Masayo Matsuzaki

目 的本研究は妊娠中期の就労初産婦・経産婦それぞれの，職業性ストレスやマタニティハラスメントの経験といった具体的な就労実態を含めた，睡眠の質に関連する心理社会的特徴を探索的に明らかにすることを目的とする。対象と方法大阪府内の産科クリニックにて妊娠中期の就労女性を対象にオンライン調査を実施した。属性，日本語版エジンバラ産後うつ病自己質問票（EPDS），ストレス対処能力，就労状況，職業性ストレス，マタニティハラスメントの経験，ピッツバーグ睡眠質問票日本語版（PSQI-J）のデータを収集した。睡眠の質に関連する心理社会的特徴を明らかにするためにPSQI-J得点をカットオフ値（5/6点）で2群に分類し，属性と就労状況について連続変数にはt検定またはWilcoxonの順位和検定を，カテゴリカル変数にはχ2検定またはFisherの正確確率検定を使用し，初経産別に睡眠の質が悪い群と良い群の間で比較した。結 果303名に質問紙を配布し，回答を得た236名のうち採用基準に該当する初産婦61名，経産婦70名を解析対象とした。正規職員は初産婦で75.4%，経産婦で55.7%であった。睡眠の質が悪い者は初産婦で44.3%，経産婦で40.0%であった。二変量解析の結果，初産婦・経産婦ともに，睡眠の質が悪い群は良い群と比較してEPDS得点が有意に高かった（p < 0.001；p = 0.004）。さらに初産婦では，睡眠の質が悪い群は良い群と比較して上司および同僚のサポート得点が有意に低かった（p = 0.007；p = 0.009）。結 論睡眠の質が悪い就労妊婦の特徴としてうつ症状の程度が強い可能性が示された。さらに初産婦の特徴として上司や同僚からのサポートが少ないことが示された。本研究結果から，睡眠の質が悪い就労妊婦に対して精神状態を考慮した支援の必要性や，初産婦では職場のサポート状況も考慮し支援を検討する必要性が示唆された。

The prevalence of low-birth-weight infants has increased over the past 40 years to approximately 9–10% of Japanese live births. This study aims to identify healthy lifestyle behaviors and psychosocial factors contributing to appropriate perinatal outcomes, gestational weight gain, and postpartum weight change. The Japan Pregnancy, Eating, Activity, and Cohort study was initiated in 2020 in Tokyo, Yamagata/Miyagi, Osaka, and Fukuoka. Participants will be enrolled at approximately 12 weeks of gestation, with follow-up at 18–27 and 35–41 weeks of gestation and 1, 6, and 12 months postpartum. Approximately 3000 participants are targeted: Yamagata/Miyagi (n = 300), Tokyo (n = 1500), Osaka (n = 800), and Fukuoka (n = 400). Participants will complete questionnaires on healthy lifestyle behaviors (dietary intake, physical activity, and circadian rhythm), psychosocial factors, weight control, and behavioral intentions. Medical records will be reviewed for antenatal checkup data. The primary outcomes will include gestational weight gain, infant birth weight, perinatal complications, breastfeeding, and postpartum weight change. Demographic and psychosocial factors and lifestyle behaviors will be examined as covariates and potential confounders. Biological samples will be collected in Tokyo and Yamagata. The study’s findings will inform efforts to improve perinatal care guidelines through evidence-based recommendations.

Advocates for victims of sexual assault are exposed to the traumatic events of victims, which can lead to occupational stress. Occupational stress specific to advocates who support victims can cause compassion fatigue and burnout, which can worsen their mental health. Furthermore, such exposure could lead to compassion satisfaction, which, in turn, may buffer compassion fatigue and burnout. To improve the mental health of advocates for victims of sexual assault in Japan, this study aimed to evaluate a hypothesized model explaining the effect of occupational stress on their mental health. This cross-sectional study was conducted using a self-administered questionnaire via mail. The sample comprised 560 advocates from one-stop support centers for victims of sexual assault. Questionnaires comprising the components of the hypothesized model, namely, compassion fatigue, burnout, compassion satisfaction, traumatic stress symptoms, and psychological distress, were mailed. After using descriptive statistics, a path analysis was conducted to test the hypotheses and the fitness of the model. Data from 250 participants were analyzed. The prevalence rates of compassion fatigue, burnout, and compassion satisfaction were 30%, 65%, and 4%, respectively. The hypothesized model demonstrated a good fit. Compassion fatigue exerted a significant positive effect on traumatic stress symptoms and psychological distress. Burnout also demonstrated a significant positive effect on psychological distress. However, its association with traumatic stress symptoms was not significant. Compassion satisfaction exerted a significant negative effect on compassion fatigue and burnout. Improving the mental health of advocates, particularly for traumatic stress symptoms, requires not only intervening in burnout but also improving compassion fatigue. Increasing compassion satisfaction contributes to the improvement of compassion fatigue and burnout. Therefore, creating a supportive environment that considered these would help improve the mental health of the advocates.

Background: One life event that requires extensive resilience and adaptation is parenting. However, resilience and perceived support in child-rearing vary, making the real-world situation unclear, even with postpartum checkups. Objective: This study aimed to explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with a classifier based on data on the resilience and adaptation characteristics of mothers with newborns. Methods: A web-based cross-sectional survey was conducted. Mothers with newborns aged approximately 1 month (newborn cohort) were analyzed to construct an explainable machine learning classifier to stratify parenting-related resilience and adaptation characteristics and identify vulnerable populations. Explainable k-means clustering was used because of its high explanatory power and applicability. The classifier was applied to mothers with infants aged 2 months to 1 year (infant cohort) and mothers with toddlers aged >1 year to 2 years (toddler cohort). Psychosocial status, including depressed mood assessed by the Edinburgh Postnatal Depression Scale (EPDS), bonding assessed by the Postpartum Bonding Questionnaire (PBQ), and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) between the classified groups, was compared. Results: A total of 1559 participants completed the survey. They were split into 3 cohorts, comprising populations of various characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into 5 groups, was generated from the self-reported scores of resilience and adaptation in the newborn cohort (n=310). The classifier identified that the group with the greatest difficulties in resilience and adaptation to a child’s temperament and perceived support had higher incidences of problems with depressed mood (relative prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40) compared to the group with no difficulties in perceived support. In the infant cohort (n=619) and toddler cohort (n=461), the stratified group with the greatest difficulties had higher incidences of problems with depressed mood (RP 9.05, 95% CI 4.36-18.80 and RP 4.63, 95% CI 2.38-9.02, respectively), bonding (RP 1.63, 95% CI 1.29-2.06 and RP 3.19, 95% CI 2.03-5.01, respectively), and sleep quality (RP 8.09, 95% CI 4.62-16.37 and RP 1.72, 95% CI 1.23-2.42, respectively) compared to the group with no difficulties. Conclusions: The classifier, based on a combination of resilience and adaptation to the child’s temperament and perceived support, was able identify psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also identified in qualitatively different infant and toddler cohorts, depending on their classifier. The vulnerable group identified in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.

This study examined the association of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake during the second trimester with low birth weight (LBW) in pregnant Japanese women and was conducted in conjunction with the Japan Pregnancy Eating and Activity Cohort (J-PEACH) study. The study included 504 pregnant women from four Japanese sites. During the second trimester (14–27 weeks), the participants filled out a self-administered questionnaire assessing the frequency of DHA and EPA supplement intake in the past month, as well as a brief-type self-administered diet history questionnaire (BDHQ). The analysis involved data from two time points: responses to the BDHQ and infant data at birth. In total, 471 and 33 participants were classified into the normal birth weight and LBW groups, respectively. The participants were divided into high-, medium-, and low-intake groups based on their total dietary and EPA and DHA supplementary intakes. The Cochran–Armitage trend test was used to analyze the data; the prevalence of LBW was higher in the low-intake group (p = 0.04). There was no significant sex-based trend (p = 0.27 and p = 0.35). In Japanese women, low dietary and supplementary EPA and DHA intake until the second trimester were risk factors for LBW.

Nausea and vomiting in pregnancy (NVP) is a common symptom. Although the influence of NVP during the first trimester on dietary intake and birth outcomes has been revealed, no study has focused on NVP during the second trimester. This study aimed to reveal whether NVP severity during the second trimester is associated with dietary intake, gestational weight gain (GWG), birth weight, and delivery week. Participants completed a questionnaire at 18–27 gestational weeks. NVP severity was assessed using the modified Pregnancy-Unique Quantification of Emesis and Nausea scale in the questionnaire. Dietary habits were assessed using a brief-type diet history questionnaire. In total, 825 responses were analyzed: 202 (24.5%), 135 (16.4%), and 8 (1.0%) women reported mild, moderate, and severe NVP, respectively; 480 (58.2%) women did not have NVP during the second trimester. No significant association was observed between energy and nutrient intake and no/mild and moderate/severe NVP. Women with moderate/severe NVP had lower total GWG than those with no/mild NVP (p = 0.007). There was no significant difference in low birth weight and preterm birth rates (p = 0.246 and p = 0.604). This is the first study to investigate whether NVP severity during the second trimester is associated with dietary intake and birth outcomes.

BACKGROUND One life event that requires extensive resilience and adaptation is parenting. However, resilience and perceived support in child-rearing vary, making the real-world situation unclear, even with postpartum checkups. OBJECTIVE This study aimed to explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with a classifier based on data on the resilience and adaptation characteristics of mothers with newborns. METHODS A web-based cross-sectional survey was conducted. Mothers with newborns aged approximately 1 month (newborn cohort) were analyzed to construct an explainable machine learning classifier to stratify parenting-related resilience and adaptation characteristics and identify vulnerable populations. Explainable k-means clustering was used because of its high explanatory power and applicability. The classifier was applied to mothers with infants aged 2 months to 1 year (infant cohort) and mothers with toddlers aged >1 year to 2 years (toddler cohort). Psychosocial status, including depressed mood assessed by the Edinburgh Postnatal Depression Scale (EPDS), bonding assessed by the Postpartum Bonding Questionnaire (PBQ), and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) between the classified groups, was compared. RESULTS A total of 1559 participants completed the survey. They were split into 3 cohorts, comprising populations of various characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into 5 groups, was generated from the self-reported scores of resilience and adaptation in the newborn cohort (n=310). The classifier identified that the group with the greatest difficulties in resilience and adaptation to a child’s temperament and perceived support had higher incidences of problems with depressed mood (relative prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40) compared to the group with no difficulties in perceived support. In the infant cohort (n=619) and toddler cohort (n=461), the stratified group with the greatest difficulties had higher incidences of problems with depressed mood (RP 9.05, 95% CI 4.36-18.80 and RP 4.63, 95% CI 2.38-9.02, respectively), bonding (RP 1.63, 95% CI 1.29-2.06 and RP 3.19, 95% CI 2.03-5.01, respectively), and sleep quality (RP 8.09, 95% CI 4.62-16.37 and RP 1.72, 95% CI 1.23-2.42, respectively) compared to the group with no difficulties. CONCLUSIONS The classifier, based on a combination of resilience and adaptation to the child’s temperament and perceived support, was able identify psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also identified in qualitatively different infant and toddler cohorts, depending on their classifier. The vulnerable group identified in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.

Adequate dietary intake during the lactation period is important for breast milk components, postpartum recovery, and physical and mental health. This study aimed to clarify the psychosocial experiences related to dietary behavior around one month postpartum among Japanese lactating women. Semi-structured interviews were conducted with 18 women between February and June 2022 in Osaka, Japan. The data were analyzed using qualitative descriptive approaches. Four core categories were identified. All participants had a [desire to have healthy meals for themselves or their families] to improve their postpartum health, regain their pre-pregnancy body shape, produce sufficient and good-quality breast milk, and keep their families healthy. Some participants, who had [subjective difficulties in getting information on diet and preparing meals] due to insufficient or complicated information and viewing meal preparation as a burden, used [services and support regarding their postpartum diet] to alleviate these difficulties. They had [postpartum-specific appetite and dietary views], including an increased appetite triggered by breastfeeding and postpartum stress and the effects of the dietary changes during pregnancy. Some of these psychosocial experiences were influenced by Japanese traditional customs in the postpartum period and familiar food preferences in the Japanese. Healthcare professionals should consider these experiences when providing tailored dietary guidance.

A 60-year-old man presented with focal swelling on the dorsal surface of the left wrist. The sonographic exam revealed the presence of a smoothly rounded hypoechoic mass, with internal blood flow in the lumen of the vein. The histopathological findings led to the diagnosis of intravenous lobular capillary hemangioma (LCH). Here, we reported an intravenous LCH arising from the cephalic vein on the dorsal surface of the left wrist hand and discussed the related ultrasonographic findings.

No dietary intervention that focuses on the diet quality of postpartum women has been developed in Japan, although most postpartum women experience an insufficient intake of vitamins and minerals. We aimed to examine whether dietary intervention, based on the health belief model, at both 1 and 3 months postpartum affects nutrient intake and food group consumption at 6 months postpartum. A randomized controlled trial was conducted at a university hospital in Tokyo between 2015 and 2016. Healthy women at 1 month postpartum were randomly allocated to either an intervention group (n = 100) or a control group (n = 94). Dietary intervention included dietary assessment, individual feedback, and dietary guidance. The dietary intakes between the two groups were compared using the Mann-Whitney U test. At 6 months postpartum, the energy-adjusted intakes of protein, total dietary fiber, potassium, magnesium, phosphorus, zinc, vitamin B₆, and β-carotene were significantly higher in the intervention group than in the control group. The changes in energy-adjusted intakes of total dietary fiber and iron from 1 month postpartum to 6 months postpartum were significantly different between the two groups. Dietary intervention based on the health belief model improved nutrition at 6 months postpartum, although the impact was limited.