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Annual trends and regional variations in medical interventions and survival to discharge for trisomies 18 and 13, 2011–2022: a nationwide inpatient database study

Journal of Perinatology (2026)Cite this article

Subjects

Abstract

Objective

This study examines annual trends and regional disparities in interventions and in-hospital outcomes for trisomies 18 and 13.

Study design

We conducted a retrospective cohort study using nationwide data from 2011 to 2022. Patients with trisomies 18 and 13 admitted on the day of birth were identified. Nonsurgical and surgical intervention rates, survival to discharge, length of stay, and costs were analyzed by year and region.

Result

This study identified 2 245 neonates with trisomy 18 (n = 1 808) and trisomy 13 (n = 437). Nonsurgical and surgical intervention rates increased annually. Between 2011 and 2022, survival to discharge rates improved from 44.5 to 57.9%, and both hospital length of stay and costs nearly doubled. Regional disparities in survival to discharge rates were significant, with differences of up to 21.5%.

Conclusion

We observed an increase in interventions and a corresponding improvement in survival to discharge, with significant regional variations.

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Fig. 1: Flowchart of study participants.
Fig. 2: Regional variations in survival to discharge rates for infants with trisomies 18 and 13.

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available due to contractual agreements with the hospitals that provided the data for the database, which restrict public access to these datasets.

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Acknowledgements

We thank Ellen Daldoss from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This work was supported by the Ministry of Health, Labor and Welfare, Japan (grant numbers 23AA2003 and 22AA2003).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan

    Shunya Sugai, Mina Itsukaichi, Koji Nishijima & Kosuke Yoshihara

  2. Department of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yusuke Sasabuchi

  3. Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan

    Akira Kobayashi

  4. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Hideo Yasunaga & Hiroki Matsui

  5. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yuya Kimura

  6. Department of Health Policy and Informatics, Institute of Science Tokyo Graduate School of Medical and Dental Sciences, Tokyo, Japan

    Kiyohide Fushimi

Authors
  1. Shunya Sugai
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  2. Yusuke Sasabuchi
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  3. Mina Itsukaichi
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  4. Akira Kobayashi
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  10. Kosuke Yoshihara
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Contributions

SS, MI, AK, and KY conceived and designed the study. YS contributed to the study design and statistical methodology. HY, YK, and KF contributed to data acquisition and data curation. SS and YS performed the data analysis. SS wrote the first draft of the manuscript. MI, AK, YK, HY, HM, KF, KN, and KY critically revised the manuscript. KY supervised the study. All authors approved the final manuscript.

Corresponding author

Correspondence to Kosuke Yoshihara.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

The study was approved by the Institutional Review Board of The University of Tokyo (approval number: 3501-(5) on 19 May 2021), and all methods were performed in accordance with the relevant guidelines and regulations. The requirement for informed consent was waived by the Institutional Review Board because all data were de-identified.

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Sugai, S., Sasabuchi, Y., Itsukaichi, M. et al. Annual trends and regional variations in medical interventions and survival to discharge for trisomies 18 and 13, 2011–2022: a nationwide inpatient database study. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02610-3

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