『保健医療科学』2026 Vol.75 No.2 p.190－191
＜研修報告＞
令和 7 年度専門課程Ⅰ
保健福祉行政管理分野
宮崎県における出生率・死産率の推移と人工死産に関連するリスク因子の検討―
豊嶋典世
Trends in birth and stillbirth rates in Miyazaki Prefecture and examination of risk factors associated with induced stillbirth
TOYOSHIMA Fumiyo
抄録
宮崎県は中絶率が全国ワースト 1 位であり，死産の約 5 割を中期中絶（人工死産）が占める．本研究は，人口動態統計の出生票・死産票を用い，中期中絶の関連要因とCOVID-19 流行の影響を分析した．解析の結果，人工死産群は出生群に比べ「未婚」の割合が有意に高く，母親の年齢は 15 ～ 24 歳と 35 ～ 39 歳にピークが認められた．また，経済的に不安定な世帯や第一子妊娠での選択が目立った．コロナ禍では出生・中絶数共に減少したが，要因の構造に変化はなかった．本研究は，中期中絶の解析を通じて「未婚・若年・経済的困窮」が宮崎県の中絶率の高さに寄与していることを統計的に示した．これらの知見は，経済支援や教育を含む本県の少子化対策や，母子保健ビジョンを実現するための具体的な施策立案における重要な根拠となる．
キーワード: 人工妊娠中絶，人工死産，新型コロナウイルス感染症，人口動態統計，宮崎
Abstract
Miyazaki Prefecture faces an exceptionally high abortion rate, with artificial stillbirths. This study aimed to identify factors associated with artificial stillbirth and evaluate the impact of the COVID-19 pandemic using vital statistics from birth and stillbirth certificates. A multi-year cross-sectional observational study analyzed approximately 16,000 birth certificates and 500 artificial stillbirth certificates. Comparative analyses were performed between the “birth group” and “artificial stillbirth group” regarding age, marital status, residential area, and household occupation. Selecting artificial stillbirth was strongly associated with non-marital status and economic hardship. A high proportion occurred among young women during their first pregnancy, with a second peak observed in the 35–39 age group. While birth and artificial stillbirth rates declined during the COVID-19 pandemic, no significant changes in specific risk factors were identified within the survey data. This study statistically demonstrated that being unmarried, young, or economically disadvantaged contributes significantly to Miyazaki’s high abortion rate. These findings provide a critical evidence base for implementing targeted measures to realize the prefecture’s vision
keywords: COVID-19, stillbirth, abortion, Vital statistics, Miyazaki Supervisor Eri Osawa and Ritei Uehara