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This article discusses the current status of paternal mental health care in obstetric institutes in Japan. Perinatal depression, which affects up to 15% of women, has been recognized as a common problem that can have adverse impacts on child development. In recent years, there has been a growing belief in Japan that the mental health of the whole family, including fathers, should be supported. However, the actual status of awareness and support for paternal depression in obstetric institutes has not been well analyzed. The article highlights the need to incorporate fathers into perinatal mental health care programs to support healthy families. [Extracted from the article]

Background: Breech presentation is observed in 3–4% at term of pregnancy and is one of the leading causes of cesarean section. There is no established treatment for breech presentation before 36 weeks. A retrospective cohort study was conducted to demonstrate that the lateral position is effective for breech presentation. However, there are no randomized controlled trials evaluating lateral position management for breech presentation. Here, we described the methodology of a randomized controlled trial of a cephalic version for breech presentation in the third trimester by lateral postural management (BRLT study). Methods: The BRLT study is an open-label, randomized controlled trial with two parallel groups allocated in a 1:1 ratio to examine the lateral position management for breech presentation, as compared with expectant management care. An academic hospital in Japan will enroll 200 patients diagnosed with a breech presentation by ultrasonography between 28 + 0 weeks and 30 + 0 weeks. Participants in the intervention group will be instructed to lie on their right sides for 15 min three times per day if the fetal back was on the left side or lie on their left sides if the fetal back was on the right side. The instruction will be given every 2 weeks after confirmation of fetal position, and the lateral position will be instructed until the cephalic version, and after the cephalic version, the reverse lateral position will be instructed until delivery. The primary outcome is cephalic presentation at term. The secondary outcomes are cesarean delivery, cephalic presentation 2, 4, and 6 weeks after the instruction, and at delivery, recurrent breech presentation after cephalic version, and adverse effects. Discussion: This trial will answer whether the lateral positioning technique is effective in treating breech presentation and, depending on the results, may provide a very simple, less painful, and safe option for treating breech presentation before 36 weeks, and it may impact breech presentation treatment. Trial registration: UMIN Clinical Trials Registry UMIN000043613. Registered on 15 March 2021 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000049800. [ABSTRACT FROM AUTHOR]

Pregnancy and childbirth have various effects on the physical as well as mental aspects of women. Therefore, appropriate considerations must be given to the mental health of pregnant women. The Guideline Review Committee of the Japanese Society of Psychiatry and Neurology launched a liaison meeting for the Japanese Society of Psychiatry and Neurology and the Japan Society of Obstetrics and Gynecology, with a view to creating a "Clinical guide for women with mental health problems during the perinatal period" by cooperation of these two fields. After repeated discussions with input from both academic societies, they jointly formulated the "Clinical guide for women with mental health problems during the perinatal period: Overview" in May 2020, and reported its "Detailed Contents" in April 2021. We hope that this guide, which is the English overview of the detailed guide, will contribute to the mental health of pregnant women, facilitating healthy pregnancies and childbirth. [ABSTRACT FROM AUTHOR]

Purpose: In Japan, the lack of obstetricians has made it impossible for a strict 24-h delivery monitoring system for high risk deliveries such as vaginal breech delivery at many obstetric facilities. The outcomes in the trial of vaginal breech delivery of singleton pregnancy limited one day at 37-38 weeks' gestation were examined.Materials and Methods: A planned induction of vaginal breech delivery at 37-38 weeks' gestation was performed in 72 women who got consent form April 2006 to March 2016 as follows: (1) insertion of a balloon catheter into the uterine cervix filled with a sterile saline fluid of 400-500 mL, (2) intravenous administration of oxytocin after confirming of the natural falling out by itself of the balloon catheter, and (3) selection of cesarean delivery when vaginal delivery cannot be expected by evening. The perinatal outcomes of them were examined from patient charts.Results: The completion rate of vaginal delivery in total was 67% (48/72). There were no cases of neonatal asphyxia or respiratory disorders. The severe perineal lacerations occurred in one case (2%).Conclusion: Planned vaginal breech delivery limited one day at 37-38 weeks' gestation seemed to be valid and safe and it can be one of the options for breech delivery in Japan. [ABSTRACT FROM AUTHOR]

Background: Few reports have presented an overall view of pregnant women with coronavirus disease 2019 (COVID-19) across an entire country and throughout the entire gestation period. Furthermore, no such reports are available for Japan. We examined the clinical characteristics and outcomes of pregnant women with COVID‑19 on a national scale in Japan.Methods: A nationwide questionnaire-based survey for all 2,185 maternity services in Japan was conducted between July and August 2020. Information regarding maternal characteristics and epidemiological, clinical, treatment, and perinatal outcomes of pregnant women diagnosed with COVID-19 between 16 January and 30 June 2020 were collected. Main outcome measures were incidence of pregnant women with COVID-19 and infant infection, positive rate of the universal screening test for asymptomatic pregnant women, identification of infection route and rates of maternal death, and severe cases.Results: Responses from 1,418 institutions were assessed (65% of all delivery institutions in Japan). Seventy-two pregnant women were reported to have been diagnosed with COVID-19. The positive rate of the universal screening test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic pregnant women was 0.03% (2/7428). The most common route of infection was familial (57%). Fifty-eight pregnant women with COVID-19 were symptomatic, of whom five (8.6%) had a severe infection and one died (a tourist). Severe respiratory symptoms, oxygen administration, and pneumonia were frequently reported in the third trimester and postpartum period compared with in early pregnancy (22.2% vs 2.5% [P = 0.03], 38.9% vs 7.5% [P = 0.01], and 50.0% vs 7.5% [P < 0.001], respectively). All pregnant women with COVID-19 underwent caesarean sections, regardless of symptoms. There were no SARS-CoV-2 transmissions to newborns.Conclusions: In Japan, the number of cases of COVID-19 infection in pregnant women is very low. Compared with early pregnancy, late pregnancy may be a risk factor for exacerbation of symptoms and familial transmission is the most common route of infection. The importance of infection prevention should be emphasised, especially in women in late pregnancy, their families, and any cohabitants. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the predictors of the effect of olaparib on platinum-sensitive recurrent ovarian cancer with unknown germline BRCA mutations. We retrospectively examined 20 patients with platinum-sensitive ovarian cancer who were treated at the Nippon Medical School Chiba Hokusoh Hospital, Japan, from 2018 to 2020. We found that the median progression-free survival was 11.4 months (95% Confidence interval (CI): 3.8–Not Available (NA)) in the group with NLPN score [recurrent neutrophil-lymphocyte ratio (rNLR) × number of previous regimens] >7.51, and median progression-free survival was not reached in the group with NLPN score <7.51 (95% CI: 21.8–NA) (p = 0.0185). There was a clear correlation between the degree of dose reduction of olaparib and recurrence (p = 0.00249). Our results show that NLPN scores lower than 7.51 are associated with a favorable outcome of olaparib treatment for platinum-sensitive recurrent ovarian cancer. In cases with a high rNLR, it may be necessary to start olaparib treatment as early as possible to obtain low NLPN scores. Our results imply that the effectiveness of olaparib can be determined after recurrence and before platinum treatment begins. As newer drugs for ovarian cancer are developed, the measurement of biomarker levels at the start of treatment for recurrent ovarian cancer, as shown in our study, may provide strong support for cancer treatment protocols. [ABSTRACT FROM AUTHOR]

Objective: In April 2008, the guidelines for obstetric practice in Japan have made the following recommendations: (1) do not use vacuum extraction (VE) for more than 20 min, and consider forceps delivery (FD) or an emergency cesarean section (CS) if necessary (20-minute VE trial rule), and (2) do not try VE more than five times, even if VE has been used for less than 20 min (5-time VE trial rule). The aims of the present study were to compare the obstetric policies related to failed VE before and after 2008.Methods: We reviewed the obstetric records of all cases of VE in cases of singleton pregnancy with a neonatal birth weight ≥ 2500 g beyond 37 weeks' gestation at our hospital from April 2002 to March 2014.Results: The success rate of VE decreased significantly (96.8 versus 94.1%, p = .02), while the rate of CS increased significantly (2.2 versus 5.0%, p < .01); however, there were no significant differences in these values between the two periods.Conclusions: We could not find the effects of the recommendation limiting the practice of VE. [ABSTRACT FROM AUTHOR]

In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy. [ABSTRACT FROM AUTHOR]

Excess water in vineyard soils during grapevine growing season is expected to become a critical issue in Japan. The objective of this study was to investigate the effects of constantly high soil water content which was controlled at constantly more than 20% water content in soil on vegetative growth and berry quality of Cabernet Sauvignon over a 3-year growing season. A wireless sensor networking system for real-time monitoring of soil moisture was used to check that the experimental plot had constantly more than 20% water content in soil. Véraison in the experimental plot controlled at constantly high soil water content started 10 days, 4 days and 1 day later than that in the non-irrigated experimental plot in the 2017, 2018 and 2019 growing seasons, respectively. The constantly high soil water content had no notable effects on berry quality, such as berry characteristics and berry composition, at harvest compared with the non-irrigated experimental plot, although there was a certain tendency that constantly high soil water content decreased anthocyanin contents in berry skins compared with those of non-irrigated grapevines during the three growing seasons. We postulated that waterlogging damage due to the increase in soil water content by frequent rainfall would be minimised by the selection of rootstock that confers tolerance to waterlogging stress for scion cultivars and/or viticultural practices to prevent decrease in soil temperature. Also, the introduction of Internet of Things technology for monitoring water status in vineyard soil is expected to contribute to improving practical approaches to vineyard soil water management. [ABSTRACT FROM AUTHOR]

Objective: We examined the clinical utility of the Whooley questions in comparison with that of the Edinburgh Postnatal Depression Scale (EPDS) in Japan.Methods: We carried out mental health screening of all postnatal mothers (n = 258) who gave birth to singleton babies at term attending our hospital using the EPDS and the Whooley questions. For the EPDS, scores were calculated, and a score of nine points or more was regarded as "positive screening" according to the results of previous observations in Japan. For the Whooley questions, if at least one question was answered "yes," we diagnosed it as "positive screen."Results: The positive rate of the Whooley questions was 16.7%, while that of the EPDS (≥ 9 points) was 14.8% (p = .55). The incidence of postpartum depression was 5.4%. The difference in the sensitivity and positive predictive value of the two tools did not reach significance (p = .09 and .45, respectively).Conclusions: There were no significant differences in accuracy on comparing the two screening tools. We should examine how to use the two tools according to the regional support systems. [ABSTRACT FROM AUTHOR]

Background: Screening of pregnant women carrying human T-lymphotropic virus type 1 (HTLV-1) has a crucial role in reducing the number of HTLV-1 carriers. A national HTLV-1 screening program for pregnant women was started in 2011 in Japan. The purpose of this study is to report on the implementation of this nationwide screening program.Methods: This was a retrospective repeated cross-sectional study. We used datasets from surveys of HTLV-1-antibody-positive pregnant women performed by the Japan Association of Obstetricians and Gynecologists in 2011, 2013, and 2016. Outcomes for evaluation included the number of persons (pregnant women) who conducted the screening test, the number of positive persons (women) identified by these tests, and the proportion of positive persons to the number of persons (women) who conducted the tests.Results: Numbers of target facilities changed yearly: 1857 in 2011, 2544 in 2013, and 2376 in 2016. The mean number of screening-test participants increased per facility, but the median increased or decreased. The mean number of positive individuals identified decreased. Multivariate analysis results revealed the number of screenings was slightly reduced yearly, although areas (Kanto and Kinki) and high volume in facility types increased. Regarding the positive rates, some areas (Hokkaido/Tohoku, Kanto, and Chugoku/Shikoku) exhibited decreases or increases by facility type. The number of western blotting (WB) implementations decreased in 2016, positive rates identified by WB decreased in 2016 in all areas, and the number of facility types increased. The number of PCR participants increased in 2016 in Kanto and Kinki, but a decrease in facility type was observed. Positive rates were decreased in all areas (except the central region) but facility types were increased.Conclusions: The nationwide screening program for HTLV-1 in Japan was almost fully implemented. However, regional variations in screening tests were observed during this implementation. Thus, some incentives are needed to encourage proper implementation across all regions. [ABSTRACT FROM AUTHOR]

We compared the current prevalence of and obstetric outcomes in underweight Japanese women with data from 16 years ago. We reviewed the obstetric records of singleton pregnant Japanese women who delivered at our institute at ≥ 22 weeks’ gestation from 2000 through 2002 and those from 2016 through 2018. From 2000–2002 to 2016–2018, numbers of pregnant women in their twenties decreased and pregnant women in their forties increased significantly (p < 0.01). There were no significant changes in the prevalence of underweight pregnant women between the 2 periods. The prevalence of women whose weight gain during pregnancy was less than optimal increased (p = 0.049). There was no difference in obstetric outcomes between the 2 periods. Based on the current results, we cannot judge the necessity of further education to curb the increasing trend of Japanese women who desire slimness. Maternal weight may not have a high priority as an indicator of the gestational nutritional status associated with obstetric outcomes in Japan. [ABSTRACT FROM AUTHOR]

Objective: We examined the clinical characteristics and obstetric outcomes in adolescent pregnancies in Japanese women.Methods: The present study was a retrospective investigation of all primiparous Japanese women with singleton pregnancies who gave birth at ≥22 weeks' gestation aged ≤18 years old (adolescent pregnancy, n = 325) and aged 28-30 years old (n = 2029) at Japanese Red Cross, Katsushika Maternity Hospital between 2002 and 2016.Results: The frequencies of smoking, economic problems, an unmarried single status at delivery and the start of prenatal care in the first trimester in the adolescent pregnancy group were significantly higher than in the control group (p < .01). The incidences of Chlamydia trachomatis, Condyloma acuminatum, and mental disorders in the adolescent pregnancy group were significantly higher than in the control group (p < .01). Pregnancy in adolescence was not related to adverse obstetric outcomes except preterm delivery (p = .02).Conclusions: Adolescent pregnancy was not associated with adverse obstetric outcomes; however, adequate social, economic, and mental support is needed for adolescent pregnant women. [ABSTRACT FROM AUTHOR]

We evaluated the current prevalence of gonococcal cervicitis among pregnant women in institutes that either do or do not routinely screen for gonococcal infection in Japan. We requested 2,330 obstetrical facilities to provide information on Neisseria gonorrhoeae cervicitis in pregnant women. A total of 1,876 (80.5%) of them responded. The universal screening test for gonococcal cervicitis, involving nucleic acid amplification for all pregnant women, was performed in 281 institutes (13.9% of institutes across Japan). The total rate of pregnant women with gonococcal cervicitis was 1.3% in the institutes performing the screening test during pregnancy, while it was only 0.2% (p < 0.01) in those not performing it. This suggests that 84% of infected women may have been missed in the institutes that do not routinely perform the screening test for gonococcal cervicitis. It may be time to examine the cost-effectiveness of providing gonococcal screening for all pregnant women in Japan. [ABSTRACT FROM AUTHOR]

In this paper, approximately 2,326,000 published patent applications applied between 2010 and 2019 by Japanese applicants in Japan were collected. 5 prefectures where patent applications much increased between 2010 and 2019 were identified, and their characteristics were analyzed. It was observed that they could be classified according to the diversity of the applicants and the IPC sections that contributed to the increase in patent applications. Based on these findings, this paper proposes a new model to classify regional patent application capability maturity. This model is useful for national and prefectural policy-makers to know the recommended policy to improve the maturity level of the target region and to assess the effectiveness of the implemented policy from the viewpoint of increases in patent applications. [ABSTRACT FROM AUTHOR]

This letter to the editor discusses the issue of antimicrobial resistance (AMR) in Neisseria gonorrhoeae (NG) infections during pregnancy in Japan. The author refers to global surveillance data from the World Health Organization (WHO) that shows increasing resistance to azithromycin and decreased susceptibility or resistance to ceftriaxone and cefixime. The author conducted a study in Japan and found that AMR in NG was recognized in a small percentage of pregnant women using azithromycin, but there was no AMR to ceftriaxone or cefixime. The author suggests that the changes in AMR levels may be due to the relative increase in ceftriaxone use and the fluctuation in NG genotypes. The author emphasizes the need for further examination of the molecular epidemiology of the disease and continued AMR surveillance. [Extracted from the article]

Objective: This study was performed to assess the differences in the birth canal lacerations following the lateral and fours posture deliveries compared with those following the supine posture deliveries.Methods: We examined the birth canal lacerations of our "low risk" pregnant women under the midwife-led delivery care at Japanese Red Cross Katsushika Maternity Hospital between April 2006 and March 2015.Results: There were 3826, 1754 and 719 women who delivered with supine, lateral and fours postures. The rate of no laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.630, 95% CI 0.56-0.71, p < 0.01); however, the incidence of perineal laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.856, 95% CI 0.76-0.90, p < 0.01). The incidence of perineal laceration of third- or fourth-degree in the women who delivered with fours posture was significant higher than that in the women who delivered with supine posture (OR 2.28, 95% CI 1.2-4.2, p < 0.01).Conclusion: The current results may be to help for self-determination of birthing postures in prenatal women. [ABSTRACT FROM AUTHOR]

This study examined the risk of deterioration/relapse in pregnant women who discontinued their antidepressant medications based on the discretion of the psychiatric specialists compared with those who performed self-interruption. We reviewed the obstetric records of all singleton deliveries beyond 22 weeks of gestation at Japanese Red Cross Katsushika Maternity Hospital from January 2009 through December 2015. Compared with the women continuing antidepressant medications throughout pregnancy, the incidence of deterioration/relapse was higher in the women who discontinued their antidepressant medications regardless of who made the decision (interruption based on the discretion of the psychiatric specialists: 61%, odds ratio (OR), 8.05; 95% confidence interval (CI), 2.4–27;p < 0.01; self-interruption: 63%, odds ratio (OR), 8.79; 95% confidence interval (CI), 2.6–29;p < 0.01 versus 16%). The continuation of medications and careful observation are required for pregnant women complicated by depressive disorders. [ABSTRACT FROM PUBLISHER]

We examined the current status of syphilis-infected pregnant Japanese women, according to the results of syphilis screening and confirmation tests of women who gave birth in Japan between October, 2015 and March, 2016. We requested 2458 obstetrical facilities to provide information of syphilis screening tests and 78.1% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of syphilis-infected pregnant Japanese women was estimated to be 250 (1/4022) per year. [ABSTRACT FROM AUTHOR]

Objective: This study was to examine the clinical usefulness of expectant management of early-onset severe preeclampsia. Methods: We reviewed the obstetric records of all Japanese singleton deliveries at ≥22 weeks' gestation managed at Japanese Red Cross Katsushika Maternity Hospital between 2007 and 2012. We compared the obstetric characteristics and perinatal outcomes between the cases of deliveries before ( n = 19) and after completion of corticosteroids ( n = 30) (immediate delivery versus expectant management). Results: Although the gestational age at delivery in the patients expectantly managed was higher than that in the patients required immediate deliveries (31.0 versus 29.3 weeks), the difference in the incidence of neonatal respiratory distress syndrome between the two groups did not reach the statistical significance (74 versus 47%, p = 0.06). The incidence of pulmonary edema in the patients expectantly managed was significantly higher than that in the patients required immediate deliveries within the first 48 h (20 versus 0%, p = 0.04). Conclusion: The current results could not support the clinical usefulness of expectant management of early-onset severe preeclampsia. [ABSTRACT FROM AUTHOR]

Aim It has not been extensively studied whether planned home and planned hospital births under primary midwife-led care increase risk of adverse events among low-risk women in Japan. Methods A retrospective cohort study was performed to compare perinatal outcome between 291 women who were given primary midwife-led care during labor and 217 women who were given standard obstetric shared care. Among 291 women with primary midwife-led care, 168 and 123 chose home deliver and hospital delivery, respectively. Perinatal outcomes included length of labor of 24 h or more, augmentation of labor pains, delivery mode, severe perineal laceration, postpartum hemorrhage of 1000 m L or more, maternal fever of 38° C or more and neonatal asphyxia (Apgar score, <7). Analysis was by intention to treat. Results The incidence of transfer from primary midwife-led care to obstetric shared care was 27% (77 women) mainly due to failure of labor progress (21%, 16 women), postpartum hemorrhage (19%, 15 women) and non-reassuring fetal status (19%, 15 women). Significantly higher incidence of transfer to obstetric shared care from primary midwife-led care was seen among women who chose hospital delivery compared with women who chose home delivery (34 vs 21%, P = 0.011). There were no significant differences in the incidence of adverse perinatal outcomes between women with obstetric shared care and women with primary midwife-led care (regardless of being hospital delivery or home delivery). Conclusion Approximately one-quarter of low-risk women with primary midwife-led care required obstetric care during labor or postpartum. However, primary midwife-led care during labor at home and hospital for low-risk pregnant women was not associated with adverse perinatal outcomes in Japan. [ABSTRACT FROM AUTHOR]

The population genetic structure of Plasmopara viticola in Japan was analyzed using grapevine downy mildew specimens collected from two islands, Honshu and Hokkaido. By simple sequence repeat analysis with the GOB microsatellite marker and DNA sequencing, an accurate copy number of the (CT)(CTAT) repeat was determined. Consequently, we found a large number of genetic variations in (CT) and (CTAT) repeats. Also, a single nucleotide polymorphism in the (CTAT) repeat of the GOB locus was detected. These genetic variations may serve as a valuable tool to understand the population structure of P. viticola. [ABSTRACT FROM AUTHOR]

No abstract available [ABSTRACT FROM AUTHOR]

Aim: In singletons, neonatal small-for-gestational age (SGA) status is an unfavorable postpartum outcome leading to cesarean section (CS) and increasing the possibility of maternal operative complications. Perinatal characteristics of SGA newborns in dichorionic (DC) twins were investigated for the prognostic impact on their mothers. Methods: A retrospective study was performed from 2004 to 2009 on 329 DC twins with two live births. Neonates were classified as SGA if they weighed less than the 10th percentile at birth according to Japanese singleton norms. Statistical differences between DC twins delivering appropriate-for-gestational age (AGA)/ AGA pairs (control group) and AGA/SGA, SGA/AGA or SGA/SGA pairs (the first/second twins) were analyzed. Results: The median (range) of the gestational ages at delivery for AGA/AGA, AGA/SGA, SGA/AGA and SGA/SGA pairs were 37.1 (27.1–40.3), 37.2 (29.0–40.9), 37.1 (28.1–40.7) and 37.3 (33.3–40.4) weeks, and the complete vaginal delivery rates of both fetuses were 66.2% (43/65), 84.8% (28/33), 82.4% (14/17) and 70.0% (7/10), respectively. Compared with AGA/AGA pairs, AGA/SGA pairs showed a higher incidence of spontaneous vaginal births of both fetuses (31.3% [26/83] vs 19.9% [37/186], OR 1.84, 95% CI 1.4 –4.73) and a lower incidence of emergent CS (25.3% [21/83] vs 38.7% [72/186], OR 0.53, 95% CI 0.30–0.95). Conclusion: The relatively small size of SGA fetuses allows both fetuses to remain inside the uterus for a longer time and to easily pass through the maternal parturient canal for complete vaginal delivery. Neonatal SGA status is a favorable factor for avoiding operative complications of CS and optimizing maternal perinatal outcomes. [ABSTRACT FROM AUTHOR]

To investigate the maternal risk factors for small-for-gestational age (SGA) newborns in Japanese dichorionic (DC) twins. A retrospective study was conducted from 2003 to 2008 on 340 DC twin pregnancies resulting in two live births. Newborns were classified as SGA if their birth weight was below the 10th percentile according to Japanese singleton norms. Statistical differences were evaluated between pregnancies resulting in appropriate-for-gestational age (AGA) pairs and those resulting in at least one SGA neonate. The study population consisted of AGA/AGA (50.8%), AGA/SGA (37.0%) and SGA/SGA pairs (12.0%). Logistic regression analysis identified significant interrelations for SGA with maternal nulliparity (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.30-0.91), smoking (OR 3.25, 95% CI 1.09-9.66), assisted reproductive technology (OR 0.52, 95% CI 0.30-0.89), pregnancy-induced hypertension (OR 2.00, 95% CI 1.01-4.31), pregravid weight (kg) (unitary OR 0.94, 95% CI 0.91-0.97) and monthly weight gain (kg/month) (unitary OR 0.25, 95% CI 0.14-0.44). Bivariable receiver operating characteristic curves were generated for monthly weight gain (area under the curve [AUC] 0.626, cutoff 1.41 kg/month, P < 0.001) and total weight gain (AUC 0.615, cutoff 14.0 kg, P < 0.001). Cigarette smoking and weight gain control are relatively modifiable factors for which interventional management is necessary to avoid perinatal problems arising from SGA pregnancy. Further studies are needed to investigate optimal nutrition, health guidance and subsequent weight gain control that lead to concrete improvement in maternal and infant prognoses. [ABSTRACT FROM AUTHOR]

The article presents a study to monitor the presence of Quinone Outside Inhibitor (QoI) fungicide resistance in Plasmopara viticola in Japan vineyards in 2009. It says that P. viticola was found in Hokkaido vineyards where QoI fungicide was used which resulted to severe problem on the control of grapevine downy mildew, but not on vineyards where QoI was not introduced. The study suggests that monitoring is important to improve Japan's pest management strategies.

In Japan, the hospitalization assistance policy (HAP) system helps pregnant women who, for financial reasons, cannot give birth at medical institutions. The HAP system allows these women to deliver at specified midwifery institutions. We compared women with singleton pregnancies who gave birth with the HAP system (n=150) or without (control; n=2,869). Although the percentage of women younger than 20 years was significantly greater in the HAP system group than in the control group, the parity number in the HAP system group was significantly greater than that in the control group. The percentage of non-Japanese was significantly higher in the HAP system group than in the control. The rates of preterm delivery and of low birth weight (<2,000 g) were significantly greater in the HAP system group than in the control group. From the perspective of perinatal medicine, social risks, such as poverty, present some perinatal problems, even in Japan. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate maternal and neonatal outcomes in dichorionic twins to nulliparous women older than 35 compared to those of their younger counterparts. This was a retrospective study of dichorionic twin pregnancies managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2006. Nulliparous women 35 years and older at delivery ( n = 60) were compared with nulliparous women between the ages of 20 and 29 at delivery ( n = 71). The women ≥ 35 year old were more likely to have used assisted reproductive technology. There were no measurable differences in obstetric outcomes such as preeclampsia, premature delivery, low birth weight and neonatal asphyxia between the two pregnancies. Advanced maternal age does not seem to affect obstetric outcomes in nulliparous dichorionic twin pregnancies. [ABSTRACT FROM AUTHOR]

In grapes, the number of flowers per inflorescence determines the compactness of grape bunches. Grape cultivars with tight bunches and thin-skinned berries easily undergo berry splitting, especially in growing areas with heavy rainfall during the grapevine growing season, such as Japan. We report herein that grape cytokinin oxidase/dehydrogenase 5 (VvCKX5) determines the number of berries per inflorescence in grapes. The number of berries per bunch was inversely proportional to the VvCKX5 expression level in juvenile inflorescences among the cultivars tested. VvCKX5 overexpression drastically decreased the number of flower buds per inflorescence in Arabidopsis plants, suggesting that VvCKX5 might be one of the negative regulators of the number of flowers per inflorescence in grapes. Similarly, the overexpression of grape sister of ramose 3 (VvSRA), which encodes trehalose 6-phosphate phosphatase that catalyzes the conversion of trehalose-6-phosphate into trehalose, upregulated AtCKX7 expression in Arabidopsis plants, leading to a decrease in the number of flower buds per Arabidopsis inflorescence. VvCKX5 gene expression was upregulated in grapevine cultured cells and juvenile grape inflorescences treated with trehalose. Finally, injecting trehalose into swelling buds nearing bud break using a microsyringe decreased the number of berries per bunch by half. VvCKX5 overexpression in Arabidopsis plants had no effect on the number of secondary inflorescences from the main inflorescence, and similarly trehalose did not affect pedicel branching on grapevine inflorescences, suggesting that VvCKX5, as well as VvSRA-mediated trehalose metabolism, regulates flower formation but not inflorescence branching. These findings may provide new information on the crosstalk between VvSRA-mediated trehalose metabolism and VvCKX-mediated cytokinin degradation for determining the number of berries per bunch. Furthermore, this study is expected to contribute to the development of innovative cultivation techniques for loosening tight bunches. [ABSTRACT FROM AUTHOR]

The article offers information on the Obstetrical hemorrhage which is more likely to produce exacerbation of systemic conditions than hemorrhage in general surgery and is often being complicated by obstetrical disseminated intravascular coagulation (DIC). It mentions that treatment with fluid and a red blood cell transfusion leads to a dilutional decrease in coagulation factors and exacerbates hemorrhagic diathesis associated with DIC. It states that need for focusing on abnormal vital signs.

We examined the current status of human T-cell leukemia virus type 1 (HTLV-1) carrier in Japanese pregnant women, according to the results of HTLV-1 screening and confirmation tests of women who gave birth in Japan in 2011. We requested 2642 obstetrical facilities to provide information of HTLV-1 tests and 71.3% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of HTLV-1 carrier in Japanese pregnant women was estimated to be 1620 (0.16%) per year. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article regarding the cesarean delivery which is a factor that promotes decreased prevalence of exclusive breastfeeding in Japan.

Delivery before arrival at a hospital did not cause major perinatal complications; however, it may reflect a serious problem of perinatal medicine in eastern Tokyo, Japan. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate standards of large-for-gestational-age (LGA) infants of twin pregnancies based on the incidence of neonatal hypoglycemia. We examined 277 dichorionic twin infants (in 201 dichorionic twin pregnancies) who were delivered weighing > or = 2,500 g at 37-41 weeks of gestation. LGA in twin pregnancies was identified when the infant deviated > by 1.5SD from the mean gestational age of this study (LGA based on the twin pregnancy standard), or when the infant deviated by >1.5 SD of the intrauterine growth curve of Japanese (LGA based the singleton pregnancy standard). Using the twin pregnancy standard, the incidence of neonatal hypoglycemia in LGA twin infants was not measurably different from that in appropriate-for-gestational-age (AGA). However, using the singleton pregnancy standard, the incidence of neonatal hypoglycemia was significantly higher than that in AGA infants. In conclusion, LGA in twin pregnancies should be studied based on the singleton pregnancy standard to assess the incidence of neonatal hypoglycemia. [ABSTRACT FROM AUTHOR]

The article discusses the impacts of grandmultiparity on adverse pregnancy outcomes on the pregnancy planning in Japan. It examines the pregnancy outcomes of 41 Japanese women and observe an increased in incidence of perinatal complications in grandmultiparous women. Two tables are presented which shows the research result on the pregnancy outcomes of Japanese women and of the age-matched Japanese women.

Objective: To evaluate clinical features of assisted reproductive technology (ART) patients with pregnancy-induced hypertension (PIH) compared to spontaneously conceived PIH patients. Methods: We retrospectively compared PIH incidence, maternal outcomes, and neonatal outcomes among these patients. Results: Preeclampsia, cesarean rate, and massive maternal bleeding were significantly more common in the ART group. Neonatal outcomes showed no significant difference between the groups. Multiple regression analysis revealed ART as an independent risk factor for preeclampsia. However, higher cesarean rate and massive bleeding were mainly associated with multiple pregnancy. Conclusion: ART patients with PIH had an increased incidence of preeclampsia, cesarean delivery, and massive maternal hemorrhage. [ABSTRACT FROM AUTHOR]

Intrapartum fetal heart rate monitoring abnormalities had been reported to correlate with decreased umbilical artery base excess associated with neonatal seizures. However, we present an infant born at 35 weeks of gestation diagnosed with cerebral palsy associated with periventricular leukomalacia (PVL) without fetal heart rate (FHR) monitoring abnormalities, According to the summary reports of PVL cases published on the home page of the Japan Obstetric Compensation System for Cerebral Palsy (JOCSC)), the percentage of placenta previa without FHR monitoring abnormalities in the cases of PVL was 5.7% (12/209), which seemed to be higher than the total percentage of placenta previa reported in Japan (0.3-0.5%)., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Suzuki S.)

The Postpartum Care Services (PCS) programme in Japan is intended to promote physical recovery and psychological rest for mothers and their children after discharge from the delivery facility, as well as nurture the mothers' own self-care skills and support healthy childrearing for mothers, children and their families. The subsidies for PCS are based on cooperation between psychiatry and obstetrics and between multiple professions, including the local government. The services should also be implemented based on the instruction to medical institutions and the local governments that they should actively screen and approach pregnant women in need of support. This narrative review describes the challenges of expanding the PCS programme nationwide in Japan., Competing Interests: Declaration of conflicting interestThe author declares that there are no conflicts of interest.

Placental abruption is separation of the placenta from its normal implantation site of the uterine body before delivery of the fetus. The Japan Obstetric Compensation System for Cerebral Palsy (JOCSC) includes it as a major cause of cerebral palsy. Placental abruption is classified as revealed or concealed hemorrhage on the basis of the presence or absence of external bleeding; concealed hemorrhage is associated with a worse prognosis for mothers and infants. If survival of the fetus is confirmed in cases of placental abruption, it should usually be delivered promptly. There is no evidence-based method to prevent placental abruption. Therefore, awareness of early symptoms of placental abruption in pregnant Japanese women is important.

Under the COVID-19 (Coronavirus Disease 2019) pandemic, limitations are known to cause some psychosocial problems. We compared the results of mental screening of the postpartum women conducted during the COVID-19 epidemic with those at the same period last year. Based on the results, the worse mother-infant bonding was suspected at 1 month after birth under the COVID-19 pandemic.

The current study was conducted to examine the number of human T-cell leukemia virus type 1 (HTLV-1) carriers and how horizontal transmission affected the prevalence of HTLV-1 carriers among pregnant Japanese women in 2019. We requested 2,214 obstetrical facilities to provide information on HTLV-1 tests for pregnant women who delivered in 2019. The estimated number of HTLV-1 carriers among pregnant Japanese women was 952. At least 10% or more of the carriers acquired HTLV-1 through horizontal transmission.

Purpose: We examined the relation between smoking habits and maternal mental status such as depression and anxiety during the first trimester of pregnancy., Material and Methods: Between July 2016 and June 2018, we examined the increased odds of depressive and anxiety symptoms in the women with smoking habits during prepregnancy with and without smoking cessation during the first trimester of pregnancy in comparison with those without smoking habits using self-administered questionnaires., Results: The rate of depressive and anxiety symptom in the women with smoking habits during prepregnancy (46.4 and 47.3%, respectively) was higher than those in the women without smoking habits during the first trimester of pregnancy irrespective of smoking cessation. The rate of depressive or anxiety symptom during the first trimester of pregnancy did not change significantly by smoking cessation in the women with smoking habits during prepregnancy (depressive symptom: 44.6 versus 53.7%, p  = .13; anxiety symptom: 45.3 versus 55.2%, p  = .17)., Conclusions: Smoking habits during prepregnancy seemed to be associated with the increased perinatal mental disorders irrespective of smoking cessation.

Widespread rubella epidemics have sometimes occurred in Japan. We compared the prevalence of rubella antibodies in women who had conceived after infertility treatments and in those who had conceived spontaneously. We reviewed the obstetric records of nulliparous Japanese women who had conceived after infertility treatments and whose babies had been born at the Japanese Red Cross Katsushika Maternity Hospital from 2014 to 2018. No significant differences in the rates of women with rubella antibody titers < 8 or < 32 emerged between those who had been treated and those who had not (titer < 8: 4.1 vs. 3.4%, p = 0.58; titer < 32: 17.3 vs. 15.3%, p = 0.45, respectively). It is necessary to thoroughly implement pre-conception care concerning the risk of congenital rubella infection for women undergoing infertility treatments, especially in Japanese obstetric clinics., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2020 Pacini Editore SRL, Pisa, Italy.)

This study was performed to investigate whether the Japanese guidelines for gestational weight gain (GWG) can be used to determine the risks of multiple pregnancy outcomes and estimate optimal GWG in 101,336 women with singleton pregnancies in 2013. Multivariable logistic regression analyses indicated that the risks associated with low birth weight, small for gestational age, and preterm birth increased significantly with weight gain below the Japanese guidelines, and the risks of macrosomia and large for gestational age increased with weight gain above the guidelines regardless of Asian-specific pre-pregnancy body mass index (BMI). The GWG cutoff points estimated from the adjusted area under the receiver operating characteristics curve >0.6 corresponded to 10-13.8 kg in underweight women with pre-pregnancy BMI < 18.5 kg/m 2 ; 10-13.7 kg in normal weight women with pre-pregnancy BMI 18.5-22.9 kg/m 2 ; 8.5-11.4 kg in overweight women with pre-pregnancy BMI 23-24.9 kg/m 2 , 5-13.3 kg in obese women with pre-pregnancy BMI 25-29.9 kg/m 2 ; and 4.7 kg in obese women with pre-pregnancy BMI ≥ 30 kg/m 2 . The optimal GWG ranges proposed by the present study are slightly higher than those recommended by the current Japanese guidelines.

Background:  Some studies have demonstrated that breastfeeding can protect mothers from postpartum depression; therefore, we examined the association between postpartum depression and lactation status at one month after delivery at a Japanese perinatal center. Methods: We reviewed the obstetric records of all (total 809) nulliparous healthy women with vaginal singleton delivery at 37-41 weeks' gestation at our institute between July 2018 and June 2019. A face-to-face interview with the women was conducted on admission for delivery to ask whether or not they hoped to perform exclusive breastfeeding for their babies, and an additional interview was conducted one month after delivery to ask about their feeding methods currently. Maternal mental status was examined based on the scores using the Edinburgh Postnatal Depression Scale (EPDS), and women with EPDS scores of ≥9 points were regarded as 'positive screening'. Results: 592 women (73.1%) hoped to perform exclusive breastfeeding for their babies on admission. Of these, at one month, 442 (74.7%) performed exclusive breastfeeding, while 150 (25.3%) performed mixed or artificial feeding. The average EPDS scores and the incidence of EPDS scores ≥9 points in the women performing exclusive breastfeeding were 4.3 ± 3.6 and 14.3% (63/442), respectively. They did not differ from those in the women performing mixed or artificial breast feeding [4.2 ± 3.7, p = 0.60 and 13.3% (20/150), p = 0.78]. Conclusion: Development of postpartum depression does not seem to be associated with incomplete breastfeeding at our hospital, and therefore there are other risk factors indicated in the development of postpartum depression., Competing Interests: No competing interests were disclosed., (Copyright: © 2020 Suzuki S.)