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1.
BMC Pregnancy Childbirth ; 24(1): 336, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38698333

ABSTRACT

BACKGROUND: Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age. METHODS: This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age. RESULTS: The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05). CONCLUSION: The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.


Subject(s)
Body Mass Index , Breast Feeding , Depression, Postpartum , Pediatric Obesity , Humans , Female , Depression, Postpartum/epidemiology , Infant , Prospective Studies , Adult , Child, Preschool , Pediatric Obesity/epidemiology , Pediatric Obesity/psychology , Breast Feeding/statistics & numerical data , Male , Mothers/psychology , Feeding Behavior/psychology , Prevalence , Birth Cohort
2.
Am J Med Genet A ; : e63710, 2024 May 11.
Article in English | MEDLINE | ID: mdl-38733159

ABSTRACT

It remains unclear whether recent changes in the prognosis and management of patients with trisomy 13 impact patient survival. We investigated changes in survival of patients with trisomy 13 in Japan. Data from the Vital Statistics Database in Japan was retrieved to examine the association of sex, surgical history, and years of birth and death with changes in survival patterns in 1164 patients with trisomy 13 between 1995 and 2021. The rates of deaths due to trisomy 13 increased from 9.8% to 23.1% in those over 1 year of age and from 7.3% to 19.2% in those within 24 h of birth between 1995 and 2021. The median survival time was longer in 2009-2021 than in 1996-2008 (40 vs. 84 days, p < 0.001). The median survival time and the rate of patients with surgical history increased from 91 days and 16.0% in 1996-2008 to 179 days and 28.0% in 2009-2021, respectively. Median survival time among patients with trisomy 13 has increased over the last 26 years, with almost 1 in 3 patients currently surviving for more than 1 year. The increased surgical intervention rate might have contributed to this improvement.

3.
J Obstet Gynaecol Res ; 50(3): 403-423, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38163757

ABSTRACT

AIM: This study aimed to determine the weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy body mass index (BMI) and make recommendations for optimal weight gain in Japan. METHODS: The Japan Society of Obstetrics and Gynecology perinatal database for 2015-2017 was used. From the 719 723 deliveries included in this database, parturients with underlying diseases or missing data were excluded, and 419 114 deliveries were analyzed. A questionnaire survey was also conducted to weigh each perinatal adverse event. For each of the nine outcomes, a restricted cubic spline model was made to estimate the association between the "expected gestational weight gain at 40 weeks" and the outcome risk. RESULTS: Since the classes of medical facilities were generally the same, weights were assigned according to the mean of the questionnaires rather than by the class of the facility. For each pre-pregnancy BMI, the weight gains during pregnancy that minimized the predicted probability of various adverse perinatal events were 12-15, 10-13, 7-10, and upper limit of 5 kg for the underweight, normal-weight, obese 1, and obese ≥2 groups, respectively. CONCLUSIONS: The weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy BMI was established.


Subject(s)
Obesity , Weight Gain , Female , Pregnancy , Humans , Japan/epidemiology , Retrospective Studies , Obesity/epidemiology , Registries
4.
J Obstet Gynaecol Res ; 50(4): 596-603, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38273716

ABSTRACT

AIM: The present study aimed to estimate the total numbers of obstetric diseases diagnosed, total amounts of medical expenses claimed for obstetric diseases, their averages per livebirth, and yearly trends in Japan. METHODS: This is a secondary analysis of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) (data from 2015 to 2019). The target population was women of reproductive age (15-49 years old) with diseases in pregnancy, childbirth, and the puerperium, defined by having O codes according to the International Classification of Diseases 10th Revision. We calculated the numbers of obstetric diseases diagnosed, amounts of medical expenses claimed for obstetric diseases marked with the "main injury/disease decision flag," and the totals divided by the annual numbers of livebirths, by year and women's age group. RESULTS: From 2015 to 2019, both the numbers of obstetric diseases diagnosed and amounts of medical expenses claimed for obstetric diseases per livebirth were on an upward trend, whereas the total numbers of obstetric diseases diagnosed were decreased. Women in advanced age groups had a higher number of diagnoses and a higher amount of medical expenses for obstetric diseases per livebirth. "Preterm labour without delivery" had the highest amounts of medical expenses claimed for and the second highest numbers of diagnoses throughout the study period. CONCLUSIONS: This study suggests that pregnant women in Japan would have an increasing number of obstetric complications and necessary medical expenses year by year. Further study is warranted to elucidate these trends and identify possible mitigation measures.


Subject(s)
Insurance, Health , Parturition , Infant, Newborn , Humans , Female , Pregnancy , Adolescent , Young Adult , Adult , Middle Aged , Japan/epidemiology , Databases, Factual , Pregnancy, Multiple
5.
Children (Basel) ; 11(1)2024 Jan 10.
Article in English | MEDLINE | ID: mdl-38255394

ABSTRACT

This study aimed to clarify diseases that occur more frequently by age and identify the peaks and trends of each disease from infancy to adolescence for early detection and treatment. This retrospective observational study was conducted using Japan's National Database of Health Insurance Claims Specific Health Checkups from January 2012 to December 2016. Using peak ages and trends in the number of patients, we grouped diseases by the International Classification of Diseases chapters. Although diseases that peaked during infancy were the most common (10 disease chapters), other diseases peaked at school-going age and adolescence. Diseases in four chapters peaked during adolescence and continued to increase toward the age of 18. These four chapters included mental, behavioral, and neurodevelopmental disorders; diseases of the nervous system; the genitourinary system; and pregnancy, childbirth, and the puerperium. Childhood-onset diseases can affect long-term health and healthcare needs, and timely screening and guidance based on disease trends can provide an effective intervention. To establish a child healthcare system that provides preventive support for children and adolescents' physical, psychological, and social health, further research is needed to comprehensively understand the issues per age and developmental stage.

6.
Nutrients ; 16(2)2024 Jan 05.
Article in English | MEDLINE | ID: mdl-38257079

ABSTRACT

A fetal growth restriction is related to adverse child outcomes. We investigated risk ratios and population-attributable fractions (PAF) of small-for-gestational-age (SGA) infants in the Japanese population. Among 28,838 infants from five ongoing prospective birth cohort studies under the Japan Birth Cohort Consortium, two-stage individual-participant data meta-analyses were conducted to calculate risk ratios and PAFs for SGA in advanced maternal age, pre-pregnancy underweight, and smoking and alcohol consumption during pregnancy. Risk ratio was calculated using modified Poisson analyses with robust variance and PAF was calculated in each cohort, following common analyses protocols. Then, results from each cohort study were combined by meta-analyses using random-effects models to obtain the overall estimate for the Japanese population. In this meta-analysis, an increased risk (risk ratio, [95% confidence interval of SGA]) was significantly associated with pre-pregnancy underweight (1.72 [1.42-2.09]), gestational weight gain (1.95 [1.61-2.38]), and continued smoking during pregnancy (1.59 [1.01-2.50]). PAF of underweight, inadequate gestational weight gain, and continued smoking during pregnancy was 10.0% [4.6-15.1%], 31.4% [22.1-39.6%], and 3.2% [-4.8-10.5%], respectively. In conclusion, maternal weight status was a major contributor to SGA births in Japan. Improving maternal weight status should be prioritized to prevent fetal growth restriction.


Subject(s)
Fetal Growth Retardation , Gestational Weight Gain , Child , Infant , Female , Pregnancy , Humans , Fetal Growth Retardation/epidemiology , Japan/epidemiology , Birth Cohort , Cohort Studies , Prospective Studies , Thinness
7.
Sci Rep ; 14(1): 659, 2024 01 05.
Article in English | MEDLINE | ID: mdl-38182710

ABSTRACT

To assess the association between gestational weight gain (GWG) and the risk of developing chronic diseases in later life, this historical cohort study of 318 non-overweight women was conducted between April 2017 and November 2020 at a hospital in Tokyo. Data about GWG in the last pregnancy and the development of any chronic diseases of the subjects were retrieved from the women's Maternal and Child Health Handbooks and through a questionnaire survey, respectively. The outcomes were chronic diseases, such as diabetes mellitus (DM), hypertension, hyperlipidemia, and being overweight (body mass index [BMI] ≥ 25 kg/m2). Association between GWG and outcomes were assessed using a logistic regression analysis.There were significant positive linear associations between GWG and the risks of developing DM, hypertension, and being overweight (P = 0.013, 0.050, and 0.017, respectively). After adjusting for later-life BMI, a significant association between GWG and DM (P = 0.025) remained, but the association between GWG and hypertension disappeared. GWG was significantly associated with DM, hypertension, and being overweight later in life. Although the association between GWG and DM was partially independent of BMI later in life, the association between GWG and hypertension was influenced by being overweight later in life.


Subject(s)
Gestational Weight Gain , Hypertension , Child , Pregnancy , Humans , Female , Cohort Studies , Overweight/epidemiology , Chronic Disease , Hypertension/epidemiology
9.
Appetite ; 194: 107200, 2024 03 01.
Article in English | MEDLINE | ID: mdl-38176441

ABSTRACT

Children and adolescents who regularly skip breakfast are at a greater risk of obesity than those who regularly eat breakfast. Guardian's food literacy, defined in this study as a collection of a guardian's knowledge, skill, and attitude towards healthy food practices, may directly influence their child's dietary habits. Thus, this study utilized a food literacy scale to assess the relationship between guardians' food literacy and breakfast skipping among school-attending Japanese children and adolescents and the most commonly reported reasons for skipping breakfast. This was a cross-sectional study using survey data collected from a nationally representative sample of households in Japan (n = 1520). Our results show that 13.0% of children self-reported skipping breakfast at least once a week. Children in households where guardians reported higher knowledge and attitude scores had significantly lower odds of skipping breakfast (odds ratios = 0.90 [95% confidence interval: 0.83-0.98] and 0.81 [0.74-0.90], respectively). These findings suggest that a guardian's attitude and knowledge towards healthy food practices influence the frequency at which their child eats breakfast. Moreover, lower parental attitude scores were associated with children skipping due to not having enough time for breakfast in the morning. Improving guardians' food literacy may provide an avenue by which to decrease the rate of breakfast skipping among children and adolescents, thereby decreasing the risk of obesity and other adverse health outcomes.


Subject(s)
Breakfast , Intermittent Fasting , Child , Adolescent , Humans , Japan , Cross-Sectional Studies , Literacy , Obesity , Feeding Behavior
10.
Obstet Gynecol ; 143(2): 284-293, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38061045

ABSTRACT

OBJECTIVE: To quantitatively evaluate the effect of a booster vaccination dose against coronavirus disease 2019 (COVID-19) on menstrual cycle in a large-scale retrospective cohort study using a menstrual cycle tracking smartphone application (app). METHODS: Prospectively or retrospectively recorded data, including the start and finish dates of menstrual cycles, were collected with the app. Detailed data on vaccinations, side effects, and participants' characteristics were retrospectively collected from a questionnaire on the app. For each COVID-19 vaccination shot (first, second, and third), within-individual changes in menstrual cycle length up to the fourth postvaccination cycle were evaluated. RESULTS: Among the 7,376 and 6,873 participants who had the first and second COVID-19 vaccine doses in different menstrual cycles, respectively, menstrual cycles immediately after the vaccination (first postvaccination cycles) were an average of 0.22 days (95% CI, 0.06-0.39) and 0.37 days (95% CI, 0.20-0.54) longer than the prevaccination cycle. In contrast, among the 1,672 participants who received the first and second doses in the same cycle, the first postvaccination cycle was an average of 4.21 days (95% CI, 3.69-4.72) longer. The second to fourth postvaccination cycles returned to the level of the prevaccination cycle. However, among the 4,768 participants who had the third COVID-19 vaccine dose, the menstrual cycle immediately after the vaccination was an average of 1.20 days (95% CI, 1.00-1.40) longer, with prolongation of cycles of 0.27 days (95% CI, 0.10-0.44) to 0.41 days (95% CI, 0.22-0.59) persisting from the second to the fourth postvaccination cycle. CONCLUSION: The booster shot against COVID-19 may have a greater and longer-lasting effect on menstrual cycles than the primary-series shots. Although the effect size was small, evidence on the side effects of immunization on menstruation should be accumulated.


Subject(s)
COVID-19 Vaccines , COVID-19 , Menstrual Cycle , Female , Humans , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Retrospective Studies , Vaccination
12.
Allergol Int ; 73(2): 264-274, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37914545

ABSTRACT

BACKGROUND: Non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFAs) seem to be increasing rapidly worldwide. However, nationwide studies have been limited to food-protein-induced enterocolitis (FPIES) and food-protein-induced allergic proctocolitis (FPIAP), with little attention to other non-IgE-GIFA subgroups. The aim of this study was to elucidate the clinical features of all patients with non-IgE-GIFAs, not just certain subgroups. METHODS: We conducted a nationwide cross-sectional survey of non-IgE-GIFAs in Japan from April 2015 through March 2016. A questionnaire was sent to hospitals and clinics throughout Japan. The questionnaire asked about the number of physician-diagnosed non-IgE-GIFA patients, the status of fulfillment of the diagnostic criteria, tentative classification into 4 clusters based on the initial symptoms, the day of onset after birth, complications, and the suspected offending food(s). RESULTS: The response rate to that questionnaire was 67.6% from hospitals and 47.4% from clinics. Analyses were conducted about "diagnosis-probable" patient cohort (n = 402) and the "diagnosis-confirmed" patients (n = 80). In half of the reported non-IgE-GIFA patients, onset occurred in the neonatal period. The patients were evenly distributed among 4 non-IgE-GIFA clusters. In Cluster 1, with symptoms of vomiting and bloody stool, the onset showed a median of 7 days after birth, which was the earliest among the clusters. Cow's milk was the most common causative food. CONCLUSIONS: In half of the patients, the onset of non-IgE-GIFAs was in the neonatal period. This highlights the importance of studying the pathogenesis in the fetal and neonatal periods.


Subject(s)
Enterocolitis , Food Hypersensitivity , Proctocolitis , Infant , Infant, Newborn , Female , Animals , Cattle , Humans , Food Hypersensitivity/diagnosis , Food Hypersensitivity/epidemiology , Food Hypersensitivity/complications , Cross-Sectional Studies , Enterocolitis/diagnosis , Enterocolitis/epidemiology , Food , Proctocolitis/diagnosis , Proctocolitis/epidemiology , Proctocolitis/complications , Allergens
13.
Sci Rep ; 13(1): 19612, 2023 11 10.
Article in English | MEDLINE | ID: mdl-37949883

ABSTRACT

To examine whether the prevailing hypothesis of an association between caesarean section (CS) delivery method and increased weight status in early childhood is observed in Japanese. A total of 1277 mother-infant pairs from a prospective hospital-based mother-infant birth cohort that recruited women in their first trimester from May 2010 to November 2013 were included. We assessed the relationship between delivery method and weight status of delivered children at 1, 3 and 6 years of age. In total, 366 children (28.7%) were delivered by CS. Delivery by CS was not associated with body mass index (BMI) z-score (≥ 75 percentile) at age 1 year, (odds ratio (OR) 0.97, 95% confidence interval (CI) 0.69-1.36), 3 years (OR 0.98, 95% CI 0.67-1.42), and 6 years (OR 0.71, 95% CI 0.45-1.12), and also showed no association with low weight status (< 25th percentile). Supplemental evaluations addressing the influence of preterm births, pre-pregnancy BMI, emergency CS, and modification by breastfeeding were consistent with the primary analyses. Our findings do not support the hypothesis that children born by CS are at risk of being overweight in childhood among the Japanese population.


Subject(s)
Cesarean Section , Pediatric Obesity , Child , Infant , Infant, Newborn , Humans , Child, Preschool , Female , Pregnancy , Cohort Studies , Delivery, Obstetric , Prospective Studies , East Asian People , Pediatric Obesity/epidemiology , Birth Weight , Risk Factors , Body Mass Index
14.
J Epidemiol ; 2023 Nov 18.
Article in English | MEDLINE | ID: mdl-37981322

ABSTRACT

BACKGROUND: An association between birth weight and cardiovascular disease (CVD) in adulthood has been observed in many countries; however, only a few studies have been conducted in Asian populations. METHODS: We used data from the baseline survey (2011-2016) of the Japan Public Health Center-based Prospective Study for the Next Generation Cohort, which included 114,105 participants aged 40-74 years. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were calculated from the prevalence of present and past histories of CVD and other lifestyle-related diseases, including hypertension, diabetes, hyperlipidemia, and gout, by birth weight, using Poisson regression. RESULTS: The prevalence of CVD increased with lower birth weight, with the highest prevalence among those with birth weight under 1,500 grams (males 4.6%; females 1.7%) and the lowest one among those with birth weight at or over 4,000g (males 3.7%: females 0.8%). Among 88.653 participants (41,156 males and 47,497 females) with complete data on possible confounders, birth weight under 1,500g was associated with a higher prevalence of CVD (aPR 1.76 [95%CI 1.37-2.26]), hypertension (aPR 1.29 [95%CI 1.17-1.42]), and diabetes (aPR 1.53 [95%CI 1.26-1.86]) when a birth weight of 3,000-3,999 grams was used as the reference. Weaker associations were observed for birth weight of 1500-2499 grams and 2500-2999 grams, while no significant associations were observed for birth weight at or over 4000 g. The association between birth weight and the prevalence of hyperlipidemia was less profound, and no significant association was observed between birth weight and gout. CONCLUSION: Lower birth weight was associated with a higher prevalence of CVD, hypertension, and diabetes in the Japanese population.

15.
J Psychosom Obstet Gynaecol ; 44(1): 2245556, 2023 12.
Article in English | MEDLINE | ID: mdl-37615367

ABSTRACT

PURPOSE: The study aims to investigate risk factors of paternal perinatal depression during the COVID-19 pandemic. METHODS: We conducted an online cross-sectional study of 473 prenatal fathers and 1246 postnatal fathers in August 2021. We applied a modified Poisson regression to estimate relative risk ratios of possible factors for paternal perinatal depression (measured by Edinburgh Postnatal Depression Scale), sequentially introducing the following factors into the model: individual factors, interpersonal factors, obstetric/pediatric factors, and service utilization factors. RESULTS: Prenatal fathers with the following risk factors were at an increased risk for having depressive symptoms: adverse childhood experiences (risk ratio; RR 1.61), past depression (RR 1.63), fear of COVID-19 (RR 2.09), lower social support (RR 1.91), low family resources (RR 1.95), and intimate partner violence (IPV) victimization (RR 1.29). Postnatal fathers having the following risk factors were at an increased risk for having depressive symptoms: past depression (RR 1.67), fear of COVID-19 (RR 1.26), low family resources (RR 1.85), IPV victimization. (RR 1.18), and preterm birth (RR 1.18). CONCLUSION: The study showed risk factors such as past history of depression, high fear of COVID-19, low family functionality, and IPV victimization were associated with perinatal depressive symptoms. The findings should contribute to future directions of interventions for paternal perinatal mental health.


Subject(s)
COVID-19 , Premature Birth , Infant, Newborn , Female , Pregnancy , Humans , Child , Japan/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Pandemics , Risk Factors
16.
Womens Health Rep (New Rochelle) ; 4(1): 280-287, 2023.
Article in English | MEDLINE | ID: mdl-37363359

ABSTRACT

Objectives: Maintaining an appropriate gestational weight gain (GWG) is essential for a safe pregnancy and delivery. This study aimed to determine the association between the habit of eating quickly and the risk of excessive GWG. Methods: We administered a questionnaire on eating habits to 1246 pregnant Japanese women in their second to third trimesters. We categorized the participants into three groups according to their answers to the question "Do you eat quickly?" Group 1, "always" or "usually"; Group 2, "sometimes"; and Group 3, "rarely" or "never." We assessed GWG according to the "The Optimal Weight Gain Chart" (Ministry of Health, Labor and Welfare, Japan), and those who exceeded the criteria were considered "excessive." Logistic regression analysis was performed with the risk of excess GWG as the dependent variable and quick food intake as the independent variable, to obtain relevant odds ratios (ORs) and 95% confidence intervals (CIs). Model 1 was unadjusted, and Model 2 was adjusted for age, prepregnancy body mass index, energy intake, mother's educational attainment, household income, exercise habits, and childbearing experience. Results: The OR (95% CI) for Groups 2 and 3 in Model 1, compared with Group 1, was 0.80 (0.62-1.05) and 0.61 (0.43-0.88), respectively (p for trend = 0.047). In Model 2, the OR (95% CI) for Groups 2 and 3 were 0.73 (0.55-0.96) and 0.59 (0.40-0.86), respectively (p for trend = 0.003). Conclusion: These results suggest that quick food ingestion increases the risk of excessive GWG.

17.
J Endocr Soc ; 7(5): bvad045, 2023 Mar 06.
Article in English | MEDLINE | ID: mdl-37122589

ABSTRACT

Context: Isolated hypothyroxinemia (low maternal free thyroxine [FT4] in the absence of thyroid-stimulating hormone [TSH] elevation) and subclinical hypothyroidism (high TSH in the absence of FT4 elevation) during early pregnancy are common. However, there are limited data regarding pregnancy outcomes, particularly their association with birthweight. Objective: We assessed the association between isolated hypothyroxinemia and subclinical hypothyroidism during the first trimester and birthweight. Methods: Analyses were conducted using a database of pregnant women (n = 1105; median age, 35 years) who delivered at the National Center for Child Health and Development, a tertiary hospital in Tokyo. The primary outcomes included the rates of small for gestational age (SGA), large for gestational age (LGA), and low birth weight. Results: Of the 1105 pregnant women, 981 were classified into the euthyroidism group, 25 into the isolated hypothyroxinemia group, and 26 into the subclinical hypothyroidism group during the first trimester. The prevalence of SGA was significantly higher in isolated hypothyroxinemia and subclinical hypothyroidism groups than the euthyroidism group (28.0% and 19.2%, respectively, vs 5.7%; P < .01). The odds ratio with 95% CI for SGA was 12.51 (4.41-35.53) for isolated hypothyroxinemia and 4.44 (1.57-12.56) for subclinical hypothyroidism in a multivariable adjustment model. Isolated hypothyroxinemia and subclinical hypothyroidism were not significantly associated with LGA and low birth weight. Conclusion: Pregnant women with isolated hypothyroxinemia and subclinical hypothyroidism in the first trimester have an increased likelihood of SGA. Screening and careful perinatal checkups for isolated hypothyroxinemia and subclinical hypothyroidism may help identify pregnant women at high risk for SGA.

18.
Soc Psychiatry Psychiatr Epidemiol ; 58(9): 1421-1429, 2023 Sep.
Article in English | MEDLINE | ID: mdl-36928546

ABSTRACT

BACKGROUND: Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan. METHODS: This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination. RESULTS: Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28-1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81-2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20). CONCLUSION: Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.


Subject(s)
Biomedical Research , COVID-19 , Psychological Distress , Humans , Male , Female , COVID-19/epidemiology , Cross-Sectional Studies , Japan/epidemiology , Health Personnel/psychology , Health Surveys
19.
J Child Health Care ; : 13674935231158842, 2023 Mar 15.
Article in English | MEDLINE | ID: mdl-36922156

ABSTRACT

Although breastfeeding has various benefits for mothers and children, there are several barriers to continuing breastfeeding practices. However, little is known about the relationship between breastfeeding in Japan and maternal socioeconomic circumstances. Based on data from the Japan Environment and Children's Study (n = 75,742), we evaluated maternal socioeconomic factors associated with breastfeeding 1 year after giving birth. Socioeconomic status (education, employment status, and household income), working hours, and breastfeeding were assessed using a self-administered questionnaire. After descriptive analysis, a logistic regression analysis was conducted with adjustments for age, educational level, employment status, and household income. Mothers with higher education and full-time homemakers were more likely to breastfeed one-year-old children. Mothers working long hours (both part-time and full-time) were less likely to breastfeed their one-year-old children. To improve breastfeeding among working mothers, it may be helpful to promote awareness of breastfeeding for every mother as well as to make the workplace environment conducive for working mothers to breastfeed.

20.
J Psychiatr Res ; 159: 153-158, 2023 03.
Article in English | MEDLINE | ID: mdl-36731380

ABSTRACT

Previous cross-sectional studies showed that COVID-19-related discrimination against healthcare workers was linked to depression. However, no study has examined the longitudinal association that allows causal interpretations. This prospective cohort study aimed to examine whether COVID-19-related discrimination at baseline is associated with depression and suicidal ideation several months later. Data were collected from October 2020 to July 2021. Multivariable logistic regression was performed. Fixed effects models were used to control for the effect of hospitals (Level 2 variable). Adjustments also included age, sex, living alone, alcohol consumption, exercise, BMI, working hours, comorbidity, and frontline worker status (Level 1 variables). Multiple sensitivity analyses were conducted to examine if the results substantially changed and were robust to unmeasured confounding. Multiple imputation for missing data was conducted via chained equations. As the final sample, 2862 healthcare workers without depression at baseline were studied. A total of 269 individuals (9.4%) experienced COVID-19-related discrimination. Depression was suggested in 205 participants (7.2%), and suicidal ideation in 108 participants (3.8%). In the adjusted models, COVID-19-related discrimination was significantly associated with subsequent depression (OR = 2.18, 95% CI = 1.39 to 2.90) and suicidal ideation (OR = 2.07, 95% CI = 1.22 to 3.50). Multiple sensitivity analyses verified the results. COVID-19-related discrimination results in depression and suicidal ideation in healthcare workers. Interventions to prevent such discrimination against healthcare workers, e.g., anti-discrimination campaigns, are crucial during the COVID-19 pandemic.


Subject(s)
COVID-19 , Suicidal Ideation , Humans , Depression , Prospective Studies , Pandemics
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