Sakata Soyoko, Konishi Shoko, Ng Chris Fook Sheng, Watanabe Chiho
Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Anthropology, University of Washington, Seattle, WA, USA.
J Obstet Gynaecol Res. 2018 Mar;44(3):390-396. doi: 10.1111/jog.13460. Epub 2017 Sep 12.
Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates.
Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at < 37 or < 34 weeks of gestation. Crude and standardized rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods.
Throughout the study period, the rates of preterm birth (both at < 37 and < 34 weeks of gestation) were higher among mothers aged 20 and younger, and mid-30s and older, compared to mothers in their 20s or early 30s. The rates of preterm birth at < 37 (but not at < 34) weeks decreased for mothers aged in their late 30s and 40s, and increased for mothers in their 20s and early 30s. Standardized rates of preterm birth showed a secular increase for preterm births at < 37 but not < 34 weeks of gestation.
The rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks.
研究1979年至2014年日本早产的长期趋势,以确定这些变化是否可以通过分娩时母亲年龄和胎次分布的变化和/或特定年龄早产率的变化来解释。
1979年至2014年的活产数据来自日本厚生劳动省。分析仅限于在日本出生的单胎儿童(n = 43632786)。早产的定义采用两个临界值,即妊娠<37周或<34周。按特定时间段内分娩时母亲年龄计算头胎和非头胎单胎的早产粗率和标准化率。
在整个研究期间,与20多岁或30岁出头的母亲相比,20岁及以下、35岁中期及以上的母亲早产率(妊娠<37周和<34周时)更高。37岁晚期和40岁母亲的<37周(而非<34周)早产率下降,而20岁和30岁出头的母亲早产率上升。早产标准化率显示,妊娠<37周而非<34周的早产率呈长期上升趋势。
1979年至2014年期间,20岁和30岁出头母亲的早产率上升,这导致了<37周早产率的长期上升。