Aim: To examine whether a longer time to pregnancy is associated with preterm births distinguished as either spontaneous or indicated delivery.

Methods: A cross-sectional survey was conducted targeting parous women aged 20-44 years old residing across Japan whose first-born children were singletons. Information on reproductive history including time to pregnancy (TTP) and use of assisted reproductive technology (ART) was collected using internet-based questionnaire. A delivery was judged spontaneous if the mother had either labor and/or membrane rupture at hospital admission. Multinomial logistic regression analyses were performed to estimate odds ratios and 95% confidence intervals (CI) for spontaneous and indicated preterm birth at ＜ 34 or at ＜ 37 weeks of gestation while adjusting for potential confounders.

Results: The analytic sample was n=4,208 mothers with first-born singletons. After adjusting for age, use of ART, and other possible confounders, women with TTP of 12＋ months had significantly higher odds of spontaneous preterm birth at ＜ 34 weeks (OR 4.55, 95% CI 1.10-18.77) but not at ＜ 37 weeks (OR 1.07, 95% CI 0.65-1.75), compared to those with TTP of ＜ 6 months. Women with unknown TTP tended to have higher odds of spontaneous preterm birth at ＜ 34 weeks (OR 3.67, 95% CI 1.02-13.19) and at ＜ 37 weeks (OR 1.38, 95% CI 0.98-1.96), though not statistically significant. There was no significant association with TTP and indicated preterm birth.

Conclusions: Compared to mothers with shorter TTP, those with longer TTP are more likely to experience spontaneous preterm birth.

This study aimed to clarify factors related to self-rated health among elderly people who live in geographically disadvantaged environments in sloped residential areas. A self-administered questionnaire was carried out among elderly residents aged 65 years or older living in a sloped residential area in Nagasaki City, Japan. Among a total of 148 respondents (46 males, 102 females), 35.8% demonstrated poor self-rated health. The factors statistically significantly associated with better self-rated health were going out, participating in social activities, and having relationships with neighbors. No relationship was found between self-rated health and sex/family structure. Logistic regression analysis showed that the factors associated with poor self-rated health were falls (odds ratio [OR]: 3.64, 95% confidence interval [CI]: 1.3-10.2), assistance with going out (OR: 10.43, 95%CI: 2.3-46.7), limited access to shopping (OR: 4.99, 95%CI: 1.8-13.7), and not participating in volunteer activities (OR: 5.26, 95%CI: 1.3-21.2). These results suggest that getting assistance when going out and voluntarily participating in social activities may improve the health of elderly residents living in sloped residential areas.