Regional differences in maternal mortality in Greece, 1973-1982.

Maternal mortality in the ten regions of Greece during the period 1973-82 is examined. In Greece as a whole, maternal mortality declined from 27.2 per 100,000 livebirths in 1973, to 12.0 in 1982. During these ten years, the age standardized maternal mortality ratios (SMRs) of two regions was significantly raised, Thrace (SMR = 295, 95% CL = 187-443) and the Aegean Islands (SMR = 197, 95% CL = 117-311). Greater Athens was the only region with significantly reduced maternal mortality (SMR = 77, 95% CL = 59-99). In two regions, Thrace and Epirus, maternal mortality increased during the ten years studied. To explore the possible reasons for the observed geographical differences in maternal mortality, data on three sociodemographic and three obstetric service indicators are presented. Regions with the highest proportion of hospital births had the lowest SMRs (p less than 0.05); and it is suggested that cultural factors in the case of Thrace, mainly emanating from the Muslim minority living in this region, and topographical factors, in the case of the Aegean Islands and Epirus, may have influenced maternal mortality by adversely affecting maternity service usage and availability.