日本の周産期死亡率の地域間格差に関する研究 : 人口動態統計を用いた調査 Regional Differences in Perinatal Mortality Rates in Japan : An Investigation Based on Vital Statistics

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Objective: This study investigated whether regional differences in perinatal mortality rates are related to distances to medical resources for perinatal care, such as the Neonatal Intensive Care Unit (NICU).<br>Methods: Using the census for Japan in 2000, all municipalities in Japan were classified into four groups based on population size: municipalities of 1, 000, 000 people or more (Group 1), municipalities between 350, 000 and 1, 000, 000 people (Group 2), municipalities between 10, 000 and 350, 000 people (Group 3), and municipalities of less than 10, 000 people (Group 4). Then, using the vital statistics, perinatal mortality rates for all groups were calculated. In addition, setting the perinatal mortality rate in Group 1 as a referent, we calculated the differences in the rates to detect regional differences in perinatal mortality in Japan. Finally, we compared the distances between the municipality center and the closest NICU among the four groups by one-way ANOVA.<br>Results: The perinatal mortality rates of Groups 1, 2, 3 and 4 were 5.38, 5.58, 5.88 and 6.31, respectively. The perinatal mortality rate ratios (95% CI) were 1.04(0.96-1.12), 1.09(1.03-1.16), and 1.17(1.05-1.31), respectively. The perinatal mortality rate differences (95% CI) were 0.20(-0.24-0.64), 0.50(0.15-0.84), and 0.93(0.23-1.62), respectively. The distances (95% CI) between the center of the municipalities and the closest NICU for Groups 1, 2, 3 and 4 were 2.61(1.56-3.66)km, 4.23(2.74-5.72)km, 20.79(17.68-23.90)km and 38.07(31.65-44.48)km, respectively. All of the differences among the groups were significant (p<0.001), except for the difference between Group 1 and Group 2.<br>Conclusion: There are regional differences in perinatal mortality rates in Japan. This study suggests that the difference is associated with the uneven distribution of NICUs.

収録刊行物

  • 日本衞生學雜誌

    日本衞生學雜誌 59(3), 342-348, 2004-07-01

    一般社団法人日本衛生学会

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各種コード

  • NII論文ID(NAID)
    10013332941
  • NII書誌ID(NCID)
    AN00185923
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00215082
  • NDL 記事登録ID
    7042486
  • NDL 雑誌分類
    ZS17(科学技術--医学--衛生学・公衆衛生)
  • NDL 請求記号
    Z19-194
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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