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Save Pdf (0.55 Population-Based Database of Multiples in Childhood of Ishikawa Prefecture, Japan Syuichi Ooki Department of Health Science, Ishikawa Prefectural Nursing University, Ishikawa, Japan new type of population-based database of multi- strong incentive for the parents to participate in such Aples in childhood at the prefecture level was studies. initiated in 2004 in Ishikawa Prefecture, Japan. We Given this background, the construction of a pop- conducted an exhaustive search for demographic ulation-based database of multiples in childhood at information concerning families with multiples, family the prefectural level began in 2004. The goals of the support provided by governmental and medical insti- registry are to contribute to the development of tutions by mailed questionnaire, and at the same time welfare programs for families with multiples as well tried to organize a human network to support such as to co-ordinate research useful for both human families. This registry aims not only to aid research on genetics and maternal and child health. human genetics and maternal and child health, but also to contribute to the development of welfare pro- Strategies for the Collection of Data grams for families with multiples. on Multiples in Japan There are four main types of data included in studies on multiples in Japan. First, vital statistics can be The rate of multiple births has been increasing in obtained without access to personal information con- Japan, as in other developed countries, since 1975 cerning individuals (Imaizumi & Nonaka, 1997; Kato, (Imaizumi & Nonaka, 1997). Currently more than 2004; Minakami et al., 1999). Second, data from large 1% of all births are multiples. Therefore, there is an hospitals have been used in the field of obstetrics, pri- increasing need for appropriate information to be marily for the purpose of managing high-risk provided to parents and nursing staff on the growth pregnancies. The collection of obstetric data on multi- and development of multiples, tips on childbearing, ples is relatively easy with the trade-off of selection and social resources for families. However, little infor- bias in favor of high-risk infants. Third, there is a vol- mation is available, in part because the absence of a unteer-based database of multiples, which includes, for population-based registry of multiples makes it diffi- example, data from mothers belonging to associations cult to gather growth data on multiples, especially for parents of multiples; it covers the gap between after birth (Ooki, 2006; Ooki & Asaka, 2005; Ooki vital statistics and hospital data (Ooki & Asaka, & Yokoyama, 2004). 2005). It contains more detailed information on the Studies on maternal and child health for families condition of multiples after birth; both vital statistics with multiples have a very short history. The majority and hospital data have difficulty addressing this. of twin registries throughout the world seem to have Fourth, the Basic Resident Registration of municipali- been constructed primarily for genetic studies, as can ties in Japan, which is open to public reading, can be be seen in the special issue of the Twin Research pub- used. This registration reflects the whole population of lished in 2002, though several of these registries each area, provides family-based information on (Derom et al., 2002; Glinianaia et al., 2002; name, sex and birth date, and serves as a possible Strassberg et al., 2002) focus on maternal and child source for complete recruitment for twin research. health for families with multiples. It appears to be Nevertheless, this method has certain weaknesses. very difficult to achieve a high participation rate from Some municipalities demand very high fees for using families with very young children in Japan, particu- the registration. For this reason, considerable funding larly if researchers perform only a genetic twin study is necessary for research. Additionally, electronic data with no feedback for the participants. The nurturing are not available, requiring arduous transcription by of multiples entails a higher burden physically, men- tally and economically than that of singletons, and participants in twin studies surely expect appropriate Received 21 July, 2006; accepted 14 September, 2006. information from twin researchers to facilitate the Address for correspondence: Syuichi Ooki, Department of Health healthy growth of their twins. Offering information Science, Ishikawa Prefectural Nursing University, Tsu7-1 Nakanuma, useful for the nurturing of multiples would be a Kahoku, Ishikawa, 929-1212, Japan. E-mail: [email protected] 832 Twin Research and Human Genetics Volume 9 Number 6 pp. 832–837 Downloaded from https://www.cambridge.org/core. IP address: 170.106.33.42, on 02 Oct 2021 at 22:14:44, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1375/twin.9.6.832 Database of Multiples in Ishikawa Prefecture, Japan Northern Noto Sapporo 900km Central Noto 700km 500km 300km ISHIKAWA Sendai Central Ishikawa PREFECTURE Kanazawa Kyoto Kobe Tokyo Fukuoka Kanazawa City Nagoya (Capital of Ishikawa Osaka Prefecture) Public Health Center Southern Kaga Branch Office Japan Ishikawa Prefecture Figure 1 Position of Ishikawa Prefecture in Japan and its five districts. hand. Moreover, some municipalities have recently Maternal and Child Health Administration begun restricting the availability of the registration in Japan data in keeping with new policies to ensure the protec- Japan consists of 47 prefectures, the basic unit of local tion of personal information. government, and about 1800 municipalities (cities, These strategies each have their own strengths and towns and villages). National government policies for limitations. Considering these, it was decided to con- the health of mothers and children are planned and struct a population-based registry of multiples. administered by the Maternal and Child Health Division of the Ministry of Health, Labor and Ishikawa Prefecture Welfare. This division sets goals related to maternal Ishikawa Prefecture is located in the middle of the and child health policies, performs research projects, Hokuriku region of Honshu Island in Japan, as shown eliminates regional differences in maternal and child in Figure 1. The prefecture is long and narrow, from health levels, and provides technical assistance to local the south-west to the north-east. This area was gov- public organizations and other associations (Maternal erned by a very strong lord in the feudal age. This and Child Health in Japan 2004; Mothers’ and former feudalism may be reflected in attitudes toward Children’s Health and Welfare Association, 2004). patriarchy, sterility, child nurturing and multiple births Public health centers were operating in approxi- in some districts. Kanazawa city, the prefectural mately 535 locations in 2006; additionally, the capital, is now the center of the Hokuriku area, government offices of cities, towns and villages operate whereas Noto area is less-populated and accessibility other municipal public health centers. These health is not good. centers administer independent policies together with When this project was initiated in 2004, the total the policies and administrative functions delegated or number of municipalities in this prefecture was 39 transferred by the Ministry of Health, Labor and (nine cities, including Kanazawa city, 24 towns and Welfare. At present, most of the functions of Maternal six villages). The population is currently approxi- and Child Health administration have been transferred mately 1,170,000, which is about 1% of the total from the prefectural level to the municipal level. Japanese population, and Kanazawa City has a popu- Typically, a single prefecture has several public health lation of approximately 450,000 (about 40%). Both centers, which serve several municipalities within their the total population and birth rate of this prefecture catchment area. Public health centers establish commu- have been gradually decreasing, while the percentage nication and coordination between municipalities with of people over 65 years of age has been increasing and respect to maternal and child health projects in cities, is now about 20%. The birthrates of this prefecture towns and villages, give guidance and advice to munici- over the past 10 years have been slightly lower than palities on technical matters, and provide expert those of Japan as a whole. maternal and child health services. Each public health Twin Research and Human Genetics December 2006 833 Downloaded from https://www.cambridge.org/core. IP address: 170.106.33.42, on 02 Oct 2021 at 22:14:44, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1375/twin.9.6.832 Syuichi Ooki 900 18 800 16 700 14 Twin (Ishikawa) 600 12 500 Twin (Japan) 10 400 8 Triplet (Japan) 300 6 200 4 Twin birth rate per 1,000delivery Triplet birth rate per 1,000,000delivery Triplet birth rate 100 Triplet (Ishikawa) 2 0 0 1995 1996 1997 1998 1999 2000 20012002 2003 2004 Figure 2 Secular trends of multiple birth rate of Ishikawa Prefecture based on the Japanese vital statistics from the Ministry of Health, Labor and Welfare. center may also have a local public health center, the medical institutions were compiled exhaustively from branch office, if necessary. In other cases, the city defined a mailed questionnaire in June 2004. Recipients were by law as the ‘core city’ of the prefecture may also
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