The Effects of the Great East Japan Earthquake on Perinatal Outcomes: Results of the Pregnancy and Birth Survey in the Fukushima Health Management Survey

Hyo Kyozuka, Tsuyoshi Murata, Shun Yasuda, Kayoko Ishii, Keiya Fujimori, Aya Goto, Seiji Yasumura, Misao Ota, Kenichi Hata, Kohta Suzuki, Akihito Nakai, Tetsuya Ohira, Hitoshi Ohto, Kenji Kamiya, Hyo Kyozuka, Tsuyoshi Murata, Shun Yasuda, Kayoko Ishii, Keiya Fujimori, Aya Goto, Seiji Yasumura, Misao Ota, Kenichi Hata, Kohta Suzuki, Akihito Nakai, Tetsuya Ohira, Hitoshi Ohto, Kenji Kamiya

Abstract

There are limited studies on the long-term effects of natural/environmental disasters, especially nuclear disasters, on obstetric outcomes. This study aimed to review the results of perinatal outcomes immediately after the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi Nuclear Power Plant accident, as well as their long-term trends over 8 years, in the Fukushima Health Management Survey. The annual population-based Pregnancy and Birth Survey is conducted as part of the Fukushima Health Management Survey. The Fukushima Prefecture government launched it to assess the health conditions of pregnant women and their neonates after the GEJE. The self-reported questionnaire was sent to 115,976 pregnant women by mail from January 2012, with 58,344 women responding to the questionnaire (50.3% response rate). Pregnancy complications, such as gestational hypertension, respiratory diseases, and mental disorders, increased in some women who were pregnant at the time of the earthquake and immediately after the earthquake. However, the direct effects on newborns, such as preterm birth, low birth weight, and congenital anomalies, were not immediately clear after the earthquake. Although there were significant differences in the occurrence of preterm birth and low birth weight among the districts, there was no change in the occurrences of preterm birth, low birth weight, or anomalies in newborns in Fukushima Prefecture from the fiscal year 2011 to the fiscal year 2018. Therefore, the long-term effects of the post-disaster radiation accident on perinatal outcomes are considered to be very small.

Keywords: congenital anomaly; earthquake; low-birth-weight infant; nuclear accident; preterm delivery.

Conflict of interest statement

Conflicts of interest: None declared.

Figures

Figure 1.. Geographic information of the Fukushima…
Figure 1.. Geographic information of the Fukushima Prefecture. Geographic districts are classified into seven areas (Kenpoku, Kenchu, Kennan, Soso, Iwaki, Aizu, and Minami-Aizu). The Aizu and Minami-Aizu areas were combined and called the Aizu area.
Figure 2.. Proportions of medical complications among…
Figure 2.. Proportions of medical complications among the pregnant women before and after the disaster. *P < 0.05, in relation to the ≤3 months before the disaster group.
Figure 3.. Incidence rate of congenital anomalies…
Figure 3.. Incidence rate of congenital anomalies by regional areas
Figure 4.. Incidence rate of low birth…
Figure 4.. Incidence rate of low birth weight in the pregnant women before and after the disaster. *P < 0.05, in relation to 9–7 months before the disaster group. **P < 0.05, in relation to ≤3 months before the disaster group.
Figure 5.. Incidence rate of preterm birth…
Figure 5.. Incidence rate of preterm birth among the pregnant women before and after the disaster. *P < 0.05, in relation to ≤3 months before the disaster group.
Figure 6.. Trends in incidence rate of…
Figure 6.. Trends in incidence rate of preterm birth, low birth weight, and congenital anomalies from FY 2011 to FY 2018

References

    1. Yasumura S, Hosoya M, Yamashita S, et al. ; Fukushima Health Management Survey Group . Study protocol for the Fukushima Health Management Survey. J Epidemiol. 2012;22(5):375–383. 10.2188/jea.JE20120105
    1. Yasumura S, Ohira T, Ishikawa T, et al. . Achievements and current status of the Fukushima Health Management Survey. J Epidemiol. 2022;32(Suppl 12):S3–S10. 10.2188/jea.JE20210390
    1. Harville E, Xiong X, Buekens P. Disasters and perinatal health: a systematic review. Obstet Gynecol Surv. 2010;65:713–728. 10.1097/OGX.0b013e31820eddbe
    1. Fujimori K, Kyozuka H, Yasuda S, et al. ; Pregnancy and Birth Survey Group of the Fukushima Health Management Survey . Pregnancy and birth survey after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident in Fukushima prefecture. Fukushima J Med Sci. 2014;60(1):75–81. 10.5387/fms.2014-9
    1. Radiation Medical Science Center for the Fukushima Health Management Survey. Proceedings of the 37th Prefectural Oversight Committee Meeting for Fukushima Health Management Survey (in Japanese). Accessed Sep 17, 2021.
    1. Ishikawa T, Yasumura S, Akahane K, et al. . External doses available for epidemiological studies related to the Fukushima Health Management Survey: first 4-month individual doses and municipality-average doses for the first year. J Epidemiol. 2022;32(Suppl 12):S11–S22. 10.2188/jea.JE20210166
    1. Ishikawa T, Yasumura S, Ozasa K, et al. . The Fukushima Health Management Survey: estimation of external doses to residents in Fukushima Prefecture. Sci Rep. 2015;5:12712. 10.1038/srep12712
    1. Kyozuka H, Fujimori K, Hosoya M, et al. ; Japan Environment and Children’s Study (JECS) Group . The effect of maternal age at the first childbirth on gestational age and birth weight: the Japan Environment and Children’s Study (JECS). J Epidemiol. 2019;29(5):187–191. 10.2188/jea.JE20170283
    1. Kyozuka H, Murata T, Yasuda S, et al. ; Pregnancy and Birth Survey Group of the Fukushima Health Management Survey . The effect of the Great East Japan Earthquake on hypertensive disorders during pregnancy: a study from the Fukushima Health Management Survey. J Matern Fetal Neonatal Med. 2020;33(24):4043–4048. 10.1080/14767058.2019.1594763
    1. Hayashi M, Fujimori K, Yasumura S, Goto A, Nakai A. Obstetric outcomes in women in Fukushima Prefecture during and after the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident: the Fukushima Health Management Survey. Open J Obstet Gynecol. 2016;06:705–713. 10.4236/ojog.2016.612088
    1. Suzuki K, Goto A, Fujimori K. Effect of medical institution change on gestational duration after the Great East Japan Earthquake: the Fukushima Health Management Survey. J Obstet Gynaecol Res. 2016;42:1704–1711. 10.1111/jog.13102
    1. Hayashi M, Fujimori K, Yasumura S, Nakai A; Pregnancy and Birth Survey Group of the Fukushima Health Management Survey . Impact of the Great East Japan Earthquake and Fukushima Nuclear Power Plant accident on assisted reproductive technology in Fukushima Prefecture: the Fukushima Health Management Survey. J Clin Med Res. 2017;9(9):776–781. 10.14740/jocmr3105w
    1. Yasuda S, Kyozuka H, Nomura Y, et al. . Influence of the Great East Japan Earthquake and the Fukushima Daiichi nuclear disaster on the birth weight of newborns in Fukushima Prefecture: Fukushima Health Management Survey. J Matern Fetal Neonatal Med. 2017;30:2900–2904. 10.1080/14767058.2016.1245718
    1. Yasuda S, Okazaki K, Nakano H, et al. . Effects of external radiation exposure on perinatal outcomes in pregnant women after the Fukushima Daiichi Nuclear Power Plant accident: the Fukushima Health Management Survey. J Epidemiol. 2022;32(Suppl 12):S104–S114. 10.2188/jea.JE20210252
    1. Cordero JF. The epidemiology of disasters and adverse reproductive outcomes: lessons learned. Environ Health Perspect. 1993;101(Suppl 2):131–136. 10.1289/ehp.93101s2131
    1. Kyozuka H, Fujimori K, Hosoya M, et al. . The Japan environment and children’s study (JECS) in Fukushima Prefecture: pregnancy outcome after the great east Japan earthquake. Tohoku J Exp Med. 2018;246:27–33. 10.1620/tjem.246.27
    1. Goldman LR, Paigen B, Magnant MM, Highland JH. Low birth weight, prematurity and birth defects in children living near the hazardous waste site, love Canal. Hazard Waste Hazard Mater. 1985;2:209–223. 10.1089/hwm.1985.2.209
    1. Levi R, Lundberg U, Hanson U, Frankenhacuser M. Anxiety during pregnancy after the Chernobyl accident as related to obstetric outcome. J Psychosom Obstet Gynaecol. 1989;10:221–230. 10.3109/01674828909016696
    1. Tan CE, Li HJ, Zhang XG, et al. . The impact of the Wenchuan earthquake on birth outcomes. PLoS One. 2009;4:e8200. 10.1371/journal.pone.0008200
    1. Kyozuka H, Yamaguchi A, Suzuki D, et al. ; Japan Environment and Children’s Study (JECS) Group . Risk factors for placenta accreta spectrum: findings from the Japan environment and Children’s study. BMC Pregnancy Childbirth. 2019;19(1):447. 10.1186/s12884-019-2608-9
    1. Yamaguchi A, Kyozuka H, Fujimori K, et al. ; Japan Environment and Children’s Study Group . Risk of preterm birth, low birthweight and small-for-gestational-age infants in pregnancies with adenomyosis: a cohort study of the Japan Environment and Children’s Study. Acta Obstet Gynecol Scand. 2019;98(3):359–364. 10.1111/aogs.13498
    1. Mother’s and children’s Health Organization. In: Maternal and Child Health Statistics of Japan. Live Births and Percentages by Period of Gestation; vol 49; 2019:1980–2011.
    1. Chang HL, Chang TC, Lin TY, Kuo SS. Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake. Psychiatry Clin Neurosci. 2002;56:139–144. 10.1046/j.1440-1819.2002.00948.x
    1. Xiong X, Harville EW, Mattison DR, Elkind-Hirsch K, Pridjian G, Buekens P. Exposure to Hurricane Katrina, post-traumatic stress disorder and birth outcomes. Am J Med Sci. 2008;336:111–115. 10.1097/MAJ.0b013e318180f21c
    1. Tong VT, Zotti ME, Hsia J. Impact of the Red River catastrophic flood on women giving birth in North Dakota, 1994–2000. Matern Child Health J. 2011;15:281–288. 10.1007/s10995-010-0576-9
    1. Hamilton BE, Sutton PD, Mathews TJ, Martin JA, Ventura SJ. The effect of Hurricane Katrina: births in the U.S. Gulf Coast region, before and after the storm. Natl Vital Stat Rep. 2009;58(2):1–28, 32.
    1. Leppold C, Nomura S, Sawano T, et al. . Birth outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: a long-term retrospective study. Int J Environ Res Public Health. 2017;14:542. 10.3390/ijerph14050542
    1. Kyozuka H, Yasuda S, Kawamura M, et al. . Impact of the Great East Japan Earthquake on feeding methods and newborn growth at 1 month postpartum: results from the Fukushima Health Management Survey. Radiat Environ Biophys. 2016;55:139–146. 10.1007/s00411-016-0636-7
    1. Goto A, Bromet EJ, Fujimori K; Pregnancy and Birth Survey Group of Fukushima Health Management Survey . Immediate effects of the Fukushima nuclear power plant disaster on depressive symptoms among mothers with infants: a prefectural-wide cross-sectional study from the Fukushima Health Management Survey. BMC Psychiatry. 2015;15:59. 10.1186/s12888-015-0443-8
    1. Ishi K, Goto A, Komiya H, et al. . Postpartum mental health of mothers in Fukushima: insights from the Fukushima Health Management Survey (FHMS) 8-year trends. J Epidemiol Revision. (submitted).
    1. Wertelecki W. Malformations in a Chornobyl-impacted region. Pediatrics. 2010;125:e836–e843. 10.1542/peds.2009-2219
    1. Wertelecki W, Chambers CD, Yevtushok L, et al. . Chornobyl 30 years later: radiation, pregnancies, and developmental anomalies in Rivne, Ukraine. Eur J Med Genet. 2017;60:2–11. 10.1016/j.ejmg.2016.09.019
    1. Wertelecki W, Yevtushok L, Kuznietsov I, et al. . Chornobyl, radiation, neural tube defects, and microcephaly. Eur J Med Genet. 2018;61:556–563. 10.1016/j.ejmg.2018.06.005
    1. Dolk H, Nichols R. Evaluation of the impact of Chernobyl on the prevalence of congenital anomalies in 16 regions of Europe. EUROCAT Working Group. Int J Epidemiol. 1999;28:941–948. 10.1093/ije/28.5.941
    1. Hoffmann W. Fallout from the Chernobyl nuclear disaster and congenital malformations in Europe. Arch Environ Health. 2001;56:478–484. 10.1080/00039890109602895
    1. Little J. The Chernobyl accident, congenital anomalies and other reproductive outcomes. Paediatr Perinat Epidemiol. 1993;7:121–151. 10.1111/j.1365-3016.1993.tb00388.x
    1. Cragan JD, Gilboa SM. Including prenatal diagnoses in birth defects monitoring: experience of the Metropolitan Atlanta Congenital Defects Program. Birth Defects Res A Clin Mol Teratol. 2009;85:20–29. 10.1002/bdra.20508
    1. Dolk H, Loane M, Garne E. The prevalence of congenital anomalies in Europe. In: Adv Exp Med Biol Posada de la Paz M, Groft S, eds. Rare Diseases Epidemiology. Dordrecht: Springer; 2010;686:349–364.
    1. International clearinghouse for birth defects surveillance and Research, Japan center. , in Japanese, Accessed September 17, 2021.
    1. Murase K, Murase J, Machidori K, Mizuno K, Hayashi Y, Kohri K. Nationwide increase in cryptorchidism after the Fukushima nuclear accident. Urology. 2018;118:65–70. 10.1016/j.urology.2018.04.033
    1. Kojima Y, Yokoya S, Kurita N, et al. . Cryptorchidism after the Fukushima Daiichi Nuclear Power Plant accident: causation or coincidence? Fukushima J Med Sci. 2019;65:76–98. 10.5387/fms.2019-22
    1. Hirata Y, Shimizu H, Kumamaru H, et al. . Congenital heart disease after the Fukushima Nuclear Accident: the Japan cardiovascular Surgery Database Study. J Am Heart Assoc. 2020;9:e014787. 10.1161/JAHA.119.014787

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