Preterm birth rates increased in 15 European countries – Oct 2013

BJOG: An International Journal of Obstetrics & Gynaecology May 2013
J Zeitlin,a,b K Szamotulska,c N Drewniak,a,b AD Mohangoo,d J Chalmers,e L Sakkeus,f L Irgens,g,h M Gatt,i M Gissler,j,k B Blondel,a,b The Euro-Peristat Preterm Study Group

Studies which cited this study

European PTB Study was cited 173 times in Google Scholar as of Jan 2019

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  • The epidemiology, etiology, and costs of preterm birth - 2016 https://doi.org/10.1016/j.siny.2015.12.011 behind paywall
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  • Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions - JAMA 2016
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  • Hospitalisations from 1 to 6 Years of Age: Effects of Gestational Age and Severe Neonatal Morbidity - 2015
    increasing odds of hospitalisation more than once: 1.49 at 33–34 weeks 10.1111/ppe.12188

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Average annual percentage change for preterm birth by country, 1996–2008.* Data series begins in 2000.

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Objective To investigate time trends in preterm birth in Europe by multiplicity, gestational age, and onset of delivery.

Design Analysis of aggregate data from routine sources.

Setting Nineteen European countries.

Population Live births in 1996, 2000, 2004, and 2008.

Methods Annual risk ratios of preterm birth in each country were estimated with year as a continuous variable for all births and by subgroup using log-binomial regression models.

Main outcome measures Overall preterm birth rate and rate by multiplicity, gestational age group, and spontaneous versus non- spontaneous (induced or prelabour caesarean section) onset of labour.

Results Preterm birth rates rose in most countries, but the magnitude of these increases varied. Rises in the multiple birth rate as well as in the preterm birth rate for multiple births contributed to increases in the overall preterm birth rate. About half of countries experienced no change or decreases in the rates of singleton preterm birth. Where preterm birth rates rose, increases were no more prominent at 35-36 weeks of gestation than at 32-34 weeks of gestation. Variable trends were observed for spontaneous and non-spontaneous preterm births in the 13 countries with mode of onset data; increases were not solely attributed to non-spontaneous preterm births.

Conclusions There was a wide variation in preterm birth trends in European countries. Many countries maintained or reduced rates of singleton preterm birth over the past 15 years, challenging a widespread belief that rising rates are the norm. Understanding these cross-country differences could inform strategies for the prevention of preterm birth.

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