In our previous report we pointed out, by analysing the official health statistics, that the mean birth weight of the Ryukyu Islands (Okinawa prefecture, Japan) during the past decade was significantly lower than that of the rest of Japan and that the annual increase rate of the mean birth weight during these periods was markedly high (the highest of all prefectures).
In this report the authors attempted to clarify these remarkable phenomena which were recognised in the Ryukyus in the recent postwar period, from the birth records of a private obstetric service in Naha, by computing the mean birth weight and its standard deviation by sex, parity (primiparous and multiparous groups) and gestational age in weeks. This obstetric service was established in July 1952 and the birth records are available since January 1955. The minimum unit of the balance used in its delivery room is 50 grams.
The number of the single live births subjected to this study accounted for 9, 080 cases. The other 2, 460 cases were excluded on account of the incomplete description on sex, parity or the commencing date of the last menstrual period, multiple births, fetal deaths, early neonatal deaths or major congenital malformations (Tab. 1-2). The gestational age in weeks was calculated in the nearest week (for example 277-283 days as 40 weeks).
The results were as follows:
1) Of the 9, 080 single live births between 1955 and 1974, the mean birth weights at 9 gestational weeks (35-43 weeks) and their standard deviations were calculated by sex and by parity in each year (Tab. 3, Fig. 1). In spite of the annual fluctuations due possibly to the small size of the sample, the mean birth weights by gestational week appear to increase gradually in each sex and parity.
2) Then the samples were gathered from 4-three year periods (1957-59, 1962-64, 1967-69, 1972-74) for the enlargement of the sample size. As a result of the similar analysis significant improvements were recognized especially between 38-42 weeks (Tab. 4-5, Fig. 2).
3) At the same time the areal distribution of the mother, the mean gestational weeks, the mean maternal ages and the number of the parities were investigated in each of the 4 periods (Tab. 6-9). In addition the differences of the mean birth weight by gestational week between males and females, and those between primiparae and multiparae were tested (Tab. 10).
4) Based on these results discussion is made from the epidemiological point of view upon a: the relationship of the biological and/or sociobiological factors related to the birth weight and of the materials (the birth records of a private obstetric service in Naha), b: the precision and reliability of the materials and its relation to the local population (total single live births in the central and southern parts of Okinawa-jima including Naha city and/or in the Ryukyu Islands), c: the method of the calculation of the gestational age in weeks, d: the relationship of the environmental factors (natural, socioeconomic and cultural) and of the mean birth weight in an area.
5) The comparisons were made with the intrauterine growth curves reported in English and French language from various countries (Ref. 14, 29-35, 64-71). In comparison with the data of Japan during the postwar period (Ref. 28), our data was somewhat lower during 38-42 gestational weeks for the same period, however it was found that mean birth weight during 1972-74 in Naha surpassed that during 1963-64 in Japan. We suggest that the present fetal growth of Japan must have made an improvement over our data in the period of 1972-74.
From these analyses, the authors concluded that the marked increase of the mean birth weight of the Ryukyus was due to the remarkable improvement of the socioeconomic environment of the area after World War II which is supported by the medium of the maternal factors.
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