Cesarean section rates in each region of Greece: A retrospective analysis

Introduction: There is a national trend in increasing cesarean section rates in Greece. The purpose of this study was to determine the frequency of cesarean sections per district of the Greek territory. Materials and Methods: In this retrospective observational study, the records of all births in Greece between 2019-2020 from the official archives of the Hellenic Statistical Authority were processed and analyzed. The NUTS-1 classification according to the EUROSTAT was used for the division of the Greek territory into districts. Based on this classification, Greece is divided into four major districts: Northern Greece, Central Greece, Attica and Aegean Islands-Crete. Results: In total, 169,417 births were recorded in Greece during the two-year period from 1/1/2019 to 31/12/2020. Of these, 55.79% were performed by cesarean section, 40.24% by vaginal delivery, 0.02% by a combination of vaginal delivery and cesarean section, while the mode of procedure was not reported in 3.95% of all deliveries. The highest frequency of cesarean sections was observed in Attica with a rate of 58.86%. The corresponding rates in the other districts were 55.50% (Aegean Islands and Crete), 53.55% (Northern Greece) and 51.49% (Central Greece). Notably, the mode of delivery was not reported in 13.75% of births in Central Greece, while the respective rates in the other districts ranged between 1.02% and 2.1%. Conclusions: The frequency of cesarean sections in Greece was high, with a rate of 55.79% of all births, during the study period. The district with the highest frequency of cesarean section was Attica, with a rate over 58%.