Takahashi Mihoko
Department of Social Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Environ Health Prev Med. 2016 Nov;21(6):501-522. doi: 10.1007/s12199-016-0560-0. Epub 2016 Oct 3.
Anomalous variations in live births on February 29/March 1, April 1/April 2 and the days before the New Year holidays/New Year holidays have been reported in Japan. The distribution of live births was investigated on those days and whether or not such dates were selected due to obstetric intervention is discussed.
Using a method similar to the [Formula: see text]-R control chart, anomalous variations in the hourly number of live births were detected. The number of unusual births was estimated.
The number of live births at 13:00-16:59 hours was significantly higher from December 24 to 28 and significantly lower from December 29-January 3, February 29, and April 1, especially on weekdays. In hospitals, the increases from 9:00-12:59 and 13:00-16:59 hours from December 24 to 27 were approximately 10 and 25 %, respectively, of the expected births for those times in the mid-1980s; thereafter, the rates were 30 and 35 %. After 2000, the child births at 13:00-16:59 hours on February 29 and April 1 decreased by approximately 35 % in hospitals and clinics. The numbers of live births at 0:00-0:59 hours were significantly higher on March 1 and April 2 until 2001.
Anomalous variations at 0:00-0:59 hours may be associated with fictitious reporting on birth certificates. Anomalous variations from 13:00 to 16:59 hours on weekdays suggest that many individuals may avoid obstetric intervention on February 29 and April 1 and that the number of higher-risk deliveries may significantly increase in the daytime on the days before the New Year holidays due to obstetric intervention for institutional reasons.
在日本,有报道称2月29日/3月1日、4月1日/4月2日以及新年假期前/新年假期期间活产儿数量存在异常变化。本研究调查了这些日期的活产儿分布情况,并探讨了此类日期的选择是否是由于产科干预所致。
采用类似于[公式:见原文]-R控制图的方法,检测每小时活产儿数量的异常变化。估算异常出生的数量。
12月24日至28日13:00 - 16:59时的活产儿数量显著增加,12月29日至1月3日、2月29日和4月1日显著减少,尤其是在工作日。在医院中,12月24日至27日9:00 - 12:59时和13:00 - 16:59时的活产儿增加数量分别约为20世纪80年代中期这些时段预期出生数量的10%和25%;此后,这两个比例分别为30%和35%。2000年后,2月29日和4月1日13:00 - 16:59时在医院和诊所的活产儿数量减少了约35%。2001年前,3月1日和4月2日0:00 - 0:59时的活产儿数量显著增加。
0:00 - 0:59时的异常变化可能与出生证明上的虚假报告有关。工作日13:00至16:59时的异常变化表明,许多人可能会避免在2月29日和4月1日进行产科干预,并且由于机构原因进行产科干预,新年假期前几天白天高风险分娩的数量可能会显著增加。