Greek economic crisis and impaired perinatal parameters: experience from a public maternity hospital

J Matern Fetal Neonatal Med. 2018 Sep;31(18):2371-2375. doi: 10.1080/14767058.2017.1342803. Epub 2017 Jul 4.

Abstract

Since 2008, Greece suffers a severe economic crisis. Adverse health outcomes have been reported, but studies on perinatal health are sparse. We aimed to examine the impact of economic crisis on perinatal parameters during early and established crisis periods. Birth records of 14 923 neonates, born in a public maternity hospital from 2005-2014, were reviewed for maternal (age, delivery mode) and neonatal (gender, birthweight, gestational age) variables. Univariable analysis tested the association of study variables with time-periods 2005-2007, 2009-2011 and 2012-2014. Multivariable logistic regression analysis identified factors independently associated with low birthweight (LBW) (<2500 g), prematurity (<37 weeks) and caesarean section (CS). During 2012-2014, compared to 2005-2007, LBW rate increased from 8.4 to 10.5% (RR 1.16; 95%CI 1.01-1.33); prematurity from 9.7 to 11.2% (RR 1.09; 95%CI 0.96-1.24), comprising mainly late-preterm neonates; CS from 43.2 to 54.8% (RR 1.21; 95%CI 1.16-1.26). Maternal age ≥30 years was risk factor for LBW, prematurity and CS; LBW was additional risk factor for CS. However, LBW and CSs increased during the study period, independently of maternal age. In conclusion, impaired perinatal parameters, manifested by increasing maternal age, LBW, prematurity and CS rate, were observed during the years of economic decline, with possible adverse consequences for later health.

Keywords: Economic crisis; caesarean section; low birthweight; maternal age; prematurity.

MeSH terms

  • Adult
  • Birth Weight / physiology
  • Cesarean Section / economics
  • Cesarean Section / statistics & numerical data
  • Economic Recession* / statistics & numerical data
  • Female
  • Greece / epidemiology
  • Hospitals, Maternity / economics
  • Hospitals, Maternity / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / economics
  • Infant, Newborn, Diseases / epidemiology*
  • Male
  • Obstetric Labor Complications / economics
  • Obstetric Labor Complications / epidemiology*
  • Pregnancy
  • Pregnancy Complications / economics
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome / economics
  • Pregnancy Outcome / epidemiology*
  • Premature Birth / economics
  • Premature Birth / epidemiology
  • Public Facilities / economics
  • Public Facilities / statistics & numerical data
  • Public Health / economics
  • Young Adult