Temporal Trends in Stillbirth in Greece: A Longitudinal Population-Based Study

Area of Science:

• Public Health
• Epidemiology
• Demography

Background:

• Stillbirths represent a significant public health concern and a key indicator of population health.
• Investigating temporal trends in stillbirth is crucial for understanding and addressing this issue.

Purpose of the Study:

• To comprehensively analyze and present the time trends of the stillbirth rate (SBR) in Greece over a 65-year period.
• To identify periods of increase, decrease, and stagnation in the SBR.

Main Methods:

• Utilized data from the Hellenic Statistical Authority spanning 1957-2021.
• Calculated the annual stillbirth rate (SBR) per 1,000 total births.
• Employed joinpoint regression analysis to assess trends and calculate annual percent changes (APC).

Main Results:

• The SBR initially increased (1957-1965), peaked in 1966, and then continuously improved for four decades (1965-2003), reaching a low in 2008.
• The SBR stagnated from 2006-2016 and showed a significant upward trend from 2016-2021 (APC=7.4%).
• By 2021, the SBR was 5.3 per 1,000 births, a 60% increase from 2008, with an estimated 1,200 additional fetal deaths since 2009.

Conclusions:

• Despite a long period of decline, the SBR in Greece has deteriorated, particularly after 2015, indicating a rising burden of fetal deaths.
• The recent upward trend necessitates urgent public health interventions.
• Addressing preventable risk factors and optimizing antenatal monitoring are critical to reversing this trend.