Importance
The association of the Great East Japan Earthquake and the subsequent Fukushima Daiichi
Nuclear Power Plant disaster of March 11 and 12, 2011, in Fukushima, Japan, with birth
rates has not been examined appropriately in the existing literature.
Objective
To assess the midterm and long-term associations of the Great East Japan Earthquake and
the Fukushima Daiichi Nuclear Power Plant disaster with birth rates.
Design, Setting, and Participants
Cohort study in which interrupted time series analyses were used to assess monthly
changes in birth rates among residents of Fukushima City, Japan, from March 1, 2011, to
December 31, 2017, relative to projected birth rates without the disaster based on
predisaster trends. Birth rates from January 1, 2007, to December 31, 2017, in Fukushima
City were determined using information from the Fukushima City government office.
Exposure
The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster,
expressed via 5 potential models of the association with birth rate: level change, level
and slope changes, temporal level change, and temporal level change with 1 or 2 slope
change(s).
Main Outcomes and Measures
Birth rate, calculated from monthly data on the number of births and total
population.
Results
The mean birth rate before the Great East Japan Earthquake and the Fukushima Daiichi
Nuclear Power Plant disaster was 69.8 per 100 000 people per month; after the
disaster, the mean birth rate was 61.9 per 100 000 people per month. Compared with
birth rates before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear
Power Plant disaster, there was an estimated 10% reduction in monthly birth rates in
Fukushima City (rate ratio, 0.90; 95% CI, 0.86-0.93) in the first 2 years after the
disaster. After that, the birth rate trend was similar to the predisaster trend. The
predisaster trend suggested a continuous decrease in birth rate (rate ratio for 1 year,
0.98; 95% CI, 0.98-0.99). This gap model was optimal and parsimonious compared with
others. A similar association was found when trimonthly averaged data were analyzed.
Conclusions and Relevance
The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster
were followed by significant reductions in birth rates for 2 years. There was
insufficient evidence to indicate that the trend in the 3 to 7 years after the disaster
differed from the predisaster trends. The recovery from the reductions in the birth rate
may be indicative of the rebuilding efforts. The continuing long-term decrease in birth
rates observed before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear
Power Plant disaster suggests that continuing measures to support birth planning should
be considered at the administrative level.