Title page Title: Promoting Factors of physical and mental development in early infancy: A comparison of preterm delivery/low birth weight infants and term infants

Abstract Objective We examined correlations between various factors and the physical and mental development of 4-month-old infants assessed using a multi-faceted evaluation. Methods In Hiroshima prefecture, Japan, we distributed 1,402 self-administered questionnaires to consenting mothers of infants that underwent a 4-month health checkup. Questionnaires included the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the KIDS type A. Data were examined from 318 of these mother-child pairs. Results Comparison between infants in a preterm delivery or low birth weight (LBW) group (preterm and/or LBW group; n=31) and a term delivery appropriate for date (AFD) infant group (term AFD group; n ＝ 287) revealed that the preterm and/or LBW group had significantly higher mother child-rearing anxiety and difficult baby scores, along with significantly lower infant development and motor skill scores. Within the term AFD group, infants of primipara mothers showed significantly higher scores for motor skill and sociability with adults than infants of multipara mothers. Language comprehension scores were significantly higher in infants that were exclusively breastfed than those formula-fed or combined breastfed and formula-fed. Verbalization scores were significantly higher in infants whose mothers worked than infants whose mothers did not work. Infants with siblings younger than 4 years old exhibited significantly lower scores for motor skill, verbalization, and sociability with adults than infants without siblings or with siblings at least five years old. In particular, we found a mother's child-rearing anxiety was related to many areas of infant development. Conclusions Evaluating the absence or presence of such factors and conducting preventive treatment could promote healthy infant development

Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder

We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects’experiences regarding dysphoria into the ‘Onset of gender dysphoria,’ ‘Experience of feeling gender dysphoria,’ and ‘Changes due to receiving medical care.’ The subjects reported experiencing great pain and distress because they did not fully understand that they were experiencing dysphoria and could not align their gender identity and their self-identity. All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems

Erratum for Vol. 69, No. 6, pp339-348, Anxiety and Feelings toward Their Baby among Pregnant Women with Uterine Leiomyomas

Pregnant women with uterine leiomyomas may experience anxiety toward their pregnancies and unfavorable feelings toward their infants. From March to July 2010, we distributed anonymous self-recorded questionnaires to 200 pregnant women who visited Okayama Central Hospital for an antenatal check-up after informed consent was provided, and 132 women (23 pregnant women with uterine leiomyomas) were included in our study. Among the multiparous women in their first trimester, the women with uterine leiomyomas had a higher rate of anxiety than those without uterine leiomyomas. ʻAvoidanceʼ scores on the Feeling Toward the Baby Scale were significantly higher in the leiomyoma group. The conflict index scores tended to be higher in the leiomyoma group. A multivariate analysis revealed no factors associated with trait-anxiety scores, whereas high state-anxiety scores were correlated with low age;however, there was no correlation between these scores and uterine leiomyomas. Although no factors were associated with State-Trait Anxiety Inventory (STAI) and approach scores toward the baby, avoidance and conflict index scores were associated with the existence of uterine leiomyomas. In pregnant women with uterine leiomyomas, efforts should be made to reduce anxiety in the first trimester, and support should be provided to help these women develop positive feelings toward their babies

Promoting factors of physical and mental development in early infancy: a comparison of preterm delivery/low birth weight infants and term infants

The aim of this study was to assess correlations between various factors and the physical and mental development of 4-month-old infants using a multi-faceted evaluation approach. A total of 1,402 self-administered questionnaires were distributed to consenting mothers of infants who had undergone a 4-month health checkup in Hiroshima prefecture, Japan. The questionnaires included items from the Japan Child and Family Research Institute Child Rearing Support Questionnaire and the KIDS type A test. Of the 421 completed questionnaires on mother-child pairs that were returned, 318 met the inclusion criteria and were eligible for further analysis. Comparison between infants in a preterm delivery or low birth weight (LBW) group (preterm and/or LBW group; n = 31) and a term delivery appropriate-weight for date (AFD) infant group (term AFD group; n =287) revealed that the preterm and/or LBW group had significantly higher mother child-rearing anxiety and difficult baby scores, along with significantly lower infant development and motor skill scores. Within the term AFD group, infants of primiparous mothers had significantly higher scores for motor skill and sociability with adults than those of multiparous mothers. Language comprehension scores were significantly higher in infants that were exclusively breast-fed than those formula-fed or combined breast-fed and formula-fed. Verbalization scores of infants whose mothers worked were significantly higher than those of infants whose mothers did not work. Infants with siblings aged < 4 years exhibited significantly lower scores for motor skills, verbalization, and sociability with adults than infants without siblings or with siblings aged at least 5 years. In particular, we found that a mother's child-rearing anxiety was related to many areas of infant development. Evaluating the absence or presence of such factors and conducting preventive treatment could promote healthy infant development

General Malaise and Physical Symptoms in Young Women with Untouched Toe

Untouched toe is a condition in which a toe does not touch the ground while standing. It is frequently observed in women even under physiological conditions. Deformities or symptoms of the toes are not observed in these women. The clinical significance of untouched toe has not been fully elucidated. Two hundred young healthy women were recruited into the present study after informed consent. We evaluated the prevalence of untouched toe by measuring various indexes of the toe using a foot-sole-measuring equipment. We also conducted a self-administered questionnaire regarding general malaise. Untouched toe was observed in 114 of these 200 women (57.0%). The fifth toe was more frequently affected than the other toes. There were no significant differences in size of foot except the area and proportion touching the ground between women with untouched toe and those without untouched toe. The prevalence of general malaise was significantly higher in women with at least one untouched toe (57.0%) compared with those without untouched toe (43.0%) (p＜0.05). Twelve symptoms―irritability, headache, tired eyes, hazy vision, congested or runny nose, irregular menstruation or menstrual pain, shoulder stiffness, neck stiffness, low back pain, cold hands, swollen feet, and cold feet―were more frequently observed in women with at least one untouched toe compared with those without untouched toes. Untouched toe was associated with various symptoms of general malaise. However, the pathological mechanism by which untouched toe causes these symptoms has not been determined. Further analysis of gait and exercise habits in women with untouched toe is necessary

Eosinophil Cationic Protein Shows Survival Effect on H9c2 Cardiac Myoblast Cells with Enhanced Phosphorylation of ERK and Akt/GSK-3β under Oxidative Stress

To assess the knowledge and attitudes of pregnant Japanese women regarding non-invasive prenatal testing (NIPT). Between March and June 2013, 557 pregnant women in the Hyogo and Hiroshima Prefectures were surveyed using an anonymous, self-completed questionnaire. A total of 91.9ｵ respondents (512/557) stated that they “agree” or “conditionally agree” with NIPT implementation in Japan. Approximately 28.5ｵ of respondents stated that they knew that the accuracy of a positive NIPT result can be affected by motherʼs age and background, while 34.5ｵ of respondents stated that it was necessary for pregnant women with a positive result to undergo fetal chromosome diagnosis using amniocentesis;both percentages were low. Additionally, 92.3ｵ of respondents would “like a detailed explanation of the test,” 65.1ｵ of them would “like psychological support if the NIPT test results came back positive,” and 5.7ｵ would terminate the pregnancy if the NIPT test results came back positive without undergoing fetal chromosome diagnosis via amniocentesis. Although a high proportion of pregnant Japanese women agreed with the introduction of NIPT into Japanese obstetrical care, there was insufficient knowledge regarding the test. It is necessary for women undergoing NIPT to be provided sufficient information and psychological support

Anxiety and Feelings toward Their Baby among Pregnant Women with Uterine Leiomyomas

Pregnant women with uterine leiomyomas may experience anxiety toward their pregnancies and unfavorable feelings toward their infants. From March to July 2010, we distributed anonymous self-recorded questionnaires to 200 pregnant women who visited Okayama Central Hospital for an antenatal check-up after informed consent was provided, and 132 women (23 pregnant women with uterine leiomyomas) were included in our study. Among the multiparous women in their first trimester, the women with uterine leiomyomas had a higher rate of anxiety than those without uterine leiomyomas. ʻAvoidanceʼ scores on the Feeling Toward the Baby Scale were significantly higher in the leiomyoma group. The conflict index scores tended to be higher in the leiomyoma group. A multivariate analysis revealed no factors associated with trait-anxiety scores, whereas high state-anxiety scores were correlated with low age;however, there was no correlation between these scores and uterine leiomyomas. Although no factors were associated with State-Trait Anxiety Inventory (STAI) and approach scores toward the baby, avoidance and conflict index scores were associated with the existence of uterine leiomyomas. In pregnant women with uterine leiomyomas, efforts should be made to reduce anxiety in the first trimester, and support should be provided to help these women develop positive feelings toward their babies

Women with Recurrent Pregnancy Loss : Their Psychology During Late Pregnancy and the Supportive Behavior of Their Partners

To elucidate the psychiatric characteristics of mothers and the supportive behavior of their partners during late pregnancy, 131 mothers who gave birth at 2 general hospitals in City A between August 2009 and September 2010 (control group: n=90; recurrent pregnancy loss (RPL) group: n=41) completed a self-administered questionnaire on four separate occasions: during late pregnancy, during hospitalization, at 1-month postpartum, and at 3-months postpartum. The RPL group had significantly (p=0.03) lower anxiety regarding potential change in their appearance than the controls, but were more likely to worry about losing their baby (58% vs. 38%) (p=0.021). At 3-months postpartum, the RPL group reported having had more stress during pregnancy than the controls (49% vs. 31%; p=0.041). There were no significant differences in state or trait anxiety (State-Trait Anxiety Inventory) between the 2 groups at any of the four measurements. However, state anxiety decreased significantly throughout the hospitalization for controls (p <0.001), but did not decrease significantly for the RPL group until 3 months postpartum (p<0.05). RPL participants who expressed high satisfaction with their partners’ supportive behavior received significantly greater psychological support than did participants with low satisfaction. Healthcare professionals should attempt to support both members of RPL couples