Effects of the COVID-19 pandemic on the rates of adverse birth outcomes and fetal mortality in Japan: an analysis of national data from 2010 to 2022.

BACKGROUND: Although the coronavirus disease 2019 (COVID-19) pandemic affected trends of multiple health outcomes in Japan, there is a paucity of studies investigating the effect of the pandemic on adverse birth outcomes and fetal mortality. This study aimed to investigate the effect of the onset of the pandemic on the trends in adverse birth outcomes and fetal mortality using national data in Japan. METHODS: We used the 2010-2022 birth and fetal mortality data from the Vital Statistics in Japan. We defined the starting time of the effect of the pandemic as April 2020, and the period from January 2010 to March 2020 and that from April 2020 to December 2022 were defined as the pre- and post- pandemic period, respectively. The rates of preterm birth, term low birth weight (TLBW), small-for-gestational-age (SGA), large-for-gestational-age (LGA), spontaneous fetal mortality, and artificial fetal mortality were used as outcomes. An interrupted time series analysis was conducted using monthly time series data of the outcomes to evaluate the effects of the pandemic. In addition, a modified Poisson regression model was used to evaluate the effects of the pandemic on these outcomes using individual-level data, and the adjusted risk ratio of the effect was calculated. RESULTS: The adverse birth and fetal mortality outcomes showed a decreasing trend over the years, except for preterm birth and LGA birth rates, and SGA birth rates tended to reach their lowest values after the onset of the pandemic. The interrupted time series analysis revealed that the pandemic decreased preterm birth, TLBW, and SGA birth rates. In addition, the regression analysis revealed that the pandemic decreased the TLBW, SGA, and artificial fetal mortality rates. CONCLUSIONS: Analyses performed using national data suggested that the pandemic decreased the TLBW and SGA rates in Japan.

A remote educational system in medicine using digital video.

BACKGROUND/AIMS: Telemedicine has opened the door to a wide range of learning experience and simultaneous feedback to doctors and students at various remote locations. However, there are limitations such as lack of approved international standards of ethics. The aim of our study was to establish a telemedical education system through the development of high quality images, using the digital transfer system on a high-speed network. METHODOLOGY: Using telemedicine, surgical images can be sent not only to domestic areas but also abroad, and opinions regarding surgical procedures can be exchanged between the operation room and a remote place. The Asia Pacific Information Infrastrucuture (APII) link, a submarine cable between Busan and Fukuoka, was used to connect Korea with Japan, and Korea Advanced Research Network (KOREN) was used to connect Busan with Seoul. Teleconference and video streaming between Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan were realized using Digital Video Transfer System (DVTS) over Ipv4 network. RESULTS: Four endoscopic surgeries were successfully transmitted between Seoul and Kyushu, while concomitant teleconferences took place between the two throughout the operations. Enough bandwidth of 60 Mbps could be kept for two-line transmissions. The quality of transmitted video image had no frame loss with a rate of 30 images per second. The sound was also clear, and time delay was less than 0.3 sec. CONCLUSIONS: Our experience has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video transmission over Internet protocol, which is easy to perform, reliable, and economical. Our network system may become a promising tool for worldwide telemedical communication in the future.