Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan.
Tokyo Foundation for Policy Research, Tokyo, Japan.
Sci Rep. 2023 Jan 31;13(1):1788. doi: 10.1038/s41598-023-28642-9.
In Japan, mean birth weight has significantly decreased from 3152 g in 1979 to 3018 g in 2010 and the prevalence of preterm birth (PTB) has risen to 5.7% in the last thirty years. However, the presence and magnitude of geographical differences in low birthweight (LBW) and/or PTB in Japan is not well understood. We implemented spatial analysis to identify localized clusters and hot spots of LBW and/or PTB during 2012-2016. The Japan national birth database was used in this study. A total of 5,041,685 (male: 2,587,415, female: 2,454,270) births were used for spatial analysis using empirical Bayes estimates of the incidence rate of LBW and/or PTB and spatial scan tests to detect hot-spot areas with p values calculated from Monte Carlo iterations. The most and second likely clusters were located in two areas: (1) the small islands in south-west Japan (Amami and Okinawa, Relative risk = 1.09-1.67 with p < 0.001) and (2) the cities on the base of Mt. Fuji, stretching over three neighboring prefectures of Yamanashi, Shizuoka and Kanagawa (Relative risk = 1.10-1.55 with p < 0.001), respectively. We need to optimize the medical resource allocations based on the evidence in geographical clustering of LBW and/or PTB at specific locations in Japan.
在日本，平均出生体重从 1979 年的 3152 克显著下降到 2010 年的 3018 克，早产率（PTB）在过去三十年上升到 5.7%。然而，日本低出生体重（LBW）和/或早产的存在和程度的地域差异尚不清楚。我们实施了空间分析，以确定 2012-2016 年期间 LBW 和/或 PTB 的局部聚集和热点地区。本研究使用了日本国家出生数据库。利用经验贝叶斯估计的 LBW 和/或 PTB 发生率和空间扫描检验对 5041685 例（男性：2587415 例，女性：2454270 例）出生进行了空间分析，以检测热点地区，并通过蒙特卡罗迭代计算 p 值。最可能和第二可能的集群位于两个地区：（1）日本西南部的小岛（奄美和冲绳，相对风险=1.09-1.67，p<0.001）和（2）富士山脚下的城市，横跨山梨、静冈和神奈川三个相邻的县（相对风险=1.10-1.55，p<0.001）。我们需要根据日本特定地点 LBW 和/或 PTB 的地理聚类证据，优化医疗资源的分配。
