Medical Information Center, Kyushu University Hospital, Fukuoka city, Japan.
Medical Information Center, Kyushu University Hospital, Fukuoka city, Japan.
J Gynecol Obstet Hum Reprod. 2024 Dec;53(10):102834. doi: 10.1016/j.jogoh.2024.102834. Epub 2024 Aug 13.
In this study, the association of non-institutional births with neonatal and infant mortality in Japan was investigated as well as sociodemographic characteristics of non-institutional births.
The Vital Statistics data in Japan (the birth data from 2012 to 2021 and mortality data from 2012 to 2022) were used. Births were classified into three types based on the place of birth and birth attendant: institutional births, non-institutional births with a physician or a midwife, and non-institutional births without a physician or a midwife. Modified Poisson regression was used in order to investigate the association between the type of birth and neonatal and infant mortality and the association between sociodemographic characteristics and the type of birth.
A total of 9,422,942 births were used in the analysis. The results of regression analysis investigating an association between the type of birth and neonatal and infant mortality showed that non-institutional births were positively associated with neonatal and infant mortality regardless of the attendance of a physician or a midwife. Furthermore, the results of regression analysis investigating predictors of non-institutional births showed that factors such as non-urban regions, older maternal age groups, and unmarried status of mothers were positively associated with the two types of non-institutional births, and non-Japanese mother was positively associated with non-institutional births without a physician or a midwife.
Non-institutional births were a predictor of neonatal and infant mortality regardless of the attendance of a physician or midwife, and some sociodemographic characteristics have been proven to be predictors of non-institutional births.
本研究旨在探讨日本非机构分娩与新生儿和婴儿死亡率的关系，并分析非机构分娩的社会人口学特征。
使用日本的生命统计数据（2012 年至 2021 年的出生数据和 2012 年至 2022 年的死亡数据）。根据分娩地点和分娩助手将分娩分为三类：机构分娩、有医生或助产士参与的非机构分娩以及无医生或助产士参与的非机构分娩。采用修正泊松回归分析以探讨分娩类型与新生儿和婴儿死亡率之间的关系，以及社会人口学特征与分娩类型之间的关系。
共纳入 9422942 例分娩进行分析。回归分析结果表明，无论是否有医生或助产士参与，非机构分娩与新生儿和婴儿死亡率呈正相关。进一步分析非机构分娩的预测因素表明，非城市地区、母亲年龄较大以及母亲未婚等因素与两种类型的非机构分娩呈正相关，而非日本籍母亲与无医生或助产士参与的非机构分娩呈正相关。
无论是否有医生或助产士参与，非机构分娩都是新生儿和婴儿死亡率的预测因素，一些社会人口学特征被证明是非机构分娩的预测因素。
