6.9至7.8）。随后，在2011年至2022年期间，早产率的上升有所缓和，呈现出轻微的、统计学上无显著意义的上升趋势（APC = 0.5，95%CI：-0.6至1.5）。这导致2018年达到历史最高水平12.07%，比1991年高出4.4倍，最终，2022年早产率达到11.90%。从1991年到2022年，中度（32 - 33周）和晚期（34 - 36周）早产率的增长更为明显，AAPC分别为4.9（3.5 - 6.4）和5.8（5.3 - 6.3）。相比之下，极早早产（<28周）和早早产（28 - 31周）率增长较慢，AAPC分别为2.2（1.7 - 2.7）和0.7（0.5 - 1.0）。
1991年至2022年期间，希腊的早产率增长了四倍多，主要原因是中度和晚期早产率的上升。尽管自2011年以来其上升速度已明显放缓，但在该国经济衰退期间，早产率仍惊人地高于所有其他欧洲和发达国家。希腊每九名新生儿中就有超过一名早产，这给实施循证预防策略和围产期护理带来了挑战。
