Abstract
BackgroundLittle is known about the association between the anxiety toward the effects of radiation on reproduction caused by the Fukushima nuclear accident and the birth rate of people in Fukushima. Therefore, we examined changes and associated factors of future pregnancy intention among mothers in Fukushima Prefecture.MethodsUsing data from three postal surveys among women who registered their pregnancies in the prefecture (N = 6,751 in 2012, N = 6,871 in 2013, and N = 6,725 in 2014), we analyzed the factors associated with women’s intention of future pregnancy using multivariable logistic regression models.ResultsThe proportion of mothers with pregnancy intention increased from 53.5% in 2012 to 57.9% in 2014, especially among multiparas (P for trend <0.001). Factors inversely associated with pregnancy intention of both groups were older maternal age (adjusted odds ratio [aOR] 0.92 for primipara and 0.87 for multipara), poor subjective health (aOR 0.75 and 0.81, respectively), and presence of depressive symptoms (aOR 0.71 and 0.79, respectively) (P < 0.01 for all items). In addition, not living with husband (aOR 0.24), dissatisfaction with obstetrical care (aOR 0.89) and child abnormalities (aOR 0.72) were inversely associated with pregnancy intention among primiparas, while receiving infertility treatment (aOR 2.05) was positively associated among multiparas (P < 0.01 for all items). A separate analysis of 2012 and 2013 data showed that concern about radiation contamination of breast milk was associated with pregnancy intention among primiparas (aOR 0.61, P < 0.001).ConclusionsMothers’ concern about radiation was associated with lower pregnancy intention, especially among primiparas. Providing quality obstetrical and mental health care and parenting support may be the keys to maintaining the temporal increase in fertility.
Highlights
Little is known about the association between the anxiety toward the effects of radiation on reproduction caused by the Fukushima nuclear accident and the birth rate of people in Fukushima
In 2016, Japan’s total fertility rate was 1.44, which was far below the replacement fertility rate of 2.1.1 our recent analysis of Japanese government statistics on live births, stillbirths, and induced abortions found that there was no upward trend in fertility since 1974, except for the abortion rate showing a slight increase during 1996–2002.2 The Fukushima Nuclear Power Plant accident occurred in 2011 after the Great East Japan Earthquake and Tsunami and caused region-wide radiation contamination
The low birth rate could, in theory, deteriorate because of anxiety over the effects of radiation on reproduction caused by the Fukushima nuclear accident, especially given that fetuses and children are more susceptible to radiation than adults
Summary
Little is known about the association between the anxiety toward the effects of radiation on reproduction caused by the Fukushima nuclear accident and the birth rate of people in Fukushima. The low birth rate could, in theory, deteriorate because of anxiety over the effects of radiation on reproduction caused by the Fukushima nuclear accident, especially given that fetuses and children are more susceptible to radiation than adults. A previous study found that the number of births declined in Japan after the 2011 disaster at the national level (ie, irrespective of proximity to the affected area).[3] Given the strong interest in increasing the birth rate in Japan and in other developed countries, and the fact that any country with nuclear power plants can potentially be affected by a nuclear accident like Japan, it is critically important to understand how a nuclear accident and radiation contamination affect women’s perceptions and decisions about future pregnancy.
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