Exploring the association between non-regular employment and adverse birth outcomes: an analysis of national data in Japan.

Background: As few studies have explored the association between non-regular or precarious employment in parents and adverse birth outcomes, this study aimed to investigate this association using national data in Japan. Methods: This study utilized the census data from 2020 and birth data from the vital statistics in 2021 and 2022 in the analysis. Adverse birth outcomes, including preterm birth, term low birth weight (TLBW), and small-for-gestational-age, were examined. Data linkage was conducted between birth data and census data to link parental employment statuses and educational attainments with birth data. Rates of adverse birth outcomes were calculated for each parental employment status. Additionally, regression analysis was used to determine adjusted risk ratios (RRs) of parental employment statuses for each birth outcome. Results: After data linkage, 334,110 birth records were included in the statistical analysis. Rates for non-regular workers were consistently higher than those for regular workers across all adverse birth outcomes for maternal employment status. Results of regression analyses indicated that the risks of preterm birth for non-regular workers were statistically significantly higher than those for regular workers, both in mothers and fathers with a RR (95% confidence intervals [CIs]) of 1.053 (1.004-1.104) and 1.142 (1.032-1.264), respectively. Furthermore, the risk of TLBW birth for non-regular workers was statistically significantly higher than that for regular workers in fathers (RR [95% CI]: 1.092 [1.043-1.143]). Conclusions: Our findings demonstrate that non-regular workers have a higher risk of some adverse birth outcomes compared to regular workers.