European Journal of Public Health最新文献

{"title":"High-risk HPV prevalence in the Czech cervical cancer screening population: a comparison of clinician-collected and self-collected sampling.","authors":"Hana Jaworek, Ondrej Bouska, Pavla Kourilova, Marian Hajduch, Vladimira Koudelakova","doi":"10.1093/eurpub/ckaf045","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf045","url":null,"abstract":"<p><p>The prevalence of high-risk human papillomavirus (hrHPV) types varies across countries, making it essential to estimate prevalence using nationwide samples. Data on hrHPV prevalence in the Czech Republic are very limited. This study aimed to determine the prevalence of various hrHPV types in an unselected screening population of Czech women aged 30-65 years, using paired clinician-obtained cervical swab (CS) and self-collected cervicovaginal swabs (CVS). A total of 1026 eligible women were recruited into two study arms. In arm A, the digene® HC2 DNA Collection Device was used for both CS and CVS. In arm B, the Evalyn Brush was used for CVS, while the Cervex Brush was used for CS. All samples were tested for hrHPV using the digene® HC2 High-Risk HPV DNA Test and genotyped with the PapilloCheck® HPV-Screening assay. The overall hrHPV prevalence was 14.8%, based on positive results from either CVS or CS samples. hrHPV positivity was detected in 10.8% of clinician-obtained CSs and 11.8% of self-collected CVSs. A combined analysis of CS and CVS samples identified the five most prevalent hrHPV genotypes: HPV16, HPV31, HPV39, HPV56, and HPV68. The comparison of hrHPV detection in paired CS and CVS samples showed an overall concordance of 93%. These findings highlight the importance of detecting hrHPV genotypes alongside conventional Pap testing in national cervical screening programs. Furthermore, the results confirm that self-sampling kits represent a suitable alternative to clinician-collected samples.</p><p><p>Clinical trials registration  ClinicalTrials.gov Identifier (NCT04133610).</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of adverse childhood experiences with physical illness and self-rated health in the population-based Tromsø Study.","authors":"Safak Caglayan, Anne Høye, Jens C Thimm, Catharina E A Wang, Ole K Grønli","doi":"10.1093/eurpub/ckaf031","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf031","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are highly prevalent and associated with life-long health consequences. Here, we investigated the relationship of ACEs to adult-onset health outcomes in general population. We conducted a cross-sectional analysis using the seventh survey of the Tromsø Study, including 20 843 participants. Main exposure variables were exposure to at least one ACE, rumination related to adverse experiences, cumulative ACEs, and two clusters of ACEs, i.e. interpersonal and impersonal ACEs. Logistic and ordinal regression models were fitted to estimate the risk of adult-onset physical illness and poor self-rated health adjusted for birth year, sex, smoking, education, and income. We found that exposure to at least one ACE together with rumination was associated with increased risk of hypertension, heart failure, atrial fibrillation, diabetes, obesity, kidney disease, chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, arthrosis, migraine, chronic pain, and poor self-rated health. We observed dose-effect relationships of cumulative ACEs to the aggregated risk of 14 among 16 health outcomes. While increased risk of heart failure, kidney disease, and rheumatoid arthritis was only linked to the interpersonal ACEs, increased risk of coronary artery disease was associated only with the impersonal ACEs. Our findings demonstrate that exposure to ACEs increases the risk of adult-onset physical illness and poor self-rated health in a dose-effect relationship, and rumination related to adverse experiences is associated with an aggravated risk. Inquiry into exposure to ACEs might inform about health risks. Early intervention approaches to promote positive experiences and increase resilience might alleviate life-long health burden.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations of different recess types on physical activity and sedentary behaviour in Estonian primary school students.","authors":"Getter Marie Lemberg, Merike Kull, Jarek Mäestu, Eva-Maria Riso, Evelin Mäestu","doi":"10.1093/eurpub/ckaf052","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf052","url":null,"abstract":"<p><p>Students' physical activity (PA) levels tend to decrease with increasing age; however, the school day structure can potentially influence students' PA levels. This study aimed to measure and compare objective levels of PA during recess and school time between schools with different recess types. 15 different schools were selected, and accelerometry-based PA levels of 9-13-year-old students were measured. Schools were selected based on the recess types: (i) 'daily outdoor recess'; (ii) 'irregular outdoor recess'; (iii) 'indoor recess'. The 'daily outdoor recess' group reached the highest moderate-to-vigorous PA (MVPA) during recess compared to other groups. 'Indoor recess' group had more sedentary time during recess compared to 'irregular outdoor recess' and 'daily outdoor recess' groups (43.6 ± 1.0%, 34.0 ± 1.0%, 30.8 ± 0.8%, respectively; P < .05). Time in MVPA was unchanged during recess across all grades in the 'daily outdoor recess' group (from 22.8% to 25.6%), while decreased MVPA from 27% to 17% and from 21% to 10% was found in 'irregular outdoor recess' and 'indoor recess' group, respectively; P < .05. Sedentary time increased from 34% to 52% in the 'indoor recess' group and from 26% to 43% in the 'irregular outdoor recess' group (P < .05). There was a positive association between the recess length and MVPA minutes acquired during recess; however, during a 15-25 min outdoor recess, students spent more time in MVPA compared to a 30-50 min outdoor recess (28%-30.5%, 21%-23%, respectively). The findings emphasize that unstructured outdoor recess has a high potential to maintain the MVPA levels with increasing age.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually transmitted infections among pre-exposure prophylaxis users in a Swedish multi-centre cohort.","authors":"Tobias Herder, Fredrik Månsson, Petra Tunbäck, Karin Sanner, Magnus Gisslén, Ester Fridenström, Minna Dawar, Susanne Strömdahl","doi":"10.1093/eurpub/ckaf034","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf034","url":null,"abstract":"<p><p>An additional upsurge in bacterial STIs has been observed in Sweden following HIV pre-exposure prophylaxis (PrEP) implementation. From a prevention perspective, it is of relevance to optimize testing strategies within PrEP programmes to identify those most at risk. An open retrospective longitudinal observational cohort study was performed at three STI clinics in Uppsala, Gothenburg, and Malmö. A questionnaire and journal data regarding STI were collected from a sample of 199 MSM enrolled in the PrEP programmes and providing informed consent. Incident bacterial STIs during follow-up were analyzed with descriptive statistics, Poisson regression, and Cox regression. Median follow-up time was 632 days. A total of 270 gonorrhoea or chlamydia infections were recorded during PrEP follow-up, compared to 194 cases in the 2-year period prior to enrolment, giving an incidence rate ratio (IRR) of 1.56 (CI 95% 1.30-1.89). The testing frequency increased by 75% (IRR 1.69, CI 95% 1.60-1.90). For diagnoses of active syphilis, the increase was 108% (IRR 2.08. CI 95% 1.04-4.06), compared with a 5-year period preceding enrolment. The hazard ratio of time (days) until a first STI after PrEP initiation was 2.87 (CI 95% 1.72-4.80) for those having had a STI prior to PrEP initiation and 2.06 (CI 95% 1.03-4.13) for those reporting experience of group sex in the past year compared with those who had not. STI prior to PrEP initiation and group sex were associated with STI after initiation of PrEP, factors that could be considered if needing prioritizing the frequency of STI screening.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner psychological violence and children's sleep difficulties up to 5 years of age: an ELFE birth cohort.","authors":"Marion Bailhache, Sabine Plancoulaine, Fabienne El-Khoury, Olivier Leproux, Eloi Chazelas, Ramchandar Gomajee, Judith Van Der Waerden, Marie Aline Charles, Maria Melchior","doi":"10.1093/eurpub/ckaf037","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf037","url":null,"abstract":"<p><p>To examine the association between intimate partner psychological violence (P-IPV) from before pregnancy to 2 years after the child's birth and child's sleep patterns, i.e. sleep onset difficulty (SOD), nighttime awakenings (NA), and nighttime sleep duration (NSD) between 2 and 5 years of child's age. Data come from the population-based French birth ELFE cohort launched in 2011. P-IPV was assessed before and during pregnancy, at 2 months and 2 years post-partum. Children's sleep patterns were measured at 2, 3, and 5 years of age. Group-based trajectory modelling was used to identify trajectories of P-IPV and each child's sleep patterns. Associations between P-IPV and children's sleep trajectories were assessed by weighted multivariate logistic regressions. Five P-IPV trajectories were identified: minimal (64%), prenatal (14%), decreasing (9%), increasing (8%), and persistent (5%). Two trajectories of SOD (few 65% and many 35%), three trajectories of NA (few 49%, decreasing 24%, and many 23%), and three trajectories of NSD (short 21%, medium 56%, and long 23%) were identified. About 9513, 9512, and 9499 children were included in comparative analyses, respectively, focused on SOD, NA, and NSD. Increasing and persistent P-IPV trajectories were both associated with the trajectory of many SODs [odds ratio (OR) = 1.53, 95% confident interval (CI) = 1.24-1.91; and OR = 1.71, 95% CI = 1.31-2.22, respectively] and the trajectory of many NA (OR = 1.66, 95% CI = 1.29-2.13); and (OR = 1.95, 95% CI = 1.42-2.69, respectively). Associations between persistent P-IPV and decreasing and many NA were significant among girls (OR = 1.76, 95% CI = 1.12-2.75 and OR = 2.27, 95% CI = 1.39-3.71, respectively), but not among boys. Family interventions in response to IPV should pay particular attention to sleep patterns of children exposed to IPV.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen-detected breast cancer and cancer stage by area-level deprivation: a descriptive analysis using data from the National Cancer Registry Ireland.","authors":"Philippa White, Aline Brennan, Joe McDevitt, Deirdre Murray, Caroline Mason Mohan, Patricia Fitzpatrick, Therese Mooney, Alan Smith, Maeve Mullooly, Niamh Bambury","doi":"10.1093/eurpub/ckae204","DOIUrl":"10.1093/eurpub/ckae204","url":null,"abstract":"<p><p>Breast cancer screening programmes can lead to better disease outcomes, but women from deprived backgrounds are less likely to participate and more likely to present with late-stage cancer. This study aimed to explore associations between deprivation and breast cancer screening outcomes in Ireland during 2009-2018. Data on all female breast cancer cases diagnosed in Ireland during 2009-2018 were extracted from the National Cancer Registry Ireland. Associations between area-level deprivation, using the Pobal Haase-Pratschke deprivation index, and detection of breast cancer through BreastCheck, Ireland's breast screening programme, and stage of screen-detected breast cancer were explored. Unadjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Among screening eligible women in Ireland in 2009-2018, there was no difference in risk of breast cancer detection through BreastCheck across deprivation quintiles (RR for most compared to least deprived group: 1.01, 95% CI: 0.96-1.06). In women with screen-detected breast cancer, the risk of late-stage cancer detection increased with deprivation in 2009-2013 (RR for most compared to least deprived group: 1.45, 95% CI: 1.10-1.93), but no association was observed between deprivation and cancer stage in 2014-2018. Notwithstanding its limitations, including the risk of confounding by uncontrolled variables, this study suggests screening eligible women in Ireland have had similar outcomes from breast cancer screening, regardless of deprivation level, since the national roll-out of BreastCheck. Associations between deprivation and screening outcomes should continue to be monitored to ensure Ireland's breast cancer screening programme is helping to reduce health inequities.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"347-352"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Community Acute Respiratory Infection surveillance programme: an evaluation of a newly established surveillance programme in Scotland.","authors":"Tonje S Laird, Mark Hamilton, Catriona Oliver, Fatima Sadiq, Yomna Moawad, Josie Evans","doi":"10.1093/eurpub/ckae200","DOIUrl":"10.1093/eurpub/ckae200","url":null,"abstract":"<p><p>The Community Acute Respiratory Infection (CARI) surveillance programme, established by Public Health Scotland (PHS) in November 2021, aims to monitor respiratory infections in communities, replacing prior schemes to ensure early detection of outbreaks and inform public health interventions. Positioned as a cornerstone of PHS's national infectious respiratory diseases plan, CARI is pivotal for safeguarding public health. This study presents key findings from the 2022/23 CARI season and evaluates the programme's performance during this period. CARI uses a network of sentinel general practitioner (GP) practices across Scotland to monitor patients with acute respiratory infection symptoms, employing multiplex polymerase chain reaction testing for 10 common pathogens. Results are linked to enhanced surveillance data, providing insights into infection trends during the season. The evaluation comprised an online GP survey and a quantitative assessment of programme performance. In the 2022/23 season, 180 GP practices participated in CARI, testing 15,823 samples. Swab positivity peaked in December 2022, driven by a large spike in influenza A activity. The evaluation showed that CARI is highly useful, with positive feedback on simplicity, flexibility, and acceptability. Representativeness varied across health boards and age groups. Despite occasional laboratory processing delays, data quality remained good, with timely reporting and stable participation. CARI reflected patterns in infections observed in secondary care in Scotland and Europe, providing valuable insights into disease patterns and impact. It also provided timely intelligence to key decision-makers, enabling prompt public health response. Changes for the 2023/24 season aim to further optimize the programme.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"282-289"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing personalized medicine: key priorities for clinical studies and funding systems based on a Europe-China collaborative Delphi survey.","authors":"Tommaso Osti, Cosimo Savoia, Sara Farina, Flavia Beccia, Francesco Andrea Causio, Lily Wang, Wenya Wang, Carmen Fotino, Chiara Cadeddu, Walter Ricciardi, Stefania Boccia","doi":"10.1093/eurpub/ckaf004","DOIUrl":"10.1093/eurpub/ckaf004","url":null,"abstract":"<p><p>Personalized medicine (PM) has the potential to revolutionize healthcare by delivering treatments tailored to individual patients based on their unique characteristics. However, ensuring its effective implementation presents complex challenges, particularly in terms of long-term sustainability. To address these challenges, the IC2PerMed project fosters collaboration between the European Union and China. This study, building on insights from the project, aims to identify key priorities for advancing PM, focusing on Clinical Studies and Funding Systems, with special attention to optimizing resource management, distribution, and protection to support sustainable development. A two-round Delphi survey was conducted to achieve consensus on common priorities among China and Europe related to Clinical Studies and Funding Systems. Consensus was measured using the Content Validity Index, requiring an agreement level of 80% or higher for item inclusion. The survey identified 20 key priorities in PM research, split evenly between research initiatives and funding mechanisms. Notable priorities include developing technology for deep phenotyping, standardizing methodological approaches, and fostering public-private collaborations. In funding, the emphasis was placed on involving patient voices in research design and establishing synergies among funders to support larger projects. The findings underscore the importance of structured collaboration between Europe and China in advancing personalised medicine. By addressing identified priorities in research and funding, this initiative can significantly enhance the efficacy of PM, ultimately improving healthcare outcomes globally. The study sets a precedent for future international partnerships aimed at fostering innovation in health sciences.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"209-215"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the AZD1222 vaccine against COVID-19 hospitalization in Europe: final results from the COVIDRIVE test-negative case-control study.","authors":"Leonie de Munter, Wilhelmine Meeraus, Akshat Dwivedi, Marianna Mitratza, Chloé Wyndham-Thomas, Lucy Carty, Mario Ouwens, Wendy Hartig-Merkel, Laura Drikite, Griet Rebry, Irma Casas, Ainara Mira-Iglesias, Giancarlo Icardi, Susana Otero-Romero, Sebastian Baumgartner, Charlotte Martin, Xavier Holemans, Gerrit Luit Ten Kate, Kaatje Bollaerts, Sylvia Taylor","doi":"10.1093/eurpub/ckae219","DOIUrl":"10.1093/eurpub/ckae219","url":null,"abstract":"<p><p>Marketing authorization holders of vaccines typically need to report brand-specific vaccine effectiveness (VE) to the regulatory authorities as part of their regulatory obligations. COVIDRIVE (now id. DRIVE) is a European public-private partnership for respiratory pathogen surveillance and studies of brand-specific VE with long-term follow-up. We report the final VE results from a two-dose primary series AZD1222 (ChAdOx1 nCoV-19) vaccine schedule in ≥18-year-old individuals not receiving boosters. Patients (N = 1,333) hospitalized with severe acute respiratory infection at 14 hospitals in Austria, Belgium, Italy, and Spain were included in the test-negative case-control study in 2021-2023. Absolute VE was calculated using generalized additive model (GAM), generalized estimating equation (GEE), and spline-based area under the curve (AUC, measuring VE up to 6 months after the last dose of AZD1222). Overall VE (against coronavirus disease 2019 [COVID-19] hospitalization) of an AZD1222 primary series was estimated as 65% using GEE (95% confidence interval [CI]: 52.9-74.5), and 69% using GAM (95% CI: 50.1-80.9) over the 22-month study period (comparator group: unvaccinated patients). The AUC of the spline-based VE estimate was 74.1% (95% CI: 60.0-88.3). VE against hospitalization in study participants who received their second AZD1222 dose 2 months or less before hospitalization was 86% using GEE (95% CI: 77.8-91.4), 93% using GAM (95% CI: 67.2-98.6). During this study period, where mainly the severe acute respiratory syndrome coronavirus 2 Omicron variant was circulating, a two-dose primary series AZD1222 vaccination conferred protection against COVID-19 hospitalization up to at least 6 months after the last dose.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"373-378"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stillbirth rate trends across 25 European countries between 2010 and 2021: the contribution of maternal age and multiplicity.","authors":"Maxi S Kniffka, Jonas Schöley, Susie Lee, Loes C M Bertens, Jasper V Been, Jóhanna Gunnarsdóttir","doi":"10.1093/eurpub/ckae214","DOIUrl":"10.1093/eurpub/ckae214","url":null,"abstract":"<p><p>Stillbirth rates have stalled or increased in some European countries during the last decade. We investigate to what extent time-trends and between-country differences in stillbirth rates are explained by the changing prevalence of advanced maternal age and teenage pregnancies or multiple births. We analysed data on stillbirths and live births by maternal age and multiplicity from 2010 to 2021 in 25 European countries using Kitagawa decomposition to separate rate differences into compositional and rate components. Rates significantly decreased in six countries, but increased in two. Changes in maternal age structure reduced national stillbirth rates by a maximum of 0.04 per 1000 in the Netherlands and increased rates by up to 0.85 in Cyprus. Changes in the prevalence of multiple births decreased rates by up to 0.19 in the Netherlands and increased rates by up to 0.01 across multiple countries. Maternal age differences explained between 0.11 of the below-European average stillbirth rate in Belgium and 0.13 of the above-average rate in Ireland. Excluding Cyprus, differences in multiple births explained between 0.05 of the below-average rate in Malta and 0.03 of the above-average rate in Ireland. For most countries, the increase in advanced-age pregnancies contributed to rising stillbirth rates over time, while reductions in multiples led to decreases in rates. However, large parts of the trends remain unexplained by those factors. By 2021, neither factor explained the differences between countries, due to increased compositional uniformity and declining stillbirth risk for advanced maternal age.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"319-327"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}