title: Highly improved perinatal states in Japan.
abstract: To report on improved perinatal states in Japan, governmental and United Nations Children's Fund reports were analyzed. Initial maternal mortality, which was 409.8 in 1899, decreased to 4.1 in 2010, with a reduction rate of 409.8/4.1 (102.4) in 111 years: 2.5 in the initial 50 years in home delivery and 39.3 in the later 60 years in hospital births. The difference between 2.5 versus 39.3 was attributed to the medicine and medical care provided in hospital births. The total reduction of neonatal mortality was 77.9/1.1 (70.8), and the rate in the initial 50 versus later 60 years was 2.8/25. Also, there was a big difference after introduction of extensive neonatal care. Virtual perinatal mortality after 22 weeks was estimated to be 428 in 1000 births in 1900 (i.e. those infants born at 22-28 weeks were unlikely to survive at that time), while the perinatal mortality was reported to be 22 weeks or more in 1979 (i.e. premature babies born at ≥22 weeks survived in 1979 because of the improved neonatal care). Actually, 60% of premature infants of 400-500 g survived in the neonatal intensive care unit. In a recent report, 36% of infants born at 22 weeks survived to 3 years. Although there were neurodevelopmental impairments, outcomes were improved. In conclusion, perinatal states have remarkably improved in Japan.
authors.affiliation: Department of Obstetrics and Gynecology (Emeritus), Tottori University Medical School, Yonago, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Maeda
mesh_terms: D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D066088:Infant Death / Q000517:prevention & control*; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000266:history / Q000639:trends; D007564:Japan / Q000453:epidemiology; D008297:Male; D063130:Maternal Death / Q000517:prevention & control*; D008428:Maternal Mortality; D018743:Perinatal Care / Q000266:history* / Q000639:trends; D066087:Perinatal Death / Q000517:prevention & control*; D054238:Perinatal Mortality; D010500:Perinatology / Q000266:history* / Q000639:trends; D011247:Pregnancy; D047928:Premature Birth / Q000266:history / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D011295:Prenatal Care / Q000266:history* / Q000639:trends; D012955:Societies, Medical / Q000266:history
keywords: maternal mortality; medical care; neonatal mortality; perinatal mortality; prematurity