J Prev Med Public Health.  2024 Nov;57(6):564-571. 10.3961/jpmph.24.355.

Factors Associated With Post-term Birth and Its Relationship to Neonatal Mortality in Japan: An Analysis of National Data From 2017 to 2022

• Okui T
• Nakashima N

• KMID: 2561673
• DOI: http://doi.org/10.3961/jpmph.24.355

Abstract

Objectives
Prior research has not yet examined the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. We investigated these associations utilizing nationwide birth data from Japan.
Methods
Birth and mortality data were obtained from the Vital Statistics of Japan for the years 2017 to 2022. The post-term birth rate was calculated by birth characteristics, and the neonatal mortality rates for post-term and term births were computed. Additionally, log-binomial regression analysis was employed to explore the associations between post-term birth and neonatal mortality, as well as between various characteristics and post-term birth. The characteristics considered included infant sex, maternal age group, parity, maternal nationality, maternal marital status, and household occupation.
Results
This study analyzed data from 4 698 905 singleton infants born at 37 weeks of gestational age or later. Regression analysis revealed that post-term birth was positively associated with neonatal mortality. The adjusted risk ratio for neonatal mortality in post-term compared to term births was 8.07 (95% confidence interval, 5.06 to 12.86). Factors positively associated with post-term birth included female infant sex, older maternal age, primiparity, non-Japanese maternal nationality, unmarried status, and various household occupations, including farmer, full-time worker at a smaller company, other type of worker, and unemployed. Younger maternal age was inversely associated with post-term birth.
Conclusions
In Japan, post-term birth represents a risk factor for neonatal mortality. Additionally, socio-demographic characteristics, such as maternal marital status, nationality, and parity were found to be predictors of post-term birth.

Keyword

Gestational age; Infant mortality; Japan; Sociodemographic factors; Vital statistics