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Secular trends in early motor development between 1980 and 2010 in Japan
  1. Keisuke Yoshii1,
  2. Nobuaki Michihata2,
  3. Kyoko Hirasawa3,
  4. Satoru Nagata3,
  5. Naho Morisaki4
  1. 1Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
  2. 2Department of Health Services Research, The University of Tokyo, Tokyo, Japan
  3. 3Department of Pediatrics, Tokyo Women’s Medical University Hospital, Tokyo, Japan
  4. 4Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
  1. Correspondence to Dr Keisuke Yoshii, Division of Endocrinology and Metabolism, National Center for Child Health and Development, Setagaya-ku, Tokyo 157-8535, Japan; yoshii-k{at}


Objective Recent changes in birth characteristics in Japan may have a potential influence on children’s developments. Therefore, we investigated secular trends in gross motor milestones.

Design Data were collected from an official Japanese nationwide serial cross-sectional survey conducted every 10 years since 1960. 22 320 participants aged 2–18 months were identified from the four surveys from 1980 to 2010.

Outcomes We assessed whether or not a child achieved four gross motor milestones including rolling over (rolling), sitting without support (sitting), standing with support (standing) and walking alone (walking). The target age was defined as the age when the attainment rate ranged from >5% to >95% of the total. Multivariate logistic regression models were fitted.

Results The final cohort included 20 570 children. The target ages were determined as follows: 3–6 months for rolling; 5–9 months for sitting; 6–11 months for standing; and 9–15 months for walking. The attainment rates of sitting, standing and walking in 1990 were higher than those in 2010, even after adjusting for child characteristics (sitting: adjusted OR (aOR)=2.07 (95% CI 1.62 to 2.65); standing: aOR=1.63 (95% CI 1.32 to 2.02); and walking: aOR=1.61 (95% CI 1.34 to 1.95)).

Conclusions The proportion of children who attained three motor milestones (sitting, standing and walking) by set target ages decreased between 1990 and 2010. The contribution of birth characteristics including a decrease in gestational age and fetal growth, as well as changes in other child characteristics, failed to explain why this decrease occurred.

  • epidemiology
  • growth

Data availability statement

Data are available in a public, open access repository.

Statistics from

Data availability statement

Data are available in a public, open access repository.

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  • Contributors KY and N Morisaki conceptualised and designed the study, collected and analysed data, drafted the initial manuscript, and revised it. N Michihata, KH and SN assisted with interpretation of the result and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspect of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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