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Abstract
OBJECTIVESThis study investigated differences in the perinatal mortality rate between white-collar and blue-collar workers.METHODSData from the “Report of Vital Statistics: Occupational and Industrial Aspects” in Japan covering the period from 1995 to 2015 were used. Five-year maternal age groups from 15-19 years to 45-49 years were analyzed according to work type, and the perinatal mortality rate for each age group and the age-standardized perinatal mortality rate according to maternal age were calculated in each analyzed year. A Bayesian age-period-cohort analysis was used to estimate age, period, and cohort effects for the perinatal mortality rate according to work type. Moreover, the perinatal mortality rate ratios between types of workers were estimated for each age group, period, and cohort.RESULTSThe estimated perinatal mortality rate ratios of blue-collar to white-collar workers were above 1 in most of the age groups and cohorts. The age effect for the perinatal mortality rate among white-collar workers was the largest in the 15-year to 19-year age group, whereas that among blue-collar workers was the largest in the 45-year to 49-year age group. Furthermore, the estimated perinatal rate ratio between white-collar and blue-collar workers tended to increase with maternal age. The magnitude of the decrease of the cohort effects on the perinatal mortality rate was rather larger in blue-collar workers in the cohorts born between 1946-1950 and 1996-2000.CONCLUSIONSThe magnitude of the disparity markedly increased with maternal age. Thus, middle-aged blue-collar workers need more prenatal care and preventive measures for perinatal mortality than white-collar workers.
Highlights
IntroductionStudies have shown that fetal death rates have decreased since the 1950s, with fetal death rates due to spontaneous and induced abortions decreasing over the years [1]
Japan is known for its favorable perinatal outcomes by current global standards [1]
The estimated perinatal mortality rate ratios between blue-collar and white-collar workers were above 1 in most of the age groups and cohorts, and the magnitude of the disparity depended on age and cohort
Summary
Studies have shown that fetal death rates have decreased since the 1950s, with fetal death rates due to spontaneous and induced abortions decreasing over the years [1] Perinatal outcomes, such as stillbirth or perinatal mortality, are known to be influenced by the socioeconomic status (SES) of mothers or households [2,3,4,5]. Some studies, albeit few, have recently investigated associations between SES and perinatal outcomes using the Vital Statistics in Japan [3,4]. One such study showed that jobless households had higher perinatal mortality and abortion rates than other households in Japan [4] Another epidemiological study found that small-for-gestational-age births were associated with maternal SES in Japan [5].
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