System-Level Analysis of Japan's Pediatric-Perinatal Disaster Liaison Operations During the 2024 Noto Earthquake

Kyosuke Kagami; Kazunori Imai; Yasuhisa Ueno; Hiroyuki Kitano; Shinya Hirabuki; Hiromasa Sasaki; Hitoshi Sato; Yusuke Mitani; Hidenori Iwasaki; Taizo Wada; Hiroshi Fujiwara; Nobuya Unno

doi:10.1111/ped.70488

System-Level Analysis of Japan's Pediatric-Perinatal Disaster Liaison Operations During the 2024 Noto Earthquake

Pediatr Int. 2026 Jan-Dec;68(1):e70488. doi: 10.1111/ped.70488.

Authors

Kyosuke Kagami¹, Kazunori Imai², Yasuhisa Ueno³, Hiroyuki Kitano³, Shinya Hirabuki⁴, Hiromasa Sasaki⁴, Hitoshi Sato⁵, Yusuke Mitani⁶, Hidenori Iwasaki⁶, Taizo Wada⁶, Hiroshi Fujiwara^{1

7

8}, Nobuya Unno⁹

Affiliations

¹ Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
² Department of Emergency and Critical Care, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
³ Department of Neonatology, Medical Center for Maternal and Child Health, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
⁴ Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
⁵ Department of Pediatrics, Faculty of Medicine, Kanazawa Medical University, Kanazawa, Ishikawa, Japan.
⁶ Department of Pediatrics, Graduate School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
⁷ Ochi Yume Clinic, Nagoya, Japan.
⁸ School of Veterinary Medicine Azabu University, Sagamihara, Japan.
⁹ Center for Perinatal Medicine, JCHO Sagamino Hospital, Kanazawa, Japan.

Abstract

Background: Children, neonates, and pregnant women are particularly vulnerable during disasters. Fragmentation between specialized pediatric-perinatal systems and general disaster response frameworks can hinder coordinated care. Following lessons from the 2011 Great East Japan Earthquake, Japan established the Disaster Liaison for Pediatric and Perinatal Medicine (DLPPM) to embed specialists within disaster command structures. However, large-scale activation under prolonged infrastructure disruption has not been systematically evaluated.

Methods: We conducted a structured retrospective descriptive analysis of DLPPM operational records during the first month after the 2024 Noto Peninsula Earthquake. Activities were reviewed across five pre-specified domains to examine how the liaison framework functioned during the acute and subacute phases.

Results: DLPPM was integrated into the prefectural disaster headquarters and consolidated maternal-child health information, enabling centralized identification of 83 pregnant women, estimated to represent most pregnant women in the severely affected region. Twenty-one obstetric transfers were coordinated. Pediatric transfers and evacuation of medically dependent children were facilitated through established networks. During the subacute phase, DLPPM initiated maternal-child support measures, including a "Children's Conference" and a support website. These findings suggest that DLPPM functioned as a centralized coordination hub linking specialized clinical networks with disaster governance, although real-time identification of vulnerable families in shelters remained limited.

Conclusions: Embedding pediatric and perinatal specialists within disaster headquarters can support structured medical coordination for vulnerable populations. Earlier and more systematic integration with public health and welfare systems is essential to extend this hub function beyond hospital-centered care.

Keywords: Japan; disaster medicine; earthquake; maternal health services; pediatric care.

MeSH terms

Child
Disaster Planning* / organization & administration
Disasters
Earthquakes*
Female
Humans
Infant
Infant, Newborn
Japan
Pediatrics* / organization & administration
Perinatal Care* / organization & administration
Pregnancy
Retrospective Studies