Transition of Depressive Symptoms and Anxiety Symptoms According to Parity and Associations of These Symptoms with Feelings for Involvement with Newborn Infants during a 6-Month Postpartum Period

Background: Depressive symptoms and anxiety symptoms during the postpartum period affect physical health and child rearing and that these effects are important social issues. Objective: The aims of this study were to clarify the differences in the transition of depressive symptoms and anxiety symptoms according to parity during a 6-month postpartum period and to clarify the differences in associations of depressive symptoms and anxiety symptoms with feelings for involvement with newborn infants in primiparous and multiparous postpartum women. Methods: The design of this study was a longitudinal investigation. This study was conducted from February 2017 to July 2018 in Japan. By using self-administered questionnaires that included questions on psychological symptoms in a standard climacteric scale and questions on feelings for involvement with newborn infants, we collected data at 3 days postpartum, 2 weeks postpartum, one month postpartum, 3 months postpartum and 6 months postpartum. Results: Responses to all of the questionnaires were obtained from 121 (52.8%) of 229 women. The score for depressive symptoms in primiparous women was significantly higher than that in multiparous women at 3 days postpartum. Depressive symptoms and anxiety symptoms showed peaks at 2 weeks postpartum in both primiparous women and multiparous women, but depressive symptoms reoccurred from 3 months postpartum to 6 months postpartum in primiparous women and anxiety symptoms reoccurred from one month to 3 months postpartum in multiparous women. Depressive symptoms and anxiety symptoms were associated with negative feelings for involvement with newborn infants and with mother’s sleeping time. Conclusion: Changes in depressive symptoms and anxiety symptoms were different in primiparous women and multiparous women during a 6-month postpartum period. In addition, depressive symptoms and anxiety symptoms were associated with negative feelings for involvement with newborn infants and with sleeping time in postpartum women.

Development of the Diabetes Oral Health Assessment Tool ©for Nurses

Although some studies had suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT ?) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT ?, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach’s alpha coefficient for all assessment items were 0.931, indicating high reliability: Factor 1, Patient’s oral health status (α = 0.831);Factor 2, Implementation of oral health behaviors (α = 0.890);Factor 3, Information transmission regarding dental visits (α = 0.862);and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT ? was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT ?, despite recognizing their importance.

Association of Low Back and Pelvic Pain with Mental Health Condition during Pregnancy and Postpartum

Background: Low back and pelvic pain (LBPP) as a physical symptom may cause psychological symptoms during pregnancy and the postpartum period. We examined the association of LBPP with mental health condition in women from pregnancy to puerperium in a prospective study. Methods: This study was conducted from March 2015 to December 2016 in a birth center in Kagawa Prefecture in Japan. We recruited 89 pregnant women who responded to questionnaires in all four stages (first, second and third trimesters and one week postpartum). We designed a self-administered questionnaire including a visual analog scale (VAS) of LBPP and Edinburgh postnatal depression scale (EPDS). Results: There were significant differences in EPDS scores and VAS scores among the 4 stages. The EPDS score at the first trimester showed significant positive correlations with VAS scores at the second and third trimesters, and the EPDS score at the second trimester showed a significant positive correlation with VAS score at the third trimester. The VAS scores at the second trimester showed significant positive correlations with EPDS scores at the third trimester and at one week postpartum. Conclusion: It was shown that the mental health condition at early pregnancy was related to an increase in LBPP at mid-pregnancy and that LBPP at mid-pregnancy was associated with the mental health condition thereafter.

A family history of diabetes is not associated with arterial stiffness in non-diabetic Japanese population

Prevalent diabetes is at high risk for cardiovascular diseases and has a high familial inheritance. However, little is known whether a non-diabetic subject with a family history of diabetes is at high risk for vascular damage or not. The purpose of this study was to evaluate the association between a family history of diabetes and arterial stiffness in adult non-diabetic Japanese population. We analyzed eligible 787 non-diabetic subjects (502 men and 285 women) aged 35-69 years who enrolled in the baseline survey of a cohort study in Tokushima Prefecture, Japan and who underwent a brachial-ankle pulse wave velocity (ba-PWV) measurement. Information on individual life-style characteristics including medical history and treatment for diseases and a first-degree family history of diabetes was obtained through a structured self-administered questionnaire. Analysis of covariance and logistic regression analyses were used to evaluate the association between a family history of diabetes and ba-PWV. We found no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted means of ba-PWVs between subjects of both sexes with and without a family history of diabetes. Logistic regression analyses including both sexes also revealed that subjects with a family history of diabetes showed no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted odds ratios for high ba-PWV compared to those without that trait. Our results suggest that a family history of diabetes itself is not associated with arterial stiffness in adult non-diabetic Japanese population.

Possible Predictive Factors for Low Back and Pelvic Pain at Three Months Postpartum Assessed in a Prospective Study from Early Pregnancy until the Postpartum Period

Background: Low back and pelvic pain (LBPP) is an important issue related to mental health as well as to difficulty for daily life activity during early pregnancy and in the postpartum period. We examined the intensity of LBPP, difficulty for daily life activity and mental health and their associations from early pregnancy until 3 months postpartum in a prospective study. We also examined predictive factors for LBPP at 3 months postpartum. Methods: We recruited 55 pregnant women who responded to questionnaires in the first, second and third trimesters and at one week, one month and 3 months postpartum. We designed a self-administered questionnaire including a visual analog scale (VAS), pregnancy mobility index (PMI) of LBPP and Edinburgh postnatal depression scale (EPDS). Results: There were significant differences in the proportions of women with LBPP in the first trimester (63.6%), second trimester (78.2%) and third trimester (83.6%) and at one week postpartum (80.0%), one month postpartum (69.1%) and 3 months postpartum (56.4%). VAS score at 3 months postpartum was significantly correlated with VAS scores at the first trimester (r = 0.410, p = 0.002), second trimester (r = 0.298, p = 0.027) and one month postpartum (r = 0.476, p Conclusion: The proportion of women with LBPP and the intensity of LBPP were increased at late pregnancy and gradually decreased until 3 months postpartum. LBPP at 3 months postpartum was associated with LBPP at the first trimester and a past history of LBPP in a previous pregnancy was an important factor for prediction of LBPP at 3 months postpartum. Provision of information regarding LBPP and confirmation of LBPP before pregnancy in addition to assessment of LBPP at early pregnancy are necessary for reduction of LBPP at 3 months postpartum.