Car seatbelt use during pregnancy in Japan: determinants and policy implications.
BACKGROUND
Pregnant women are exempted from the current seatbelt legislation in Japan despite the fact that seatbelt use is essential to reduce the risk of fatalities for these women and their fetuses in car crashes.


OBJECTIVE
To examine factors that might influence seatbelt use during pregnancy.


METHODS
A cross sectional study, with data collected via an anonymous, self administered questionnaire at obstetric clinics in suburban areas of Japan. Altogether 880 pregnant women receiving prenatal care in July 2001 were recruited. The relative effects of factors that might influence seatbelt use during pregnancy were estimated using logistic regression analysis.


RESULTS
Almost 70%-80% of pregnant women were consistent seatbelt wearers before pregnancy but seatbelt compliance was reduced by about half at 20 weeks or more gestation. Only 20% had received information on maternal seatbelt use, with one third reporting that seatbelt use is beneficial during pregnancy. Those who perceived that maternal seatbelt use is beneficial tended to maintain use, but daily car users and those who knew that they were exempted from seatbelt legislation were more likely to reduce use.


CONCLUSIONS
Knowledge of the legislative exemption for pregnant women, misunderstanding of the benefits, and daily car use contributed to the reduction in seatbelt use after pregnancy.
Ichikawa
M
M
Department of Community Health, School of International Health, Graduate School of Medicine, University of Tokyo, Japan. masao@m.u-tokyo.ac.jp
Nakahara
S
S
Okubo
T
T
Wakai
S
S
D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007564:Japan; D016015:Logistic Models; D011247:Pregnancy; D012622:Seat Belts / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000517:prevention & control