Greater Poland births fell 31.9% from 2017 peak to 2023

Researchers analysed annual live births by residents’ place of residence and delivery records from all 34 maternity facilities in Greater Poland. The retrospective longitudinal ecological study covered 2013–2023 and used trend modelling to assess changes in births and deliveries by perinatal reference level. It also examined income–birth associations and conducted sensitivity analyses, including one restricted to facilities operating throughout the period.

Live births increased from 36,561 in 2013 to 40,450 in 2017, then fell to 27,532 in 2023—a 31.9% decline from the peak. For 2017–2023, the estimated annual decrease was 2,118 births (95% CI, 1,807 to 2,429 fewer; p<0.001). Deliveries declined by 40.3% at Level I, 30.3% at Level II and 29.2% at Level III. Among continuously operating units, the Level I decline was 33.0%; the greater overall reduction reflected closure of four peripheral facilities. Income was not significantly associated with births after accounting for changes over time.

The findings may inform regional perinatal-network and older-adult-care planning, but do not test the effects of particular service changes. This was an ecological analysis of one region using aggregate administrative data, so it cannot establish individual-level causes or predict outcomes from network reorganisation. The authors reported no external funding.