Ueda K, Onomichi M, Harada K, Miyakita T, Ueda A
Kumamoto University College of Medical Science, Japan.
Nihon Eiseigaku Zasshi. 1998 Jul;53(2):470-6. doi: 10.1265/jjh.53.470.
The aims of this investigation were to describe the relationship between perinatal mortality rates and the proportions of live births among low birth weight (LBW) infants from 1968 to 1994, and to determine risk factors in infants of low birth weight. Using vital statistics from 1968 to 1994 of the Japanese government and the Kumamoto Prefecture and Maternal and Child Health Statistics of Japan from 1968 to 1995, perinatal deaths and live births of infants of low birth weight were studied according to national statistics criteria. In Japanese and Kumamoto Prefecture, there was an association between perinatal deaths and live births of LBW. The significant decline of perinatal mortality rates from 1968 to 1976, of which the fetal death ratio at 28 weeks and over mostly declined, was closely related to the decline of live births of LBW. In this period, the improvement of socioeconomic conditions and the comprehensive health care provided by the government contributed in improving perinatal mortality rates. From 1977 to 1988, the annual variation of Kumamoto was different from that of all Japan. Both perinatal mortality rates continued to decline due to a general decrease in early neonatal mortality rates. The number of Live births of LBW infants in Kumamoto prefecture increased in 1977 and once again started to decline in 1982. In 1977, the insufficient maternal-child health care and the increase of female workers contributed to increasing rates of live births of LBW. Advances in neonatal medicine contributed to the increase in survival rates of infants of LBW. Although, after 1982, the improvement of maternal-child health care and the perinatal care system contributed to the declining rates of live births of LBW. On the other hand, those rates in all Japan continued to gradually increase from 1977 to 1988. After 1989, perinatal mortality rates continued to decline, and live births of LBW continued to increase in both Kumamoto prefecture and all Japan. These results were contrary to the above results from 1968 to 1976. It was considered that medical advances in the care of pregnant women and neonates increased survival rates of the LBW. In future, the perinatal mortality rates will appear to approach a minimum constant, that is, a minimum of fetal death rates. It is important to reduce the number of LBW infants, particularly birthweight of 2000 g-2499 g, with maternal-child health care.
本调查的目的是描述1968年至1994年间低体重（LBW）婴儿的围产期死亡率与活产比例之间的关系，并确定低体重婴儿的风险因素。利用日本政府1968年至1994年的人口动态统计数据、熊本县的数据以及日本1968年至1995年的母婴健康统计数据，按照国家统计标准对低体重婴儿的围产期死亡和活产情况进行了研究。在日本和熊本县，低体重婴儿的围产期死亡与活产之间存在关联。1968年至1976年围产期死亡率显著下降，其中28周及以上的胎儿死亡率下降最为明显，这与低体重活产数量的下降密切相关。在此期间，社会经济状况的改善以及政府提供的全面医疗保健有助于围产期死亡率的降低。1977年至1988年，熊本县的年度变化与全日本不同。由于早期新生儿死亡率普遍下降，两地的围产期死亡率均持续下降。熊本县低体重婴儿的活产数量在1977年有所增加，并于1982年再次开始下降。1977年，母婴保健不足以及女性工人数量的增加导致了低体重活产率的上升。新生儿医学的进步有助于低体重婴儿存活率的提高。尽管1982年以后，母婴保健和围产期保健系统的改善导致了低体重活产率的下降。另一方面，全日本的这一比例从1977年至1988年持续逐渐上升。1989年以后，熊本县和全日本的围产期死亡率持续下降，低体重活产数量持续增加。这些结果与1968年至l976年的上述结果相反。据认为，孕妇和新生儿护理方面的医学进步提高了低体重婴儿的存活率。未来，围产期死亡率似乎将接近最低常数，即最低胎儿死亡率。通过母婴保健减少低体重婴儿数量，尤其是体重在2000克至2499克之间的婴儿数量非常重要。
