Cesarean delivery rates for overall and multiple pregnancies in Japan: a descriptive study using nationwide health insurance claims data

Research Project

Project/Area Number	18K17372
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
Research Institution	Akita University
Principal Investigator	Maeda Eri 秋田大学, 医学系研究科, 准教授 (30778395)
Project Period (FY)	2018-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000) Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000) Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000) Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	帝王切開率 / 周産期医療 / レセプトNDB / 多胎妊娠 / 多胎 / 帝王切開術 / 帝王切開 / 医療の質
Outline of Final Research Achievements	Due to the lack of national perinatal registries, population-wide descriptive statistics on cesarean deliveries in Japan are unknown. We aim to describe cesarean deliveries for overall and multiple pregnancies using the Japan National Database of health insurance claims. We calculated the national and prefectural cesarean delivery rates for overall and multiple pregnancies in 2014. We described maternal morbidities (e.g., blood transfusion) and the place and type of the institutions providing prenatal and perinatal care. The national cesarean delivery rates were 18.6% overall and 82.7% for women with multiple pregnancies. Prefectural cesarean delivery rates for overall and multiple pregnancies varied from 12.5% to 24.2% and from 49.2% to 100%, respectively, showing a moderate positive correlation (r = 0.59, p < 0.001). The overall cesarean delivery rate in Japan was optimal, but the rate was high for multiple pregnancies, with large regional differences.
Academic Significance and Societal Importance of the Research Achievements	わが国の多胎妊娠に対する帝王切開率は80%を越えており、地域差が大きかった。本研究で得られた施設間・地域間の移動に関する情報は、周産期医療体制の議論の基盤となり得る。