[Relationship between pregnancy factors and low birth weight infants, miscarriages, and stillbirths: A follow-up survey on birth conditions of pregnant women who received the maternal and child health handbook from public health nurses and midwives].

Objectives　The final evaluation of the Japanese government's Healthy Parents and Children 21 project in 2014 noted an increase in low birth weight infants as an aspect that worsened. In order to reduce the number of low birth weight infants, miscarriages, and stillbirths in Kurume City, we conducted a survey aimed at researching new measures, including the search for new risk factors of birth complications.Methods　The participants of this study were 2,986 pregnant women who submitted a pregnancy notification form in 2014. We excluded women who moved away from Kurume city or for whom birth weight records could not be obtained. Information from the pregnancy notification form was linked to birth weight records to examine the relationships between low birth weight infants, miscarriages, stillbirths, and pregnancy attributes. Variables that were shown to be related in an initial univariate analysis were analyzed further in a multiple logistic regression analysis with low birth weight, miscarriage, or stillbirth as the response variables.Results　A multiple logistic regression analysis showed that being 35 years or older (odds ratio [OR]: 1.41), height less than 158 cm (OR: 1.45), non-pregnant body mass index (BMI) less than 18.5 (OR: 1.48), and detection of physical abnormalities by a physician during the pregnancy (OR: 2.20) were independent maternal factors that were significantly associated with low birth weight. Being aged 35 years or older (OR: 2.05) and smoking (OR: 3.42) were independent factors that were significantly associated with miscarriage and stillbirth. In addition, the cessation of alcohol use (OR: 0.51) significantly reduced this risk.Conclusion　Because some biological factors such as "age" and "non-pregnant BMI" are invariable, we encourage pregnant women to get checkups to detect abnormalities early or to attend birthing classes that offer mental support, especially for pregnant women over 35 years. We want to tell young generations that pregnant women over 35 are at an increased risk of having low birth weight infants, miscarriages, and stillbirths, and those pregnant women with a lower BMI have an increased risk of low birth weight infants. "Maintenance of appropriate body weight," "smoking," "alcohol," socioeconomic issues such as "lack of systems for seeking advice and support staff," and "financial concerns" can be improved with health education from public health nurses and multidisciplinary support interventions. At the Children Care Support Center in Kurume city, professionals work together to provide continuous support to families during pregnancy, childbirth, and parenting. As a result, we may be able to contribute to reducing the number of low birth weight infants, miscarriages, and stillbirths.