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死産は少子化問題を抱える現代の我が国にとって,母体とそれをとりまく社会的,自然的環境的背景が要因となって起こる深刻な問題である。近年,死産率は全国平均的にみて減少傾向にあるが,その緩急の程度は地域によって異なっている。これまで,死産危険度について全国規模での体系的な報告はまだされていない。本研究では,死産の実態を記述すると共に,日本全国の各市区町村別に死産相対危険度を推定し,それらの経年的変動および地理分布の視覚化を行った。特に,死産の地理的環境的背景要因の探索を行うために,母親の出産の背景が比較的均一と考えられる集団に層別化し,嫡出子として届けられたもののうち初産で自然死産したものに焦点をあて解析を行った。本研究で用いた資料は,1992年から1997年までの市区町村単位で個人別に記載された,日本の人口動態出生児調査票及び死産児調査票(3,396市区町村の死産児116,067名,出生児7,303,534名分)を対象とした。これらの資料を用いて,標準化死亡比(SMR)に準じ,全市区町村全期間を基準集団とし,市区町村ごとに標準化死産比を算出した。この指標は人口規模の小さな市区町村では不安定であるため,Poisson-gammaモデルで事前分布を導入し,経験ベイズ法とノンパラメトリック時空間平滑化法を用いて修正標準化死産比を求め,死産相対危険度の推定値とした。これらの値を日本地図上に色分けしてプロットすることにより死産危険度の地理分布の視覚化を行った。上記解析の結果,自然死産の嫡出子では経年的に死産危険度の地域格差が少なくなる傾向にあったが,非嫡出子においては依然として地域格差が認められた。嫡出子では母親の全年齢階級で経産が初産より高い死産..., Objective: The purpose of this study is to investigate the actual condition of inter annual change and geographic distribution of the stillbirth risk, and to consider the relationship between the stillbirth and its background factors. Method: The data are the vital-statistics of annual birth and stillbirth for each municipality in Japan for the period 1992 to 1997. The targets were 7,303,534 birth and 116,067 stillborn for 3,396 municipalities. In the analysis of its spatial-time distribution, mother's age, primipara/multipara and legitimate/illegitimate child were used as background factors. After adjusting mother's age, applying SMR (Standardized Mortality Rate), we constructed the modified relative risk index using the empirical Bayes and nonparametric smoothing methods. We estimated the modified relative risk of stillbirth in each municipality in each year and visualized the time-spatial distribution of them. Results: It was obtained that the risk of a natural stillbirth of multipara in legitimate child was high compared to that of primipara. Recently, the number of natural stillbirth has decreased, and the regional difference of its risk has reduced as well. However, some districts with especially high or low relative risk were recognized.

The prevalence of urinary incontinence and risk factors of stress urinary incontinence were studied in 710 working women between 21 and 59 year old. Six hundred (89%) of them responded to a 10-item questionnaire regarding urinary incontinence (UI). Ul was found in 178 (29.7%). The prevalence was consistent with those in previous reports. Of the 178 UI, 158 (88.7%) were stress urinary incontinence (SUI). Four risk factors, age, childbirth, obesity, and gynecological/urological diseases, were statistically analyzed in 158 women with SUI. Mantel-Haenszel odds ratio (MH-OR) of obesity adjusted for age was 0.97 (95% Confidence interval CI: 0.58-1.60). Furthermore, in the obese group, the incidence of SUI adjusted for childbirth was apparently lower (MH-OR: 0.18, 95%CI: 0.11-0.30, p

The causes of a disease have not been clarified sufficiently. For example, there may be no one who denies the relationship between tabacco smoking and lung cancer. Besides no one can assert that the former should be only one cause of the latter, because genetic factors may be involved. The factors which should elevate the risk for the occurrence of a disease, are called as risk factors before they have been identified as the cause of it. In present paper, authors intend to give some interpretations to the methods of epidemiologic studies and the indeces for evaluation of risk factors by using some samples. Both of them may help young researchers to realize the basis of Evidence-based Medicine.