掲載種別：研究論文（学術雑誌）   国際・国内誌：国際誌  

Background
Predicting the periovulatory period is very important for conception. Current approaches to predicting the periovulatory period include monitoring of basal body temperature and urine luteinizing hormone (LH) concentration; however, these methods are time-consuming. Here, we examined the potential of using vaginal discharge (VD) as a non-invasive means of sample collection for determining the LH surge that indicates ovulation.

Methods
Urine and VD samples were collected from 35 healthy women aged 20–39 years. VD samples were collected with panty liners to reduce the burden on participants. Daily first urine samples and used panty liners were collected from the 10th through 19th days of the menstrual cycle. Urine and VD LH (uLH and vLH) levels in the samples were measured by enzyme-linked immunosorbent assay. Measured vLH baseline and first surge values were analyzed using Student's t-test and ROC curves.

Results
Samples for a total of 55 menstrual cycles were collected. We used uLH surge to establish the date of ovulation. uLH surges were observed in 49 cycles, 34 of which had corresponding VD samples that qualified for measurement. Five cycles were excluded due to a lack of vLH data. In the remaining 29 cycles, the vLH surge appeared within the fertile window 90% of the time, and the sensitivity and specificity of the test were 86% and 83%, respectively.

Conclusions
VD has potential for use as a sample for predicting the periovulatory period by measuring LH content.

DOI： https://doi.org/10.1186/s12905-024-02916-4

その他URL： https://www.biomedcentral.com/

掲載種別：研究論文（学術雑誌）   国際・国内誌：国際誌  

Background: Urinary biopyrrin (UBP) is an oxidative metabolite formed from the reaction of bilirubin with reactive oxygen species. Previous studies have explored the relationship between UBP levels and certain diseases or pregnancy. However, UBP levels in healthy nonpregnant women have not been well examined. We aimed to clarify the representative value of UBP in healthy nonpregnant women and explore its relationship with menstrual cycles and concomitant symptoms.

Methods: We included healthy, nonpregnant Japanese women aged 20–39 years with normal body mass index and menstrual cycle. In total, 1260 urine samples collected during 43 menstrual cycles of 36 women were analyzed to determine the representative values and reference intervals of UBP levels. The correlation between daily UBP levels and the order of the day was explored, and median UBP levels of 5-day clusters were compared using Friedman and Mann–Whitney U tests. These analyses were also conducted in women with concomitant symptoms during the menstrual cycle.

Results: The median UBP level in all samples was 0.2291 (reference: 0.0102–2.9335) μmol/gCr. There was no significant relationship between the median UBP level and menstrual cycle, regardless of the presence of self-manageable symptoms during or before menstruation.

Conclusions: The representative UBP value and its reference interval can serve as standards for comparison with other populations. Our findings suggest that the UBP level may be an objective oxidative stress indicator that is less sensitive to menstrual cycle and concomitant symptoms. UBP levels in healthy nonpregnant women could be assessed regardless of the menstrual cycle and concomitant symptoms.

DOI： https://doi.org/10.1089/whr.2023.0074

掲載種別：研究論文（学術雑誌）   国際・国内誌：国際誌  

Objectives
We aimed to clarify the content of care provided by midwives working in hospitals and clinics in Japan and the unmet needs in midwifery care from mothers’ perspectives.

Design
This study employed a qualitative approach through semi-structured interviews.

Setting
Fifteen Japanese women, whose youngest singleton children were aged 12–18 months, were asked to recall their experiences with midwives, from pregnancy through the first postpartum year. Verbatim records were analyzed using thematic analysis.

Results
Seven themes regarding the care provided by midwives were generated: confirmation of physical condition, maintenance and promotion of perinatal physiological process, support for better preparation for childbirth, assistance in labour and childbirth, support for a new life with a baby at home, support for the family, and care for comfort and confidence as a mother. Unmet needs were identified in all themes, except for ‘confirmation of physical condition’ and ‘support for the family’. Ten subthemes, under the five themes of unmet needs, were integrated into three categories: midwives’ responses to potential concerns, lack of continuity of care, and lack of personalised care.

Key conclusions and implications for practice
Midwives in hospitals and clinics in Japan mainly provided care from pregnancy to one-month postpartum, in line with global core competencies. However, they could respond more effectively to the potential concerns of women, and provide continuous, personalised care more sufficiently. Improving working environments for midwives and collaborating with postpartum public health services are key to addressing these unmet needs of women, leading to women-centred care.

DOI： https://doi.org/10.1016/j.heliyon.2023.e18747

その他URL： https://www.sciencedirect.com/journal/heliyon

担当区分：筆頭著者   掲載種別：研究論文（学術雑誌）   国際・国内誌：国際誌  

Background: Many factors affect mothers’ decisions to continue or terminate breastfeeding, and they frequently experience difficulty making this decision. However, there is little research on mothers’ information needs and decisional conflict experiences regarding breastfeeding continuation/termination.

Objective: To examine breastfeeding decisional conflict and information needs in mothers in Japan.

Methods: This was a cross-sectional survey of 158 mothers (aged ≥20 years) attending health check-ups in Japan. Decisional conflict was assessed using the Decisional Conflict Scale-Japanese version. Participants responded to self-devised items on decisional conflict reasons and information needs.

Results: Of participants, 107 (67.7%) experienced decisional conflict about breastfeeding continuation/termination. Conflict was strongest after 6 months postpartum. The most common reasons for conflict were lack of sleep for both mother and child (both n = 33; 30.8%), lack of knowledge of how to terminate breastfeeding (n = 27; 25.2%), plans to return to work (n = 25; 23.4%), and plans for children to attend nursery school (n = 23; 21.5%). Participants relied most on the Internet (n = 112; 70.9%), friends (n = 76; 48.1%), and midwives (n = 67; 42.4%) to help them make decisions. More than half of mothers reported needing information about breast care and how to terminate breastfeeding. Few mothers had received professional education and support about breastfeeding.

Conclusion: Many mothers experience decisional conflict about breastfeeding continuation/termination but receive little professional support, particularly after 6 months postpartum. Strategies are needed to provide informed support to help mothers make better decisions about whether and when to terminate breastfeeding.

DOI： https://doi.org/10.29011/2688-9501.101372

その他URL： https://www.gavinpublishers.com/

国際・国内誌：国内誌  

【目的】バイオピリンは、生体内の酸化ストレス反応の結果尿に排泄される物質で、非侵襲的採取が
可能である。本研究の目的は、妊娠後期から産後 8 週までの女性を対象に、尿中バイオピリン値の変
動と、尿中バイオピリン値と精神的健康度との関連性を明らかにすることである。【方法】20 歳以上
の単胎妊娠中の初産婦 14 名に妊娠 36 週、産後 1 週、2 週、4 週、6 週、8 週での採尿と、自記式の精
神的健康度の調査票である General Health Questionnaire-12（GHQ-12）と Edinburgh Postpartum
Depression Scale（EPDS）への記入を依頼した。尿中バイオピリン値と精神的健康度得点の代表値の
時系列変動を求め、各週の値のペアごとの多重比較を行った。またバイオピリン値と精神的健康度得
点の間の相関係数を求めた。【結果】妊娠 36 週のバイオピリン値と比べて産後 2 週と産後 6 週のバイ
オピリン値は有意に低下していた（p<0.05）。産後の尿中バイオピリン値は GHQ-12 得点との間に有意
な低い相関を認めたが（p=0.034）、EPDS 得点との間には有意な相関を認めなかった。【結論】バイオ
ピリン値からは産後 2 週時点での生体内の酸化ストレス反応が妊娠後期と比べて少なくなっているこ
とが推察され、また産褥期の尿中バイオピリンと精神的健康度との関連性が示唆された。

その他URL： https://kyotokango.repo.nii.ac.jp/?page=1&size=20&sort=controlnumber

担当区分：筆頭著者   共著区分：共著  

担当区分：筆頭著者   共著区分：単著  

会議種別：ポスター発表  

会議種別：ポスター発表  

会議種別：ポスター発表  

会議種別：ポスター発表  

会議種別：口頭発表（一般）