Indicators of maternal and neonatal health and chances of survival improved between 2015 and 2019 in Europe, although not in all countries. Such data from a report on perinatal health conducted as part of the Euro-Peristat project was published by Termedia. The project was coordinated by the French institute INSERM (Institut National de la Santé et de la Recherche Médicale). Participants included clinicians, epidemiologists and statisticians working on perinatal health issues from all countries of the European Union, as well as Iceland, Norway, Switzerland and the United Kingdom.
Between 2015 and 2019, stillbirth and infant mortality rates declined in most parts of Europe, but the declines were less pronounced than in previous years, and in some countries the situation did not improve, but even worsened. Stillbirths are - according to the Euro-Peristat definition - fetal deaths at 24 weeks of gestation or later (international comparisons generally use a threshold of 28 weeks). In 2019, the median rate of stillbirths at 24 weeks' gestation or later was 3.2 per 1,000 total live and stillbirths (from 1.8 in Estonia to 4.7 in Cyprus; 2.9 in Poland). A slight overall decrease in stillbirths, estimated at 1 percent per year, was seen between 2015 and 2019, but many countries - Belgium and Germany, for example - showed no change or even a slight increase in stillbirths.
Neonatal deaths are deaths of infants within 27 days after live birth. Some countries, such as France and Germany, could not provide data on neonatal mortality because the data are not linked to birth records. Among the countries that provided data, the median neonatal mortality rate was 2.2 per 1,000 live births. Rates ranged from 1.5 or less (0.9 in Estonia) per 1,000 live births in Slovenia, Iceland, Finland, Norway, the Czech Republic and Sweden to more than 3.5 per 1,000 live births in Northern Ireland, Malta, Romania and Bulgaria. For Poland, the rate was 2.7.
Rates of preterm birth and low birth weight have varied widely in Europe, but have declined over time in most countries. Low birth weight is defined as a birth weight of less than 2,500 grams. In 2019, the percentage of low birth weight babies ranged from 4.0 to 10.1 percent of live births. There were significant geographic differences, with the lowest percentages in Northern European countries (less than 4.5 percent in Finland, Sweden, Denmark, Estonia, Norway, and Lithuania and Latvia) and the highest in Southern and Eastern Europe (Cyprus 9 percent, Portugal, Spain, Slovakia and Hungary). In Poland, low birth weight was in 2019. 4.8 percent of newborns. In most European countries, the percentage of low birth weight babies declined slightly between 2015 and 2019.
Preterm birth is a birth before the completed 37th week of pregnancy. In 2019, preterm births affected between 5.3 (Finland and Lithuania) and 11.3 percent (Cyprus) of live births, with a median of 6.9 percent. In Poland, it was 7.2 percent of births. Between 2015 and 2019, the rate of preterm births fell in Europe in all but four countries, with an overall estimated annual decline of 1 percent.
Differences between countries regarding gestational age at delivery are evident throughout the distribution of gestational ages. Early deliveries (37th-38th week of pregnancy) ranged from 17.0 to 42.8 percent (median 22.6 percent). Births after the due date (at 42 weeks or later) were generally rare (less than 1 percent in most countries), with some exceptions (6 percent in Sweden, 4.4 percent in Norway). In Poland, only 0.5 percent of pregnancies lasted more than 42 weeks.
As can be seen, the impact of young mothers on the number of births is moderate, whether they give or don't give in the neck. In Europe, the number of very young mothers is relatively small and steadily declining. In 2019, the median percentage of women giving birth under the age of 20 was 1.7 percent. The highest percentage of teenage mothers (>3 percent) was recorded in Malta, Wales and Slovakia. In Poland, they were in 2019. 2.2 percent, when in 2015 it was 3.3 percent. On the other hand, the percentage of women in Europe giving birth at age 35 and later continues to rise. Between 2015 and 2019, the median increase in their percentage was 2.6 percent, and the median percentage alone in 2019 was 23.1 percent (19.5 percent in Poland). For the percentage of women aged 40 and older, the median was 4.5 percent (2.2 percent in Poland). Countries with higher percentages of women aged 35 and older giving birth were Luxembourg (31.6 percent), Portugal (33.2 percent), Italy (34.4 percent), Ireland (39.4 percent) and Spain (40.0 percent). In these countries, more than 5 percent of all births occur to women aged 40 and older, with the highest rates exceeding 7 percent in Italy, Portugal and Spain.
When it comes to cesarean sections, the situation varies greatly, with trends contrasting with each other. In some countries, caesarean section rates are stable or declining, while in others they increased between 2015 and 2019. In 2019, the median caesarean section rate in the countries providing data was 26.0 percent; it ranged widely from 16.4 (Norway) to 53.1 percent (Cyprus). In Poland, babies were born by cesarean section in 2019. 44.4 percent of babies, compared to 42.9 percent in 2015. The median incidence of instrumental vaginal deliveries was 6.1 percent, with a range from 1.4 to 13.8 percent. Cesarean sections varied geographically, with lower rates in northern Europe and higher rates in southern and central Europe. Twelve countries saw declining rates of cesarean sections, nine saw increases, and others were stable in this regard.
