Journal of Preventive Medicine and Public Health

Original Articles

Factors Associated With Post-term Birth and Its Relationship to Neonatal Mortality in Japan: An Analysis of National Data From 2017 to 2022: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2024;57(6):564-571. Published online September 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.355

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Abstract Summary PDF Supplementary Material: Objectives
Prior research has not yet examined the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. We investigated these associations utilizing nationwide birth data from Japan.
Methods
Birth and mortality data were obtained from the Vital Statistics of Japan for the years 2017 to 2022. The post-term birth rate was calculated by birth characteristics, and the neonatal mortality rates for post-term and term births were computed. Additionally, log-binomial regression analysis was employed to explore the associations between post-term birth and neonatal mortality, as well as between various characteristics and post-term birth. The characteristics considered included infant sex, maternal age group, parity, maternal nationality, maternal marital status, and household occupation.
Results
This study analyzed data from 4 698 905 singleton infants born at 37 weeks of gestational age or later. Regression analysis revealed that post-term birth was positively associated with neonatal mortality. The adjusted risk ratio for neonatal mortality in post-term compared to term births was 8.07 (95% confidence interval, 5.06 to 12.86). Factors positively associated with post-term birth included female infant sex, older maternal age, primiparity, non-Japanese maternal nationality, unmarried status, and various household occupations, including farmer, full-time worker at a smaller company, other type of worker, and unemployed. Younger maternal age was inversely associated with post-term birth.
Conclusions
In Japan, post-term birth represents a risk factor for neonatal mortality. Additionally, socio-demographic characteristics, such as maternal marital status, nationality, and parity were found to be predictors of post-term birth.; Summary

Key Message
This study investigated the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. Regression analysis revealed that post-term birth was significantly and positively associated with neonatal mortality. Additionally, socio-demographic characteristics, such as older maternal age, primiparity, non-Japanese maternal nationality, and unmarried status were found to be predictors of post-term birth.

Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020: Tasuku Okui; J Prev Med Public Health. 2023;56(4):348-356. Published online July 3, 2023; DOI: https://doi.org/10.3961/jpmph.23.133

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Objectives
We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan.
Methods
We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant’s sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. “Other countries” indicates countries except for Japan, Korea, China, the Philippines, and Brazil.
Results
The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively).
Conclusions
The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.

Summary

Citations

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Comparisons of the Rates of Large-for-Gestational-Age Newborns between Women with Diet-Controlled Gestational Diabetes Mellitus and Those with Non-Gestational Diabetes Mellitus
Sirida Pittyanont, Narongwat Suriya, Sirinart Sirilert, Theera Tongsong
Clinics and Practice.2024; 14(2): 536. CrossRef

Analysis of Differences in Preterm Birth Rates According to Household Occupation in Japan From 2007 to 2019: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2022;55(4):371-378. Published online June 20, 2022; DOI: https://doi.org/10.3961/jpmph.22.178

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2 Web of Science
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Abstract PDF

Objectives
No studies have examined the association between preterm birth rates and socioeconomic factors in Japan using nationwide statistical data. We analyzed the association between preterm birth rates and household occupation using Vital Statistics data.
Methods
Aggregated Vital Statistics data from Japan from 2007 to 2019 were obtained from the Ministry of Health, Labour and Welfare. From the data, the number of births according to year, age group, gestational period, number of pregnancies, and household occupation were used in this study. Crude preterm birth rates and preterm birth rates adjusted by maternal age according to household occupation were calculated for each year. Poisson regression analysis was conducted to evaluate the association between household occupation and preterm births.
Results
Unemployed households had the highest preterm birth rate, and households with an occupation classification of “full-time worker 2” (an employee at a large company, civil servant, or board member) had the lowest preterm birth rate throughout each period. Poisson regression analysis revealed that unemployed households were statistically significantly associated with a high preterm birth risk. In contrast, the preterm birth rate adjusted by maternal age remained stable throughout each period regardless of household occupation, and preterm birth rates were found not to have increased in recent years in Japan.
Conclusions
Unemployed households had higher preterm birth rates than other household occupations. Further studies investigating the characteristics of unemployed households are needed to identify the reasons for this disparity.

Summary

Citations

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Analysis of an Association between Preterm Birth and Parental Educational Level in Japan Using National Data
Tasuku Okui
Children.2023; 10(2): 342. CrossRef
Association of maternal nationality with preterm birth and low birth weight rates: analysis of nationwide data in Japan from 2016 to 2020
Tasuku Okui, Yoko Sato, Seiichi Morokuma, Naoki Nakashima
Maternal Health, Neonatology and Perinatology.2023;[Epub] CrossRef
Does the father’s job matter? Parental occupation and preterm birth in Korea
Taemi Kim, Eunseon Gwak, Bolormaa Erdenetuya, Jeong-Won Oh, Jung-won Yoon, Myoung-Hee Kim, Jia Ryu, Seung-Ah Choe
Epidemiology and Health.2023; 45: e2023078. CrossRef

Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data: Tasuku Okui; J Prev Med Public Health. 2021;54(5):352-359. Published online August 14, 2021; DOI: https://doi.org/10.3961/jpmph.21.215

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158 Download
3 Web of Science
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Abstract PDF Supplementary Material

Objectives
The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality.
Methods
Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis.
Results
The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile.
Conclusions
Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.

Summary

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Shimin Jiang, Tianyu Yu, Dingxin Di, Ying Wang, Wenge Li
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef
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Kyoung-Hee Cho, Juyeong Kim, Young Choi, Tae-Hyun Kim
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Diabetes mellitus.2022; 25(4): 327. CrossRef

Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan: Tasuku Okui; J Prev Med Public Health. 2020;53(6):409-418. Published online August 13, 2020; DOI: https://doi.org/10.3961/jpmph.20.159

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233 Download
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Abstract PDF

Objectives
This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan.
Methods
We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort.
Results
Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women.
Conclusions
Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

Summary

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Tasuku Okui
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An Age-Period-Cohort Analysis of Biomarkers of Lifestyle-Related Diseases Using the National Health and Nutrition Survey in Japan, 1973–2018
Tasuku Okui
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Brief Report

Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018: Tasuku Okui; J Prev Med Public Health. 2020;53(3):198-204. Published online April 14, 2020; DOI: https://doi.org/10.3961/jpmph.20.037

5,921 View
178 Download
14 Crossref

Abstract PDF Supplementary Material

Objectives
This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis.
Methods
We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases’ mortality rates into age, period, and cohort effects.
Results
The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later.
Conclusions
The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

Summary

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Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999–2019
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Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan
Tasuku Okui
Journal of Preventive Medicine and Public Health.2020; 53(6): 409. CrossRef

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