Related Experiment Video
Updated: May 15, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Trends of preterm birth and low birth weight in Japan: a one hospital-based study
Takashi Yorifuji1, Hiroo Naruse, Saori Kashima
1Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan. yorichan@md.okayama-u.ac.jp
Insights
Rising preterm birth (PTB) and low birth weight (LBW) in Japan were linked to increased obstetric interventions. However, neonatal outcomes improved, suggesting benefits of these interventions for perinatal health.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health
Background:
- Preterm birth (PTB) and low birth weight (LBW) rates are increasing in developed nations.
- Investigating contributing factors to these trends in Japan is crucial.
- The role of obstetric interventions requires specific examination.
Purpose of the Study:
- To analyze the factors contributing to the rise in PTB and LBW in Japan.
- To evaluate the impact of obstetric interventions on these trends.
- To assess changes in neonatal outcomes over time.
Main Methods:
- Retrospective analysis of a hospital database in Shizuoka, Japan (1997-2010).
- Inclusion of 19,221 live singleton births.
- Comparison of PTB and LBW proportions and neonatal outcomes across four time intervals.
Main Results:
- A significant increase in PTB, particularly medically indicated PTB, was observed.
- Changes in cesarean section rates largely explained the rise in PTB.
- Neonatal outcomes, including Apgar scores and NICU admission rates, showed improvement.
- Reduced risk of NICU admission was noted in later intervals for all and medically indicated births.
Conclusions:
- Obstetric interventions appear beneficial despite rising PTB and LBW rates.
- Evaluating perinatal health should consider outcomes beyond simple PTB/LBW categorization.
- Focusing on indicators like perinatal mortality offers a more appropriate assessment.
Background:
The proportions of preterm birth (PTB, ie., delivered before 37 gestational weeks) and low birth weight (LBW, ie., birth weight less than 2500 g at delivery) have been rising in developed countries. We sought to examine the factors contributing to the rise in Japan, with particular focus on the effects of obstetric interventions.
Methods:
We used a database maintained by one large regional hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered live singleton births from 1997 to 2010 (n = 19,221). We assessed the temporal trends in PTB and LBW, then divided the study period into four intervals and compared the proportions of PTB and LBW. We also compared the newborns' outcomes between the intervals.
Results:
PTB, in particular medically indicated PTB, increased considerably. The increase was largely explained by changes in caesarean sections. The neonatal outcomes did not worsen, and instead the Apgar scores and proportions requiring neonatal intensive care unit (NICU) admission improved. In particular, the risks of NICU admission in the interval from 2007 to 2010 were decreased among all births [odds ratio (OR): 0.84; 95% confidence interval (CI): 0.75, 0.95] and medically indicated births (OR: 0.44; 95% CI: 0.29, 0.68) compared with the interval from 1997 to 2000.
Conclusions:
Despite the increases in PTB as well as LBW, the present study suggests benefits of obstetric interventions. Rather than simple categorization of PTB or LBW, indicators such as perinatal mortality or other outcomes may be more appropriate for evaluation of perinatal health in developed countries.
Related Concept Videos
Regression Toward the Mean
Bias in Epidemiological Studies
Prevalence and Incidence
Prevalence indicates the proportion of individuals in a population who have a specific disease or health condition at a...
Factors Affecting Illness
For instance, risk factors are connected to illness, disability,...
Hospitals-II
Nurses that work in hospitals have...
Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...

