The Open Nursing Journal

ISSN: 1874-4346 ― Volume 13, 2019

Relationship Between Advanced Maternal Age, Hiesho (Sensitivity to Cold) and Abnormal Delivery in Japan

Sachiyo Nakamura*, 1, §, Shigeko Horiuchi2, §
1 Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan
2 St. Luke's College of Nursing and St. Luke's Birth Clinic, 10-1, Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan



In Japan, the proportion of women aged 35 and older giving birth has greatly increased in recent years, and maternal age is continuing to increase. Advanced maternal age is a risk factor for abnormal delivery, as is hiesho (sensitivity to cold).

Research Question:

This study aimed to assess whether advanced maternal age and hiesho precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding.


The study design was a descriptive comparative study with a retrospective cohort group design. Subjects in this study were 2,810 Japanese women in hospital after childbirth. The research methods employed were a paper questionnaire and extraction of data from medical records.


Comparing the rate of occurrence of abnormal delivery among women aged 35 to 39 according to whether or not they had hiesho, results were premature delivery OR: 3.51 (95% CI: 1.66-7.43), premature rupture of membranes OR: 1.25 (95% CI: 0.90-1.74), weak labor pains OR: 2.94 (95% CI: 1.65-5.24), prolonged labor OR: 2.56 (95% CI: 1.23-5.26), and atonic bleeding, OR: 1.65 (95% CI: 0.14-2.40) when hiesho was present. Among women aged 40 and over, results were premature delivery OR: 5.09 (95% CI: 1.16-22.20), premature rupture of membranes OR: 1.60 (95% CI: 0.73-3.46), weak labor pains OR: 7.02 (95% CI: 1.56-31.55), prolonged labor OR:7.19 (95% CI: 1.49-34.60) and atonic bleeding OR: 2.00 (95% CI: 0.64-6.23).


Regardless of maternal age, the presence of hiesho is a risk factor that can precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. Furthermore, hiesho coupled with advanced maternal age increases the incidence of premature delivery, weak labor pains and prolonged labor.

Keywords: : Maternal age, abnormal delivery, hiesho.

Article Information

Identifiers and Pagination:

Year: 2013
Volume: 7
First Page: 142
Last Page: 148
Publisher Id: TONURSJ-7-142
DOI: 10.2174/1874434601307010142

Article History:

Received Date: 15/2/2013
Revision Received Date: 17/8/2013
Acceptance Date: 22/8/2013
Electronic publication date: 6/9/2013
Collection year: 2013

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© Nakamura and Horiuchi; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan; Tel/Fax: +81-466-49-6237; E-mail:§ These authors contributed equally to this work.


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