Related Experiment Video

Updated: Sep 2, 2026

Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice

Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice

Published on: October 10, 2025

Rising Perinatal Mortality in Greece, 2014-2024: Are Changes in Stillbirth Registration Practices the Only

Eirini Nikaina¹, Georgia Kourlaba², Kyriaki Velali¹

¹Neonatal Unit, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sofia' Children's Hospital, Athens, Greece.

Paediatric and Perinatal Epidemiology

|August 31, 2026

Abstract

Background:

Perinatal mortality appears to have increased recently in Greece; however, it is unclear whether this increase can be solely attributed to the 2018 change in the defined gestational age threshold for stillbirth registration.

Objectives:

To examine temporal trends in perinatal mortality rates in Greece during the period 2014-2024 and evaluate the potential impact of changes in stillbirth registration practices.

Methods:

Nationwide data from the Hellenic Statistical Authority (2014-2024; Ν = 926,154 total births) were analysed to estimate trends in perinatal mortality. Changes in stillbirth recording after 2018, following the adoption of a 22-week gestational viability threshold, were taken into account. Poisson Regression, Interrupted Time Series (ITS) and Joinpoint Regression analyses were used.

Results:

Perinatal mortality was 5.6 in 2014 versus 8.2 in 2024 per 1000 total births. Poisson regression showed an overall increase in perinatal mortality rates (4.4% annually, 95% confidence interval [CI] 3.5 to 5.3), driven by rising stillbirth rates (6.8% annually, 95% CI 5.5 to 8.1), while early neonatal mortality rates declined (-2.0% annually; 95% CI -3.0 to -1.1). Stillbirth rates at < 26 weeks' gestation increased sharply (36.1% annually, 95% CI 24.9 to 47.4), whereas a smaller increase was observed at ≥ 26 weeks (1.7% annually, 95% CI 0.4 to 2.9). ITS analysis showed a level increase in 2019 and an increasing post-2019 trend in stillbirth rates at < 26 weeks, whereas no corresponding level or post-2019 trend changes were detected at ≥ 26 weeks. Joinpoint regression also identified 2019 as a breakpoint for stillbirths at < 26 weeks.

Conclusions:

The rise in perinatal mortality in Greece over the past decade has been driven by increased stillbirth rates, largely attributable to changes in stillbirth recording practices at gestational ages < 26 weeks. The modest upward trend in stillbirths at ≥ 26 weeks' gestation warrants further investigation and ongoing monitoring.

Keywords:

antenatal care early neonatal mortality fetal deaths health indicators neonates pregnancy

Related Concept Videos

Regression Toward the Mean

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...

Pathophysiology of Diabetes

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...

Development of the Oral Microbiota

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...

Teratogenicity

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...

Articles linked to this work by shared authors, journal, and citation graph.

Rare-ID: Genomic Diagnosis in Symptomatic Neonates and Young Infants with Complex Clinical Phenotypes: A Descriptive Cohort Study.

Genes·2026

Gestational Diabetes Mellitus Across the Perinatal Continuum: A Narrative Review of Woman-Centered, Holistic Care Models.

Healthcare (Basel, Switzerland)·2026

Management of Hereditary Hypofibrinogenemia During Pregnancy: A Scoping Review Towards Personalized Obstetric Care.

Journal of clinical medicine·2026

Under-5 mortality trends and leading causes of death in Greece, 2016-2020: A nationwide study.

Public health in practice (Oxford, England)·2026

Wiedemann-Steiner Syndrome (WSS): A Neonatal Case Report Expanding the Phenotypic Spectrum of a Previously Reported Missense Variant.

International journal of molecular sciences·2026

Healthcare Workers' Knowledge, Attitudes, and Practices on Catheter-Associated Urinary Tract Infection Prevention in a Tertiary General Hospital: A Cross-Sectional Study.

Cureus·2026

See all related articles