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Hatakeyama T, Matsumura K, Tsuchida A, Inadera H. Inverse Association Between Mothers' Cognitive Social Capital During Pregnancy and Postpartum Depression: The Japan Environment and Children's Study. Neuropsychiatr Dis Treat 2024; 20:1279-1292. [PMID: 38887542 PMCID: PMC11182038 DOI: 10.2147/ndt.s456295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/27/2024] [Indexed: 06/20/2024] Open
Abstract
Purpose Several studies have reported an apparent inverse association between cognitive social capital and depression in various groups, but insights into this association in perinatal mothers are fairly limited. Therefore, we explored the possible associations between expectant mothers' cognitive social capital (ie, neighborhood trust and reciprocity and generalized trust and reciprocity) and postpartum depression at 1 and 6 months after delivery. Patients and Methods As part of an ongoing cohort study, the Japan Environment and Children's Study, cognitive social capital was evaluated using a questionnaire survey during mid-late pregnancy and postpartum depression was assessed using the Japanese version of the Edinburgh Postnatal Depression Scale. This study analyzed data from 81,670 mothers. Logistic regression analysis was performed to calculate the odds ratios (ORs) for postpartum depression by the degree of neighborhood and generalized trust and reciprocity (high, relatively high, neutral, relatively low, and low) using the high category as a reference. Results Regardless of the measurement time point, prevalence gradually increased as the degree of neighborhood trust decreased (all p < 0.001), suggesting a higher likelihood of postpartum depression with less neighborhood trust. A comparable tendency was also observed for the other three variables of cognitive social capital (all p < 0.001). Moreover, the inverse association of postpartum depression with generalized trust and reciprocity was markedly stronger (ORs for low category ≥ 2.70) than that with neighborhood trust and reciprocity (ORs for low category ≤ 1.96). Conclusion Our findings highlight a statistically significant inverse association between cognitive social capital during pregnancy and postpartum depression at both time points.
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Affiliation(s)
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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Xu H, Liu R, Wang X, Yang J. Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis. PLoS One 2023; 18:e0287650. [PMID: 38019729 PMCID: PMC10686497 DOI: 10.1371/journal.pone.0287650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population. METHODS We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221. RESULTS Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here. CONCLUSION The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.
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Affiliation(s)
- Hao Xu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Renyi Liu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Xiubing Wang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Jiahui Yang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
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Nagamine M, Matsumura K, Tsuchida A, Inadera H. Relationship between prenatal checkup status and low birth weight: a nationwide birth cohort-the Japan Environment and Children's Study. Ann Epidemiol 2023; 83:8-14. [PMID: 37094623 DOI: 10.1016/j.annepidem.2023.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/29/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE We investigated the association between prenatal checkup status and low birth weight (LBW). We also sought to identify the background factors of pregnant women that influence their attendance at prenatal checkups and consider measures that might prove useful in reducing the LBW rate. METHODS Using data from a large nationwide birth cohort study, the Japan Environment and Children's Study (JECS), the sample comprised 91,916 unique mother-infant pairs with singleton live births. The outcome variable was cases of LBW, and the exposure variable was prenatal checkup status (number of visits missed). Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated by logistic regression analysis. RESULTS AORs (95% CIs) for cases of LBW were 1.57 (1.46-1.69) for 1 missed checkup, 2.40 (1.97-2.94) for 2 missed checkups, and 2.38 (1.46-3.88) for ≥3 missed checkups. A linear trend was also observed (P < .0001). Further analysis revealed that the main risk factors for missed checkups were divorced or widowed marital status, followed by negative attitude toward pregnancy, and single marital status, whereas protective factors were being employed and better mental health in mid-late pregnancy. CONCLUSIONS Our results suggest the importance of implementing various measures to promote regular attendance at prenatal checkups.
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Affiliation(s)
- Mitsue Nagamine
- Tokyo Tech Academy for Leadership (ToTAL)/Institute for Liberal Arts, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo, Japan; Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan.
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama, Toyama, Japan
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Futakawa K, Matsumura K, Tsuchida A, Konishi M, Sasaki H, Mezawa H, Yamamoto-Hanada K, Inadera H, Hasegawa T. Longitudinal study of the relationship between number of prior miscarriages or stillbirths and changes in quality of life of pregnant women: the Japan Environment and Children's Study (JECS). BMC Pregnancy Childbirth 2023; 23:297. [PMID: 37118672 PMCID: PMC10148530 DOI: 10.1186/s12884-023-05578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/06/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Although a history of miscarriage or stillbirth has been reported to negatively affect quality of life (QOL) during the subsequent pregnancy, the association between the number of previous miscarriages or stillbirths and QOL, as well as trends in QOL during pregnancy, has not been clarified. This study sought to determine this association during early and mid- to late pregnancy. METHODS Data from 82,013 pregnant women who participated in the Japan Environment and Children's Study (JECS) from January 2011 to March 2014 were analyzed. In early and mid/late pregnancy, participants completed questionnaires and QOL was assessed using the Physical and Mental Component Summary (PCS and MCS, respectively) scores from the 8-item Short-Form Health Survey (SF-8). The pregnant women were divided into four groups according to number of previous miscarriages or stillbirths (0, 1, 2, and ≥ 3), and the PCS and MCS scores in early pregnancy and mid/late pregnancy were compared between group 0 and groups 1, 2, and ≥ 3. Generalized linear mixed models were used for analysis. RESULTS PCS score in early pregnancy was lower in group 1 (β = - 0.29, 95% confidence interval [CI] - 0.42 to - 0.15), group 2 (β = - 0.45, 95% CI - 0.73 to - 0.18), and group ≥ 3 (β = - 0.87, 95% CI - 1.39 to - 0.35) than in group 0. Group 1 and group ≥ 3 showed a trend for increased PCS score during pregnancy (β = 0.22, 95% CI 0.07 to 0.37 and β = 0.75, 95% CI 0.18 to 1.33, respectively) compared with group 0. CONCLUSIONS PCS score in early pregnancy was lower with a more frequent history of miscarriage or stillbirth. However, in terms of changes in QOL during pregnancy, pregnant women with a history of miscarriage or stillbirth showed greater increases in PCS score during mid/late pregnancy than pregnant women with no history of miscarriage or stillbirth.
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Affiliation(s)
- Kaori Futakawa
- Department of Maternal Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Mizuho Konishi
- Department of Psychology, Tokyo Seitoku University, 1-7-13 Jujodai, Kita-Ku, Tokyo, 114-0033, Japan
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Hatoko Sasaki
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
- Shizuoka Graduate University of Public Health, 4-27-2, Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, 420-0881, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama-Shi, Toyama, 930-0194, Japan
- Toyama Regional Center for JECS, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan
| | - Tomomi Hasegawa
- Department of Maternal Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama-Shi, Toyama, 930-0194, Japan.
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Terashita S, Yoshida T, Matsumura K, Hatakeyama T, Inadera H. Caesarean section and childhood obesity at age 3 years derived from the Japan Environment and Children's Study. Sci Rep 2023; 13:6535. [PMID: 37085536 PMCID: PMC10121560 DOI: 10.1038/s41598-023-33653-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/17/2023] [Indexed: 04/23/2023] Open
Abstract
Caesarean section (CS) birth is widely reported to be a risk factor for childhood obesity. Although susceptibility to childhood obesity is influenced by race and ethnicity, it is unclear whether this risk of childhood obesity with CS birth also applies in the Japanese population. We investigated the impact of CS birth on obesity at 3 years of age in Japanese children. We obtained data from 60,769 mother-toddler pairs in the Japan Environment and Children's Study, a large-scale birth cohort study. Obesity was determined by body mass index measured at 3 years of age. Analysis revealed that 11,241 toddlers (18.5%) had a CS birth and that 4912 toddlers (8.1%) were obese. The adjusted risk ratio for obesity at 3 years of age when born by CS compared with vaginal delivery, estimated using inverse probability of treatment weighting, was 1.16 (95% confidence interval 1.08-1.25). These results suggest that CS birth modestly increases the risk of obesity at 3 years of age in Japanese children.
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Affiliation(s)
- Shintaro Terashita
- Department of Pediatrics, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | | | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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Tsunoda K, Matsumura K, Inano H, Hatakeyama T, Tsuchida A, Inadera H. Association of infants' feeding pattern up to 2 years postpartum with mothers' mental and physical health: the Japan Environment and Children's Study. J Affect Disord 2023; 327:262-269. [PMID: 36739006 DOI: 10.1016/j.jad.2023.01.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/09/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Exclusive breastfeeding, a longer breastfeeding duration, and interaction with the baby during lactation improve mothers' mental health. However, few studies have targeted women around 2.5 years after childbirth, when women are still considered to have been in a period of mental and physical health vulnerability. This study examined this aspect in a large cohort of mother-child pairs. METHODS Data were obtained from 85,735 mothers in an ongoing nationwide birth cohort study in Japan. Exposures were exclusive breastfeeding (yes/no), continued breastfeeding up to 2 years (yes/no), and interaction with the baby during feeding (yes/no). Outcomes were mothers' mental and physical health 2.5 years after childbirth measured using Mental and Physical Component Summary scores (MCS and PCS scores, respectively) from the 8-item Short-Form Health Survey. Generalized additive mixed model analysis was used to derive each estimate for the three exposures and their interactions, with each "no" answer as reference. RESULTS Exclusive breastfeeding and interaction with the baby during feeding were associated with MCS score increases of 0.28 (95%CI: 0.10-0.47) and 0.41 (95%CI: 0.29-0.54), respectively. However, no associations were found for continued breastfeeding up to 2 years and no interactions were identified. No significant differences were observed for PCS scores. LIMITATIONS All variables were measured using a self-administered questionnaire. CONCLUSIONS Continued exclusive breastfeeding until 6 months and interaction with the baby during feeding may help to promote mother's mental health 2.5 years after childbirth. These findings further strengthen the rationale for the World Health Organization's recommended lactation practices.
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Affiliation(s)
- Kasumi Tsunoda
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Department of Food and Nutrition, Toyama College, Toyama, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hitomi Inano
- Department of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Education, University of Toyama, Toyama, Japan
| | | | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
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Matsumura K, Hatakeyama T, Yoshida T, Tsuchida A, Inadera H. Cesarean section and parenting stress: Results from the Japan Environment and Children's Study. Eur Psychiatry 2023; 66:e18. [PMID: 36691785 PMCID: PMC9970147 DOI: 10.1192/j.eurpsy.2023.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Accumulating evidence suggests a long-term health risk of cesarean section for the mother and child, but few studies have examined the link between cesarean section and parenting stress. Here, we examined this association by exploiting a large dataset. METHODS Participants were 65,235 mothers participating in the Japan Environment and Children's Study, an ongoing nationwide birth cohort. Outcome variables were parenting stress assessed as total score and subscale scores (representing the difficult child, parental distress, and spouse factors) on the Japanese 19-item version of the Parenting Stress Index Short Form (J-PSI-SF). Exposures were the mode of delivery, the timing of the J-PSI-SF assessment (1.5, 2.5, and 3.5 years postpartum), and the interaction between them. Multivariate regression analysis was used to calculate adjusted β coefficients and standard error of the means (SEMs). RESULTS The J-PSI-SF total score was higher in the cesarean section group than in the vaginal delivery group (adjusted β = 0.24, SEM = 0.09). This increase was primarily due to higher scores for the difficult child factor (adjusted β = 0.18, SEM = 0.05) and not to higher scores for the parental distress or spouse factor. CONCLUSIONS Cesarean section was associated with higher parenting stress, especially in relation to the difficult child factor. Our results highlight the importance of paying particular attention to the mental health of both mother and child in the case of cesarean section.
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Affiliation(s)
- Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | | | - Taketoshi Yoshida
- Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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Morimoto D, Washio Y, Sato T, Okamura T, Watanabe H, Yoshimoto J, Tsukahara H. Prediction model for nonopiate-induced neonatal abstinence syndrome. Pediatr Int 2023; 65:e15435. [PMID: 36478019 DOI: 10.1111/ped.15435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neonatal abstinence syndrome (NAS) induced by opiate use is common worldwide. Psychiatric drugs are a more common cause of NAS in Japan but infants of mothers taking psychiatric medications do not always develop NAS. The purpose of this study was to develop a practical model for predicting the onset of nonopiate-induced NAS, using variables available at birth. METHODS In this diagnostic study, prediction models were developed using multivariable logistic regression with retrospective data collected at our hospital between 2010 and 2019. The NAS diagnosis was based on the Isobe score, and maternal medications were converted to dose equivalents. RESULTS A total of 164 maternal and infant dyads met the inclusion criteria; 91 were included in the analysis, of whom 29 infants (32%) were diagnosed with NAS. Final models were created with and without the drug indices. The model without the drug indices consisted of neonatal head circumference in z-scores and Apgar scores at 5 min < 9, and the model with the drug indices included these, as well as antipsychotics and hypnotics indices. The C-statistics were 0.747 (95% CI: 0.638-0.856), and 0.795 (95% CI: 0.683-0.907), respectively, indicating that the models possessed good predictive accuracy for NAS onset. CONCLUSIONS This study developed models that predicted nonopiate-induced NAS accurately. They may be further improved through the use of drug indices.
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Affiliation(s)
- Daisaku Morimoto
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Washio
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takeshi Sato
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoka Okamura
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hirokazu Watanabe
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Junko Yoshimoto
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hirokazu Tsukahara
- Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Aoki C, Imai K, Owaki T, Kobayashi-Nakano T, Ushida T, Iitani Y, Nakamura N, Kajiyama H, Kotani T. The Possible Effects of Zinc Supplementation on Postpartum Depression and Anemia. Medicina (B Aires) 2022; 58:medicina58060731. [PMID: 35743994 PMCID: PMC9230907 DOI: 10.3390/medicina58060731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The effects of postpartum zinc supplementation are still unclear. Our purpose in this study is to investigate the association between Zn supplementation and postpartum depression, defined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 9, and the effect on the hematological status of postpartum women. Materials and Methods: We first investigated whether zinc supplementation affected the perioperative levels of zinc, hemoglobin, and hematocrit in 197 cases who underwent cesarean section and had postpartum anemia. Next, logistic regression analyses were performed on 148 eligible cases to determine the association between zinc supplementation and postpartum depression. Results: Postpartum zinc supplementation significantly improved the status of maternal blood zinc levels and reduced the risk of developing postpartum depression (adjusted odds ratio: 0.249; 95% confidence interval: 0.062–0.988; p = 0.048). Iron supplementation is a standard and effective strategy for treating anemia; however, the combination of oral iron plus zinc supplementation resulted in slightly significant negative effects on postpartum hemoglobin and hematocrit compared to oral iron supplementation only. Conclusions: Postpartum zinc supplementation causes a significant positive effect on postpartum depression (EPDS score ≥ 9). Zinc supplementation had a negative but transient influence on the hematological status in women with postpartum anemia treated with oral iron supplementation; however, the differences were not clinically significant. Thus, we did not regard it as an adverse effect to be considered, and postpartum zinc supplementation may be viewed as beneficial in postpartum women.
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Affiliation(s)
| | - Kenji Imai
- Correspondence: ; Tel.: +81-52-744-2261; Fax: +81-52-744-2268
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