Preterm birth trends in Greece, 1980-2008: a rising concern

Objective. To identify preterm birth trends in Greece. Design. Retrospective epidemiological study. Setting. Women giving birth in Greece from 1980 to 2008. Population. Live births beyond the 24th gestational week. Methods. Data acquisition from the Hellenic Vital Statistics records. Statistical analysis of preterm birth rate among neonates estimated for each year. Main outcome measures. Total number of births and preterm births, as well as rate of preterm birth by gestational week. Stillbirth rates by gestational age. Results. 3 218 463 births occurred during the period under study, 151 594 (4.7%) of which were preterm. A steep rise in preterm births was noted during the final years of the study, reaching 9.6% in 2008. This was mainly due to the "late preterm" subgroup (34(+0)-36(+6) gestational weeks). The rates of stillbirth fell in a constant way regardless of the maturity index. Conclusions. Although preterm birth etiology is multifactorial, the selective rise in the "late preterm" group possibly was due to an increase in medical reasons necessitating a preterm delivery, changes in obstetric practice, or both. Further studies are needed to estimate the precise effect of each contributing factor.