Life · 9 authors, 4 centres
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This population-based study analyzed 57,375 pregnancies over 8 years after the Great East Japan Earthquake and Fukushima nuclear accident. There was no significant increasing trend in preterm birth, low birth weight, or congenital anomalies across all six districts of Fukushima Prefecture. The disaster was associated with increased cesarean section rates but did not cause significant adverse effects on the obstetrics outcomes studied.
**Background:** The Great East Japan Earthquake and subsequent tsunami and Fukushima Daiichi Nuclear Power Plant accident in March 2011 were devastating events. While some studies examined immediate perinatal outcomes, longitudinal data over several years were lacking. This study aimed to analyze 8-year chronological trends in obstetrics outcomes across six districts of Fukushima Prefecture using data from the Fukushima Health Management Survey (FHMS).
**Methods:** The FHMS Pregnancy and Birth Survey mailed self-report questionnaires to women who received maternal and child health handbooks since 1 August 2010. Women were asked to refer to their handbooks for accurate data. The study included deliveries from 11 March 2011 to 31 December 2018. Exclusions: deliveries before 11 March 2011, handbooks issued outside Fukushima, insufficient data, pregnant at survey, abortion, triplets. Final sample: 57,375 women. Geographic districts: Kenpoku, Kenchu, Kennan, Soso, Iwaki, Aizu. Outcomes: preterm birth (PTB, <37 weeks), low birth weight (LBW, <2500 g), congenital anomalies (11 specified types), mode of delivery, conception after sterility treatment. Statistical analysis: Chi-square test for categorical comparisons, extended Mantel–Haenszel test for linear trends in proportions, Jonckheere–Terpstra test for continuous variable trends. Significance: p<0.05.
**Key Results:** Overall response rate was 50.0% (57,537/115,155), decreasing significantly from 58.2% in 2011 to 51.4% in 2018 (p<0.001). Maternal age increased over time (p<0.001). Conception after sterility treatment increased (p<0.001). Cesarean section delivery increased (p=0.005). Mean neonatal weight showed no significant change (p=0.912). PTB overall rate: 4.6% in 2011, 5.2% in 2018; no significant trend (p=0.197). LBW overall rate: 8.6% in 2011, 9.1% in 2018; no significant trend (p=0.500). Congenital anomalies overall: 2.85% in 2011, 2.23% in 2018; no significant trend (p=0.069). Kenchu district showed a decrease in anomalies (p=0.011). Most common anomaly each year was cardiac malformation (1.01% in 2013). No significant trends for any specific anomaly type.
**Clinical Implications:** The study provides reassuring evidence that the complex disaster did not lead to sustained increases in preterm birth, low birth weight, or congenital anomalies over 8 years. The observed increases in maternal age, sterility treatment, and cesarean delivery likely reflect broader demographic trends rather than disaster effects. Limitations include moderate response rate (50–60%), potential over-representation of affected women in early years, self-reported data, and lack of individual radiation dose measurements. The findings support the resilience of the perinatal care system in Fukushima and suggest that disaster preparedness and support programs may mitigate adverse outcomes.