Comparative analysis of necrotizing enterocolitis in preterm infants born in Japan and born to mothers of Japanese ethnicity in California
Infants born in Japan are reported to have a low incidence of necrotizing enterocolitis (NEC) among countries, and these differences remained significant after adjusting for common clinical factors. To investigate the impact of ethnic background, we compared the incidence of NEC between infants born in Japan and those born to mothers of Japanese ethnicity in California. Preterm infants born between 2008 and 2019 at 22-29 weeks of gestational age were analyzed retrospectively. Four groups were analyzed: infants born in Japan (JP), infants born in California to mothers born in Japan (JP-J), infants born in California to mothers with Japanese ethnicity but born in the United States or another country (JP-CA), and a comparison group of infants born in California to non-Hispanic White mothers (NHW-CA). Each cohort consisted of 52,049, 115, 226, and 12,275 infants, respectively. Unadjusted NEC incidences were significantly lower in JP compared to the other three cohorts (1.7% JP, 4.5% JP-J, 4.6% JP-CA, and 3.3% NHW-CA, respectively; p < 0.01). After adjusting for confounding factors, odds ratios for NEC in JP vs. JP-J, JP-CA, and NHW-CA were 3.04 (1.18-7.80), 2.89 (1.45-5.75), and 1.96 (1.56-2.47), respectively. This study suggests that differences in NEC incidence in Japan are not explained by ethnicity.Clinical trial regstration number: Registration numbers is UMIN000006961 ( https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000008217 ) for the Neonatal Research Network of Japan. However, the the California Perinatal Quality Care Collaborative (CPQCC) aims only to assess neonatal outcomes for the purpose of quality assessment and improvement. So, no clinical trial number is available. Please refer to the web site https://www.cpqcc.org/ .
Authors
- Satoshi Toishi
- Hirokazu Arai (ORCID: https://orcid.org/0000-0002-1415-4831)
- Toshinori Nakashima (ORCID: https://orcid.org/0000-0003-4740-0207)
- Kuniko Ieda
- Yoshihisa Nagayama
- Hiroshi Takeshita
- Kyone Ko
- Yoshiya Yukitake
- Makoto Nabetani (ORCID: https://orcid.org/0000-0002-9762-0438)
- Yuko Nagaoki (ORCID: https://orcid.org/0000-0002-5065-2205)
- Daisuke Ogata
- Satsuki Kakiuchi (ORCID: https://orcid.org/0009-0003-7646-7643)
- Masatoshi Sanjo
- Naoki Fukushima
- Satoshi Watanabe (ORCID: https://orcid.org/0000-0003-0041-6981)
- Jeffrey B. Gould (ORCID: https://orcid.org/0000-0002-8495-077X)
- Akira Oishi
- Makoto Ohshiro
- Tsutomu Ogata (ORCID: https://orcid.org/0000-0001-7178-9991)
- Yoshio Shima (ORCID: https://orcid.org/0000-0003-2287-4430)
- Osamu Shinohara
- Nobuhiro Takahashi (ORCID: https://orcid.org/0000-0003-2508-8419)
- Tsutomu Ishi‐i (ORCID: https://orcid.org/0000-0002-2238-8013)
- Taizo Ueno
- Ayako Fukuyama
- Genichiro Sotodate (ORCID: https://orcid.org/0000-0002-8530-4219)
- Goro Asada
- Yae Michinomae
- Mihoko V. Bennett (ORCID: https://orcid.org/0000-0002-3449-9538)
- Yukiteru Tachibana
- Yasuaki Kobayashi (ORCID: https://orcid.org/0000-0003-3244-6915)
- Mari Ishii
- Hiroshi Mizumoto
- Kenji Ichinomiya (ORCID: https://orcid.org/0000-0001-8979-5388)
- Harumi Otsuka
- Yasushi Uchida (ORCID: https://orcid.org/0000-0002-7998-2427)
- Kanemasa Maki
- Keiji Goishi
- Kozue Shiomi (ORCID: https://orcid.org/0000-0002-2614-9538)
- Takashi Okuno
- Atsushi Nemoto (ORCID: https://orcid.org/0000-0001-5330-5324)
- Rie Fukuhara
- Yuichi Kato (ORCID: https://orcid.org/0000-0001-5363-8487)
- Ken Kumagaya
- Atsushi Uchiyama (ORCID: https://orcid.org/0000-0003-0339-8571)
- Yoshio Kusumoto
- Masayuki Suzuki (ORCID: https://orcid.org/0000-0002-0436-1490)
- T Ando
- Ryosuke Araki (ORCID: https://orcid.org/0000-0003-0962-0815)
- Hiroaki Imamura
- Yayoi Miyazono (ORCID: https://orcid.org/0000-0001-6195-0737)
- Moriharu Sugimoto
- Kazutaka Nakasone (ORCID: https://orcid.org/0000-0002-0262-9932)
- Takashi Yamagami
- Takahiko Saijo
- Yasushi Ōki (ORCID: https://orcid.org/0000-0002-0767-5209)
- Hidehiko Nakanishi (ORCID: https://orcid.org/0000-0001-5768-3971)
- Hiroshi Tateishi (ORCID: https://orcid.org/0000-0003-1225-0720)
- Toru Yamakawa
- Shuya Nagaoki
- Masanori Iwai (ORCID: https://orcid.org/0000-0002-9173-0652)
- Seiji Yoshimoto
- Yusei Nakata
- Dai Kataoka
- Katsuaki Toyoshima (ORCID: https://orcid.org/0000-0002-7817-9907)
- Shoko Ohashi
- Hiromichi Shoji (ORCID: https://orcid.org/0000-0003-2532-8910)
- Hiroshi Suzumura
- Taizo Murabayashi
- Katsutoshi Ogo
- Koichi Iida
- Hiroyasu Kawano
- Takuya Hikino (ORCID: https://orcid.org/0000-0003-2673-7505)
- Ryoko Yoshinare
- Mitsuaki Unno
- Daisuke Nishi
- Mikio Aoki
- Takeshi Utsunomiya (ORCID: https://orcid.org/0000-0002-9770-9803)
- Miho Sato (ORCID: https://orcid.org/0000-0001-9321-8487)
- Sakae Kumasaka
- Osuke Iwata (ORCID: https://orcid.org/0000-0001-9277-1109)
- Yukihide Koyama (ORCID: https://orcid.org/0000-0002-5975-2579)
- Hiroshi Yamamoto (ORCID: https://orcid.org/0000-0002-6297-1991)
- Hiroshi Kanda (ORCID: https://orcid.org/0000-0002-7922-7309)
- Márcia Tie Kawamura
- Toshiya Saito
- Takushi Hanita (ORCID: https://orcid.org/0000-0001-5855-0222)
- Toru Huchimukai
- Nobuko Shiono
- Yuki Kodama (ORCID: https://orcid.org/0000-0002-5657-1473)
- Fumihiko Ishida
- Masaru Shirai
- Yuki Hasegawa
- Kazumichi Fujioka (ORCID: https://orcid.org/0000-0002-9913-6447)
- Takuya Tokuhisa (ORCID: https://orcid.org/0000-0001-8580-5657)
- Hiroshi Yoshida (ORCID: https://orcid.org/0000-0002-7569-7813)
- Shinya Hirano
- Manabu Sugie (ORCID: https://orcid.org/0000-0002-9563-2312)
- Takashi Maeda (ORCID: https://orcid.org/0000-0002-5133-8146)
- Yasuhisa Ueno
- Ichiro Morioka (ORCID: https://orcid.org/0000-0002-5685-2670)
- Toru Ishioka
- Yosuke Kaneshi (ORCID: https://orcid.org/0000-0002-6801-3639)
- Tomomasa Terada (ORCID: https://orcid.org/0000-0003-0238-4258)
- Osamu Matsuda
- Masato Ito (ORCID: https://orcid.org/0000-0002-8084-4451)
- Yutaka Nishimura
- Tetsuya Kunikata
- Toshihiko Mori (ORCID: https://orcid.org/0000-0003-0421-2740)
- Tatsuya Yoda
- Reiko Kushima
- Takeshi Arakawa
- Toru Kuboi (ORCID: https://orcid.org/0000-0003-2121-1862)
- Fumiko Kinoshita (ORCID: https://orcid.org/0000-0001-7146-7271)
- Kaoru Okazaki (ORCID: https://orcid.org/0000-0001-7002-468X)
- Satoshi Onishi
- Yuko Maruyama (ORCID: https://orcid.org/0000-0002-4303-2489)
- Hitoshi Yoda (ORCID: https://orcid.org/0009-0005-6465-9327)
- M Kudo
- Riki Nishimura
- Azusa Kobayashi (ORCID: https://orcid.org/0009-0009-6876-8968)
- Kosuke Koyano (ORCID: https://orcid.org/0000-0003-1189-1980)
- Masahiro Tahara (ORCID: https://orcid.org/0000-0003-2164-0421)
- Hiroshi Sumida (ORCID: https://orcid.org/0000-0003-1596-5991)
- Masayuki Ochiai (ORCID: https://orcid.org/0000-0001-7169-3690)
- Yoriko Kisato
- Masahito Yamamoto (ORCID: https://orcid.org/0000-0001-9683-6678)
- Koki Nakamura (ORCID: https://orcid.org/0000-0002-3036-234X)
- Taketoshi Yoshida (ORCID: https://orcid.org/0000-0002-9937-1703)
- Tohei Usuda
- Masami Shirai
- Yukihide Miyosawa (ORCID: https://orcid.org/0000-0002-7034-1148)
- Asao Yara
- Takahide Hosokawa
- Satoshi Kusuda (ORCID: https://orcid.org/0000-0001-5318-8877)
- Takahiro Okutani (ORCID: https://orcid.org/0000-0003-3435-8687)
- Ayumu Noro
- Muneichiro Sumi
- Yuji Ito (ORCID: https://orcid.org/0000-0002-5239-5070)
- Fumihiko Namba (ORCID: https://orcid.org/0000-0001-6137-4477)
- Koji Nozaki
- Takehiko Hiroma (ORCID: https://orcid.org/0000-0003-3089-8889)
- Naoto Nishizaki (ORCID: https://orcid.org/0000-0001-9471-6146)
- Toshio Ikeda (ORCID: https://orcid.org/0000-0003-0055-9157)
- Rei Kobayashi (ORCID: https://orcid.org/0000-0001-6369-444X)
- Nobuhisa Kamata
- Misao Yoshii
- Toshiya Nishikubo (ORCID: https://orcid.org/0000-0002-6030-5207)
- Isamu Hokuto
- Junichiro Ohira (ORCID: https://orcid.org/0000-0002-1888-9173)
- Akihiro Takatera
- Ritsuyo Taguchi
- Yasuyuki Tokunaga
- Gen Kuratsuji
- Kiyoaki Sumi (ORCID: https://orcid.org/0000-0003-0934-6449)
- Hironobu Tokumasu
- Misao Kageyama (ORCID: https://orcid.org/0000-0003-3815-9546)
- Kei Inomata (ORCID: https://orcid.org/0000-0003-3420-0732)
- Seiichi Hayakawa (ORCID: https://orcid.org/0000-0002-2833-2010)
- Masashi Hayashi
- Hikaru Yamamoto (ORCID: https://orcid.org/0000-0002-2155-6468)
- Kenji Mine
- Mitsuhiro Ito (ORCID: https://orcid.org/0000-0001-9505-2441)
- Yuki Sudo (ORCID: https://orcid.org/0000-0001-8155-9356)
- Kei Takemoto
- Akira Nishimura (ORCID: https://orcid.org/0000-0002-0168-9829)
- Takahide Yanagi (ORCID: https://orcid.org/0000-0002-4524-3167)
- Kenichiro Hosoi
- Tomoaki Ioroi (ORCID: https://orcid.org/0000-0003-1666-8841)
- Ken Nagaya (ORCID: https://orcid.org/0000-0003-4093-3211)
- Shigeharu Hosono (ORCID: https://orcid.org/0000-0002-5319-6153)
- Motoichiro Sakurai
- Tasho Kim
- Masumi Miura
- Tadayuki Kumagai
- Eiki Nakamura
- Shinosuke Akiyoshi
- Takashi Imamura
- Kazuhide Ohta
- Hiroshi Komatsu (ORCID: https://orcid.org/0000-0003-3248-7901)
- Naoki Ito
- Hiroshi Matsumoto (ORCID: https://orcid.org/0000-0001-9560-0030)
- Yumi Kono (ORCID: https://orcid.org/0000-0002-0647-7868)
- Takashi Tachibana (ORCID: https://orcid.org/0000-0001-5004-6312)
- Atsushi Nakao (ORCID: https://orcid.org/0000-0002-9810-1381)
- Kazumasa Takahashi
- Masahiro Kinoshita (ORCID: https://orcid.org/0000-0001-6719-1241)
- Atsushi Ogihara (ORCID: https://orcid.org/0000-0002-2819-0868)
- Rikio Suzuki (ORCID: https://orcid.org/0000-0001-5628-1719)
- T Takayanagi (ORCID: https://orcid.org/0000-0002-3027-602X)
- Masaki Kobayashi
- Rahul Negi (ORCID: https://orcid.org/0009-0008-7832-4407)
- Satoru Ogawa
- Masahiko Sato
- Tamaki Ohashi
- Rie Kanai (ORCID: https://orcid.org/0009-0002-1995-0877)
- Takashi Nakano
- Masahiro Kobayashi (ORCID: https://orcid.org/0000-0002-6645-860X)
- Kenji Nakamura
- Hiroyuki Ichiba
- K Hirakawa
- Yasuhiko Sera
- Yasushi Takahata
- Hirotaka Minami
- Takahiro Muramatsu
- Masaki Shimizu
- Shinji Usui
- Akiko Tamura
- S. Niwa
- T Kokubo
- Toru Fujiu
- Tatsuo Oshiro
- Masahiko Kai
- Reiji Nakano
- Takeshi Morisawa
- Takashi Nasu
- I. Hayasaka
- Atsuo Miyazawa
- Masashi Miyata
- Shutaro Suga (ORCID: https://orcid.org/0000-0002-4257-2109)
- Koji Takemoto
- Hideaki Fukushima
- Machiko Sawada
- Masahiko Murase
- Hideshi Fujinaga
- Hitomi Okabe
- Yosuke Shima
- S. Fukunaga
- Keiko Hasegawa
- T Hirooka
- Yoichi Kondo
- Shinsuke Adachi
- Shigeru Oki
- R Hasegawa
- Masaru Yamakawa
- Takahiro Motoki (ORCID: https://orcid.org/0000-0001-9098-2180)
- Maki Sato
- Daisuke Kinoshita (ORCID: https://orcid.org/0000-0001-8909-0425)
- Takeshi Hutani
- Masanori Kowaki
- Hiroshi Uchizono
- Yusuke Ohkado
- Mitsushi Goushi
- Shuichi Yanagibe
- Chika Morioka
- Daisuke Haruhara
Institutions
- Kanazawa University (JP)
- Kurume University (JP)
- University of Fukui (JP)
- Hiroshima University (JP)
- Otsuka (Japan) (JP)
- University of Miyazaki (JP)
- SHOWA Medical University (JP)
- Tokyo Medical and Dental University (JP)
- Kansai Medical University (JP)
- Toho University (JP)
- Tokuyama (Japan) (JP)
- Kyushu University (JP)
- Shinshu University (JP)
- Fujita Health University (JP)
- University of Tsukuba (JP)
- Jichi Medical University (JP)
- Asahikawa Medical University (JP)
- Bunkyo University (JP)
- Tokyo Medical University (JP)
- St. Marianna University School of Medicine (JP)
- Aichi Medical University (JP)
- Kanazawa Medical University (JP)
- Gunma University (JP)
- Shiga University (JP)
- Yamaguchi University (JP)
- Iwate Medical University (JP)
- University of Occupational and Environmental Health Japan (JP)
- Kawasaki Medical School (JP)
- Wakayama Medical University (JP)
- Kyorin University (JP)
- Tohoku University (JP)
- Hannan University (JP)
- Akita University (JP)
- Osaka Medical and Pharmaceutical University (JP)
- Kyoto University (JP)
- Saitama Prefecture (JP)
- NTT Medical Center (JP)
- Yokohama City University Medical Center (JP)
- Nagara Medical Center (JP)
- National Kyushu Medical Center (JP)
- Osaka Prefectural Medical Center (JP)
- Fukuoka University (JP)
- Juntendo University (JP)
- Kobe Kaisei Hospital (JP)
- Konan Kosei Hospital (JP)
- Toyama Prefectural Central Hospital (JP)
- Toyonaka Municipal Hospital (JP)
- Fukui Prefectural Hospital (JP)
- Tsuchiura Kyodo General Hospital (JP)
- Sendai Red Cross Hospital (JP)
- Kumamoto City Hospital (JP)
- Kurashiki Central Hospital (JP)
- Ashikaga Red Cross Hospital (JP)
- Aomori Prefectural Central Hospital (JP)
- Gifu Prefectural Tajimi Hospital (JP)
- Nagasaki Municipal Hospital (JP)
- Kanazawa Medical Center (JP)
- Sasebo City General Hospital (JP)
- San-ikukai Hospital (JP)
- Toyota Memorial Hospital (JP)
- Nippon Medical School Musashi Kosugi Hospital (JP)
- Okinawa Red Cross Hospital (JP)
- Municipal Tsuruga Hospital (JP)
- Ijinkai Takeda General Hospital (JP)
- Osaka Women's and Children's Hospital (JP)
- Miwa Hospital (JP)
- Hyogo Prefectural Awaji Medical Center (JP)
- Chiba Kaihin Municipal Hospital (JP)
- Yokohama City Seibu Hospital (JP)
- Osaka City General Hospital (JP)
- Yokohama City University Hospital (JP)
- Niigata Prefectural Central Hospital (JP)
- Iwata City Hospital (JP)
- Otaru Municipal Hospital (JP)
- Fukuoka Children's Hospital and Medical Center for Infectious Diseases (JP)
- Ikeda Municipal Hospital (JP)
- SHOWA Medical University Northern Yokohama Hospital (JP)
- Kobe Central Hospital (JP)
- Tokushima Prefectural Central Hospital (JP)
- Saiseikai Shimonoseki General Hospital (JP)
- Tokyo Metropolitan Bokutoh Hospital (JP)
- Hiroshima General Hospital (JP)
- Kyoto City Hospital (JP)
- Chibune General Hospital (JP)
- Saku Central Hospital (JP)
- Hiroshima Prefectural Hospital (JP)
- Kushiro Rosai Hospital (JP)
- Niigata City General Hospital (JP)
- Yodogawa Christian Hospital (JP)
- Uwajima City Hospital (JP)
- Osaki Citizen Hospital (JP)
- National Cerebral and Cardiovascular Center (JP)
- Shizuoka Saiseikai General Hospital (JP)
- Kitasato University Hospital (JP)
- Nayoro City General Hospital (JP)
- Fukuyama City Hospital (JP)
- Kameda Medical Center (JP)
- Obihiro Kosei General Hospital (JP)
- Okazaki City Hospital (JP)
- Tokai University Hospital (JP)
- Kanagawa Children's Medical Center (JP)
- National Sagamihara Hospital (JP)
- Tsuyama Chuo Hospital (JP)
- Tenshi Hospital (JP)
- Okayama Red Cross General Hospital (JP)
- Oita Prefectural Hospital (JP)
- Matsuyama Red Cross Hospital (JP)
- Nagasaki Medical Center (JP)
- Ishikawa Prefectural Central Hospital (JP)
- Nagaoka Red Cross Hospital (JP)
- Okinawa Prefectural Chubu Hospital (JP)
- Kagoshima City Hospital (JP)
- Saitama Prefectural Tokorozawa Nishi High School (JP)
- Hokkaido hospital (JP)
- Tottori University Hospital (JP)
- Handa City Hospital (JP)
- Kobe Children's Hospital (JP)
- Yamagata Prefectural Central Hospital (JP)
- Saiseikai Suita Hospital (JP)
- Uji Hospital (JP)
- Tottori Prefectural Central Hospital (JP)
- Kyoto first Red Cross hospital (JP)
- Naha City Hospital (JP)
- Shimane Prefectural Central Hospital (JP)
- Matsue Red Cross Hospital (JP)
- Seirei Hamamatsu General Hospital (JP)
- Numazu City Hospital (JP)
- Yokohama Rosai Hospital (JP)
- Japanese Red Cross Nagoya Daiichi Hospital (JP)
- National Center For Child Health and Development (JP)
- Saitama International Medical Center (JP)
- Himeji Red Cross Hospital (JP)
- Otsu Red Cross Hospital (JP)
- Gifu Prefectural General Medical Center (JP)
- Berurando General Hospital (JP)
- Odawara Municipal Hospital (JP)
- Kagawa University Hospital (JP)
- Akita Red Cross Hospital (JP)
- Shibuya (Japan) (JP)
- Tokyo Women's Medical University (JP)
- Saiseikai Nakatsu Hospital (JP)
- Fujieda Municipal General Hospital (JP)
- Juntendo University Urayasu Hospital (JP)
- Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital (JP)
- Japanese Red Cross Narita Hospital (JP)
- Almeida Memorial Hospital (JP)
- Sendai City Hospital (JP)
- Mitsubishi Kyoto Hospital (JP)
- Kyoto Katsura Hospital (JP)
- Toyooka Hospital (JP)
- Toyota Kosei Hospital (JP)
- Asahi General Hospital (JP)
- Nagano Children's Hospital (JP)
- Tokyo Metropolitan Children's Medical Center (JP)
- National Institute of Technology, Miyakonojo College (JP)
- Aso Iizuka Hospital (JP)
- Anjo Kosei Hospital (JP)
- Gunma Children's Medical Center (JP)
- Kitakyushu City Hospital Organization (JP)
- Ehime Prefectural Central Hospital (JP)
- Toyohashi Municipal Hospital (JP)
- Komaki City Hospital (JP)
- Edogawa Hospital (JP)
- Yokkaichi Municipal Hospital (JP)
- Sapporo City General Hospital (JP)
- Yokosuka Kyosai Hospital (JP)
- Gunma Chuo Hospital (JP)
- Nagahama City Hospital (JP)
- Imakiire General Hospital (JP)
- National Institute of Technology, Tomakomai College (JP)
- Ise Red Cross Hospital (JP)
- Osaka Red Cross Hospital (JP)
- Okayama Medical Center (JP)
- Nagoya Medical Center (JP)
- Japanese Red Cross Nagoya Daini Hospital (JP)
- Saiseikai Yokohama Eastern Hospital (JP)
- Yamaguchi Prefecture Central Hospital (JP)
- Ibaraki Children's Hospital (JP)
- Takayama Red Cross Hospital (JP)
- Shizuoka University of Welfare (JP)
- Tokushima Hospital (JP)
- Asahikawa Kosei Hospital (JP)
- Hiraka General Hospital (JP)
- Toshima Hospital (JP)
- Kure Medical Center (JP)
- Shikoku Medical Center for Children and Adults (JP)
- Kouseiren Takaoka Hospital (JP)
- Shizuoka Children's Hospital (JP)
- Tokushima Municipal Hospital (JP)
- Kitano Hospital (JP)
- Kokura Memorial Hospital (JP)
- Toujinkai Hospital (JP)
- Takatsuki General Hospital (JP)
- Nihon University Itabashi Hospital (JP)
- Yamagata University Hospital (JP)
- Yamanashi Prefectural Central Hospital (JP)
- Jichi Medical University Saitama Medical Center (JP)
- University of Toyama (JP)
- Nagasaki University (JP)
- Tokyo Women's Medical University Yachiyo Medical Center
- Osaka Metropolitan University (JP)
- Nagoya University (JP)
- Nara Medical University (JP)
- Kobe University (JP)
- Tokyo Metropolitan University (JP)
- Niigata University (JP)
- Dokkyo Medical University (JP)
- Saitama Medical University (JP)
- Teikyo University (JP)
- Yokohama City University (JP)
- Tokushima University (JP)
- Kumamoto University (JP)
- Stanford University (US)
- The University of Osaka (JP)
Publication Details
- Journal
- Scientific Reports
- Published
- 2025-03-22
- DOI
- https://doi.org/10.1038/s41598-025-92393-y
- Citations
- 1
- Primary Topic
- Infant Nutrition and Health
- Type
- article
- Field-Weighted Citation Impact
- 1.12