Changes in preterm and extremely preterm birth rates in Japan after the introduction of obstetrical practice guidelines in 2008

Author:

Shimano Satoshi1ORCID,Yamada Takashi2ORCID,Cho Kazutoshi3ORCID,Sengoku Kazuo4ORCID,Mariya Tasuku5ORCID,Saito Tsuyoshi5ORCID

Affiliation:

1. Department of Obstetrics and Gynecology Nakashibetsu Municipal Hospital Nakashibetsu Hokkaido Japan

2. Department of Obstetrics and Gynecology JCHO Hokkaido Hospital Sapporo Hokkaido Japan

3. Department of Pediatrics JCHO Hokkaido Hospital Sapporo Hokkaido Japan

4. Mori Obstetrical and Gynecological Hospital Asahikawa Hokkaido Japan

5. Department of Obstetrics and Gynecology Sapporo Medical University, School of Medicine Sapporo Hokkaido Japan

Abstract

AbstractAimObstetrical guidelines were established in Japan in 2008, and obstetrical diagnoses and treatments were subsequently standardized nationally. We examined changes in the preterm birth rate (PTBR) and extremely preterm birth rate (EPTBR) following the introduction of such guidelines.MethodsInformation on 50 706 432 live births in Japan between 1979 and 2021, including Japanese reproductive medicine, the childbearing age of pregnant women, and the employment status of reproductive‐age women between 2007 and 2020, were obtained from the Japanese government and academic societies. Regression analysis was used to compare chronological changes nationally and those of eight Japanese regions. Regional and national average PTBRs and EPTBRs from 2007 to 2020 were compared by using a repeated measures analysis of variance.ResultsFrom 1979 to 2007, PTBRs and EPTBRs in Japan increased significantly. However, from 2008, the national PTBR and EPTBR decreased until 2020 (p < 0.001) and 2019 (p = 0.02), respectively. From 2007 to 2020, overall PTBR and EPTBR were 5.68% and 0.255%, respectively. A significant difference in the PTBR and EPTBR existed between the eight Japanese regions. During this period, the number of pregnancies using assisted reproductive technology increased from 19 595 to 60 381, pregnant women became older, the employment rate of those of reproductive age increased, and nonregular employment was 54%, which was 2.5 times higher than for men.ConclusionsIn Japan, after obstetrical guidelines were enacted in 2008, PTRBs decreased significantly even under the pressure of increasing preterm births. Countermeasures may be necessary for regions showing high PTBRs.

Publisher

Wiley

Subject

Obstetrics and Gynecology

Reference50 articles.

1. Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetrical and Gynecologists (JAOG). Guidelines for obstetrical practice in Japan. 2008 edition; 2008: 1–193 (in Japanese).

2. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2011 edition

3. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition

4. Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG). Guidelines for obstetrical practice in Japan. 2017 edition. 2017: 1–449 (in Japanese).

5. Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG). Guidelines for obstetrical practice in Japan. 2020 edition. 2020: 1–384 (in Japanese).

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