Sociodemographic determinants of low birthweight in Greece: A population study

A total population sample of 10,654 singleton births from the Greek National Perinatal Survey of April 1983 was analysed to identify factors independently associated with low birthweight (LBW). The sample was divided into two groups according to the gravidity of the mothers (3368 primigravidae and 7286 multigravidae). Data examined included regional characteristics, marital status, age at and duration of marriage, parental ages at delivery, crowding in the home, insurance status, parental occupational classification and parental education levels. Logistic regression was used to define the socioeconomic and demographic characteristics independently associated with the delivery of an LBW singleton baby. Significantly different LBW rates were found among the two groups: 4.3% in the primigravidae and 5.2% for multigravidae. For primigravidae significant associations were found with marital status, maternal occupation and father's education, while for multigravidae significant features were mother's education and place (region) of residence. The study showed little to assist in devising strategies of primary prevention of LBW in Greece. This study examines the sociodemographic determinants of low birth weight (LBW) in Greece. The study population comprised 10,654 singleton births (3368 primigravid and 7286 multigravid mothers) from the Greek National Perinatal Survey of April 1983 was used to identify factors associated with LBW. The study considered classifications based on parental occupations, educational levels, marital status and parental ages, with the ultimate aim of providing clues about causal etiology. The results indicated no significant correlation with paternal occupation group. There was, however, a significant association with maternal occupation group. The housewife, whether primigravid or multigravid, had the lowest risk of having an LBW baby as compared to laborers and commercial workers. In Greece, paternal and maternal education showed a significant relationship with LBW. Unmarried primigravidas had a significant residual risk of LBW; however, marital status was not an independent risk factor for multigravidas. The mother's age was significantly associated with LBW among multigravidas, the highest rate being found among the oldest group of mothers. Paternal age was also significantly related to LBW among multigravidas, with women whose husband was either a teenager or age 45 or older being most at risk. In conclusion, factors such as maternal age and social class based on the father's occupation are not independently associated with LBW in Greece. For primigravidas significant associations were found with marital status, maternal occupation and father's education, while for multigravidas significant features were the education and place of residence of the mother

Are there gaps in the provision of perinatal care in Greece?

STUDY OBJECTIVE: The objective was to test the hypothesis that easy access to sophisticated hospitals is associated with a reduction in perinatal mortality. DESIGN: The study was a nationwide questionnaire survey of a birth cohort. SUBJECTS: All deliveries greater than 500g weight of singleton live births and stillbirths occurring throughout Greece during April 1983 were included. Completed questionnaires were returned for 10,953 deliveries (8% of total annual registered births in Greece), and data on 10,790 singleton births were analysed, including 127 stillbirths and 137 early neonatal deaths. MEASUREMENTS AND MAIN RESULTS: The questionnaires contained information on demographic characteristics of each parent, mother's reproductive history, and clinical course of pregnancy, labour and perinatal period. Mothers living in big urban centres were compared with the rest of the country. Overall mortality rates were similar but births in the big urban centres were of significantly lower weight due to fetal growth retardation. Logistic regression analysis, taking account of birthweight, parity, maternal age, and maternal education showed that there was an advantage to mothers living in big urban centres, perinatal mortality being 63% higher in the rest of the country (chi 2 = 7.4, p less than 0.01). CONCLUSION: The evidence obtained supports the original hypothesis and suggest that a reduction in the high perinatal mortality rate in Greece may be achieved by restructuring the perinatal services