Perinatal mortality and its background in recent Japan.

This study reports on perinatal mortality (PM) in Japan from 1950 to 1977. The PM rate in 1951 was 46.7; in 1977 it was 14.1. Comparison of the PM mortality rate is made with other developed countries. The etiology of PM is presented by reporting statistics from 3 sources which differ from one another in rating the causes. However among the causes all found: 1) immaturity and/or intrauterine growth retardation; 2) congenital abnormalities; 3) toxemia of pregnancy; 4) placental abnormalities; 5) umbilical cord anomalies; and 6) perinatal anoxia/hypoxia. In 1977 the incidence of low birth weight was 5.1 in males and 6.0 in females. PM is influenced by a maldistribution of neonatologists who tend to concentrate in the larger cities. Other factors are: 1) failure in the systematization of perinatal care; 2) defective reeducation system for obstetricians and pediatricians; 3) insufficient financial support for private clinics and small hospitals; and 4) inadequate criteria for selection of medical teachers and students and inadequate medical school education.