Influence of Cesarean Section on Postpartum Fertility and Dysmenorrhea: A Retrospective Cohort Study in Japan.

Objective: To investigate the association between cesarean section (CS) and postpartum fertility and dysmenorrhea using data from a Japanese insurance registry. Methods: This retrospective cohort study used a data set of patients registered between 2007 and 2021 in an insurance registry comprising specific employee-based health insurance companies in Japan. Of those data sets, we included data from participants who had their first recorded childbirth between 2014 and 2018. The exclusion criteria were any prior deliveries, dysmenorrhea, or complications that would affect the next pregnancy or postpartum dysmenorrhea since 2007. The occurrence of subsequent childbirth and postpartum dysmenorrhea until 2021 was compared between the CS and vaginal delivery (VD) groups using the log-rank test and Cox proportional hazards model with stratification according to age and age matching. Results: This study included 25,984 (5,926 after age matching) and 5,926 participants in the VD and CS groups, respectively. After age matching, the rate of subsequent childbirth was 18.3% and 16.3%, and the rate of postpartum dysmenorrhea was 6.5% and 7.8% in the VD and CS groups, respectively. There were fewer subsequent childbirths in the CS group than in the VD group after age matching in the stratified Cox proportional hazards model (hazard ratio [HR] 95% confidence interval [CI]: 0.86 [0.79-0.94]). The CS group had a significantly higher risk of dysmenorrhea (HR [95% CI]: 1.18 [1.03-1.36]). Conclusions: Although confounding might be existing, our study suggests that CS might be associated with decreased postpartum fertility and increased dysmenorrhea. The medical indications for CS should be carefully determined; post-CS women should be meticulously followed up.

Associations Between Habitual Dietary Behaviors and Glutamic Acid Levels in Human Milk.

BACKGROUND: Glutamic acid, an amino acid that exhibits umami taste, is utilized in Japanese food and is abundant in human milk. We examined the influence of maternal habitual eating behavior on glutamic acid concentration in human milk. RESEARCH AIM: To determine the association between maternal dietary behaviors at the end of pregnancy and the 1st month postpartum and glutamic acid concentration in colostrum and mature milk. METHOD: This was a prospective, correlational, one-group longitudinal study. Women aged 20-30 years during the third trimester of pregnancy (N = 30) consented to participate and completed the data collection. Dietary history questionnaires were used to measure food intake. Glutamic acid levels in whey from colostrum and mature milk and in plasma during late pregnancy and the first month postpartum were measured. Data were considered significant at p < .05. Basic statistics, correlation coefficients analysis, unpaired t test, and one-way analysis of variance were performed. RESULTS: Glutamic acid concentrations in human milk and plasma were found to be significantly associated with the consumption of several different foods. There was no association between glutamic acid concentrations in human milk and plasma or between glutamic acid concentrations in colostrum and mature milk. The glutamic acid content of mature milk differed by physical activity level (mild and moderate) during the first month postpartum (t [46] = 2.87, p < .01). CONCLUSION: There was no clear association between habitual dietary behavior and glutamic acid concentration in human milk. However, maternal factors other than diet may be important and require additional research.

Association of Milk Secretion Volume with Nipple Pain: A Prospective Hypothesis Verification Study.

Background: Many mothers stop breastfeeding due to nipple pain, which is experienced when the baby sucks the mother's nipples during breastfeeding. Objective: To verify how nipple pain during breastfeeding is associated with nipple perfusion and volume of milk secretion. Study Design: Prospective hypothesis verification study. Methods: Fifty-nine lactating women who delivered at term were enrolled. The CS Probe S and laser Doppler ALF21 were used to measure perfusion, and PowerLab 2/26 and LabChart 8 were used to analyze perfusion. The difference in the infant's weight (g) before and after breastfeeding was used to measure milk secretion. Results: The participants' mean age (± standard deviation) was 30.88 ± 3.77 years. Although 80-90% of participants had proper breastfeeding posture and infant attachment, 34 (57.6%) and 30 (42.4%) mothers experienced nipple pain on postpartum days 1 and 4, respectively. For postpartum days 1 and 4, the group with nipple pain exhibited significantly less nipple perfusion than the group without pain. Milk secretion was lower in the group with nipple pain on postpartum day 4 than in the group without pain, although this was not statistically significant. The reduction in nipple perfusion did not differ significantly between the high (75%) and low secretion groups (25%) and between the nipple trauma and nontrauma groups. However, the low secretion group and nipple trauma group had larger reductions in nipple perfusion. Conclusion: Assessing the amount of milk secretion can provide a new perspective on preventive care for nipple pain and trauma.

Effectiveness of aloe fomentation for nipple-related complications during the early puerperium period: a randomized, controlled, interventional study.

OBJECTIVE: Nipple-related complications are major factors that prevent breastfeeding for many new mothers. Hence, we tested the effects of aloe arborescens fomentation applied to the nipples as a treatment for nipple-related complications. RESULTS: This study included 60 women who breastfed for the first time on day 1 after delivery. Every 24 h, all women breastfed six times and bottle-fed two times (at night). Women were classified into an intervention group (aloe arborescens fomentation) and a control group (no treatment). Aloe fomentation was applied after breastfeeding six times per day. We observed the nipples three times per day for 5 days after delivery. The most common nipple-related complication in this study was redness. A significant decrease was observed for women in the intervention group. Trial Registration Retrospectively Registered to registry: UMIN; Registration no.: UMIN000044514; Registered on: 11th June 2021.

Common Pregnancy Complaints Can Lead to Motor Vehicle Collisions or Near-Miss Incidents.

Pregnant women commonly report various health complaints during pregnancy, the occurrence of which is believed to cause human error. However, no study has examined the relationship between the occurrence of pregnancy complaints and the risk of motor vehicle collisions (MVCs). This study aimed to clarify the relationship between the frequency and severity of common pregnancy complaints and the occurrence of MVCs or near-miss incidents. We conducted a multicenter cross-sectional survey of 1000 pregnant women in Shiga Prefecture, Japan. The event group experiencing MVCs or near-miss incidents during pregnancy comprised 10.8% of respondents. The frequency of compression of the stomach or abdomen, tension and cramps in the lower abdomen, pelvic pain, irritability, depressed mood, distractedness, and hot flashes was significantly higher in the event group. The results of our multivariate logistic regression analysis revealed that tension and cramps in the lower abdomen, distractedness, and irritability were independent contributory factors to such events, with an odds ratio of 2.414, 1.849, and 1.746, respectively. Educating pregnant women to avoid driving when experiencing these symptoms would improve maternal and fetal safety.

Fundamental Research on the Invention of Breast Support Underwear with a Focus on Women's Comfort.

The purpose of this study was to establish a system for measuring breast underling pressure, evaluate the degree of sustained underling pressure, and verify basic data on the breast lifting distance to improve it. We measured the lifting distance and force at which 24 adult women felt comfortable when their breasts were lifted with an uncovered cloth. The results revealed that the larger the breast size, the greater the pull-up distance and the wider the lifting distance perceived as comfortable. The validity of the measurement method in this study was determined to be useful for the measurement of breast ptosis pressure and breast ptosis position because the measurement was performed at least three times per participant, and the error was small. In the future, we would like to clarify the type of brassiere that supports the breast and gives women a sense of comfort.

Education for appropriate seatbelt use required for early-phase pregnant women drivers.

Considerable numbers of pregnant women do not understand the correct way to use seatbelts; thus, they are inappropriately restrained when wearing seatbelts. To improve appropriate seatbelt wearing by pregnant women vehicle passengers, we examined their use by pregnant women drivers and the independent factors influencing appropriate use. We undertook a cross-sectional survey of 1,000 pregnant women in Shiga Prefecture, Japan. Among 774 returned questionnaires, we analysed those of 680 pregnant women who always wore a seatbelt. The mean participant age was 31.4 ± 5.0 years and mean gestational age 26.2 ± 8.2 weeks; 97.7% of subjects always wore a seatbelt; 86.9% wore a seatbelt correctly and 13.1% incorrectly. Multivariate analysis indicated that receiving information about correct seatbelt use (odds ratio, 2.25; P < 0.005) and gestational age (odds ratio, 1.06; P < 0.001) were significant independent factors for correct seatbelt use. Providing information about correct seatbelt use during the early term is required for pregnant women to protect both the mother and fetus.

Bisphenol A Concentration in Breast Milk following Consumption of a Canned Coffee Drink.

BACKGROUND: Bisphenol A (BPA) is generally considered to be an endocrine disruptor. Previous reports indicate that the BPA content in breast milk is higher than that in serum; however, BPA is considered to be excreted in the urine and not to accumulate in the body. OBJECTIVE: The current study aimed at evaluating the migration of BPA from a commercially available canned coffee drink in a container that was coated with vinyl chloride resin into breast milk. METHODS: Ten women who had breastfed for ≥12 months, were ready to cease breastfeeding, and drank commercially available canned coffee drinks daily were approached to participate. A canned coffee drink in which the can contained vinyl chloride resin was chosen. Samples (5 mL each) of urine and breast milk were collected prior to and after ingestion (1 h, 2 h, 4 h, and 6 h) of a 190-mL canned coffee drink. BPA measurements were conducted using an ELISA kit. RESULTS: Each 190-mL can of coffee contained 196.9 ng/mL BPA, resulting in 37.4 µg that was consumed in each drink. In breast milk, peak BPA excretion occurred at 1 hour; in urine, excretion occurred rapidly during the first hour, remaining relatively unchanged at 2 hours. CONCLUSION: The present results indicate that BPA is excreted into the breast milk in addition to the urine and feces. Therefore, it is important to reduce both direct and indirect dietary BPA intake.

Measurement of bisphenol A concentrations in human colostrum.

Bisphenol A (BPA), an estrogenic endocrine disrupting chemical, has been reported to affect embryos and alter their postnatal development. In the present study, we measured the concentrations of BPA in human colostrum by a competitive enzyme-linked immunosorbent assay (ELISA) with the aim of understanding the present status of BPA burden in human breast milk in Shizuoka, Japan. Human colostral samples were collected from 101 healthy mothers within three days after delivery. The BPA concentrations of colostral samples were estimated by ELISA after the acetonitrile extraction and solid phase extraction column purification. BPA in 101 samples was detected in the concentration range of 1-7 ng ml(-1). The mean concentration of BPA was 3.41+/-0.13 (mean+/-SD) ng ml(-1). This is the first demonstration as to what BPA concentrations are in human colostrum. The BPA concentrations in colostrum were higher than those in blood sera samples obtained from healthy women in a previous study. In our study, there was no significant correlation between the concentrations of BPA in colostrum and the age and parity of mothers.