九州大学 研究者情報
論文一覧
疋田 直子(ひきたなおこ) データ更新日:2024.06.03

教授 /  医学研究院 保健学部門


原著論文
1. 春名 めぐみ, 田中 萌子, 中野 恵子, 西原 菜帆, 笹川 恵美, 米澤 かおり, 臼井 由利子, 疋田 直子, 藤田 愛, 【DOHaDとCOVID-19】COVID-19禍での妊娠期から産後のコホート調査 J-PEACH Studyの取り組み, DOHaD研究, 10, 1, 46-48, 2021.12.
2. Naoko Hikita, Ritsuko Iso, Kiyoko Mizuhata, Hiroko Arai, Akemi Isoyama, Impact of altered gestational weight gain guidelines on midwives in Japan: A cross-sectional study, Journal of Nursing Education and Practice, 10.5430/jnep.v14n8p22, 14, 8, 22-22, 2024.04, Objective: In March 2021, modifications were made to the dietary guidelines for expectant and nursing mothers in Japan, resulting in an increased recommended gestational weight gain (GWG) based on the pre-pregnancy body mass index. However, the existing landscape of midwives’ health-guidance practices remains unexplored. This study aimed to elucidate the situation and perceptions of the revised GWG guidelines among midwives in Japan.Methods: This cross-sectional study, conducted between January and March 2023, targeted midwives employed across primary, secondary, and tertiary hospitals in Japan. The participants completed a web-based questionnaire via a QR code and provided responses. Descriptive analysis was employed to discern the midwives’ perceptions of the revised GWG guidelines.Results: A total of 160 midwives (24.2%) completed the web-based questionnaire and were included in the analysis. Of them, 117 (73.1%) knew the recommended GWG had been adjusted. A significant difference was observed in the self-evaluation of health guidance before and after the guideline change (p = .015). While 47.9% of the midwives viewed the guideline change positively, 50.4% considered it neither good nor detrimental. The reasons for this positive perspective included the perceived stringency of previous standards and concerns about the potential effects of strict weight guidance on the physical and mental health of both mothers and children. Those with a neutral stance gave the following reasons: 1) uncertainties about the post-change impact and 2) concerns regarding potential health implications for pregnant women gaining excessive weight.Conclusions: Because not all midwives were aware of the guideline adjustments, the new guidelines must be prioritized..
3. Seto Natsuki, Emi Tahara‐Sasagawa, Kaori Yonezawa, Hikita Naoko, Yuriko Usui, Megumi Haruna, The association between fear of childbirth and social support through the Internet and Social Networking Services in pregnant women: A cross‐sectional study, Nursing & Health Sciences, 10.1111/nhs.13082, 26, 1, 2024.01, Abstract

Social support is an important factor in reducing fear of childbirth (FOC). Recently, the Internet and Social Networking Services (SNS) have become new forms of social support. However, it is unclear whether such support can reduce pregnant women's fear. This study aimed to investigate the association between FOC and social support through the Internet and SNS in pregnant women. A cross‐sectional study using a web‐based questionnaire including questions about FOC, social support, the Internet and SNS usage, psychological variables, and sociodemographic variables was conducted. Data from 111 participants were analyzed. A greater number of social support from people who are often seen during pregnancy, and becoming relieved by interaction with others through the Internet and SNS were negatively associated with FOC. This study showed that face‐to‐face social support was associated with lower FOC, while social support through the Internet and SNS was not. Further research is needed on how to use Internet and SNS to reduce FOC in pregnant women..
4. Rikako KANAI, Emi TAHARA-SASAGAWA, Kaori YONEZAWA, Naoko HIKITA, Yuriko USUI, Mariko MAEJIMA, Megumi HARUNA, Association of work engagement with job resources and perceived symptoms among working pregnant women: A cross-sectional study, Journal of Japan Academy of Midwifery, 10.3418/jjam.jjam-2023-0004, 2023.08.
5. Naoko Hikita, Enkhtungalag Batsaikhan, Satoshi Sasaki, Megumi Haruna, Ariunaa Yura, Otgontogoo Oidovsuren, Evaluation of salt intake estimated from 24-h urinary sodium excretion in medical professionals in Darkhan-Uul Province, Mongolia: a cross-sectional study, Scientific Reports, 10.1038/s41598-023-37631-x, 13, 1, 2023.06, Abstract

This cross-sectional study aimed to estimate the daily salt intake of medical professionals working in public health facilities in Darkhan-Uul Province, Mongolia. We conducted a multiple logistic regression analysis to identify factors associated with their consumption of salt exceeding the recommended daily salt intake (≥ 5 g/day). A self-administered questionnaire and 24-h urine samples were used to obtain data on the participants’ salt intake. Of 338 participants, 159 completed the 24-h urine collection. The mean sodium excretion into urine was 122.3 mmol/day, which was equivalent to a mean salt intake of 7.7 g/day when the urinary excretion rate was considered as 93%. Body mass index was positively correlated with excess salt intake (adjusted odds ratio [AOR]: 1.27; 95% confidence interval [CI] 1.10–1.46), while age was negatively correlated with excess salt intake (AOR: 0.95; 95% CI 0.91–1.00). Participants who consumed ≥ 2 cups of salted suutei tsai (Mongolian milk tea) daily had a higher risk of consuming ≥ 5 g/day of salt than those who consumed ≤ 1 cup/day. The average estimated salt intake of the participants was higher than the recommended value. Medical professionals should be aware of factors associated with excessive salt consumption and make appropriate adjustments to minimize it..
6. Nao Nishihara, Megumi Haruna, Yuriko Usui, Kaori Yonezawa, Naoko Hikita, Emi Sasagawa, Keiko Nakano, Moeko Tanaka, Riko Ohori, Satoko Aoyama, Satoshi Sasaki, Megumi Fujita, Masayo Matsuzaki, Yoshiko Suetsugu, Yoko Sato, Dietary Intake and Its Association with Birth Outcomes in Women with Nausea and Vomiting during the Second Trimester of Pregnancy: A Prospective Cohort Study in Japan, Nutrients, 10.3390/nu15153383, 15, 15, 3383-3383, 2023.07, Nausea and vomiting in pregnancy (NVP) is a common symptom. Although the influence of NVP during the first trimester on dietary intake and birth outcomes has been revealed, no study has focused on NVP during the second trimester. This study aimed to reveal whether NVP severity during the second trimester is associated with dietary intake, gestational weight gain (GWG), birth weight, and delivery week. Participants completed a questionnaire at 18–27 gestational weeks. NVP severity was assessed using the modified Pregnancy-Unique Quantification of Emesis and Nausea scale in the questionnaire. Dietary habits were assessed using a brief-type diet history questionnaire. In total, 825 responses were analyzed: 202 (24.5%), 135 (16.4%), and 8 (1.0%) women reported mild, moderate, and severe NVP, respectively; 480 (58.2%) women did not have NVP during the second trimester. No significant association was observed between energy and nutrient intake and no/mild and moderate/severe NVP. Women with moderate/severe NVP had lower total GWG than those with no/mild NVP (p = 0.007). There was no significant difference in low birth weight and preterm birth rates (p = 0.246 and p = 0.604). This is the first study to investigate whether NVP severity during the second trimester is associated with dietary intake and birth outcomes..
7. Mariko Maejima, Kaori Yonezawa, Emi Sasagawa, Naoko Hikita, Yuriko Usui, Megumi Haruna, Psychological factors of pregnant women associated with inadequate maternal weight gain in Japan, The Journal of Maternal-Fetal & Neonatal Medicine, 10.1080/14767058.2023.2217466, 36, 1, 2217466-2217466, 2023.05, OBJECTIVES: Inadequate gestational weight gain (GWG) has been associated with low birth weight (LBW). However, factors associated with inadequate GWG in Japan remain unclear. Here, we aimed to determine the factors associated with inadequate GWG and the characteristics of inadequate GWG based on the pre-pregnancy body mass index (BMI) among pregnant women in Japan. METHODS: This observational study included pregnant women at ≥16 weeks of gestation. The study was conducted at two general hospitals in Tokyo, Japan. The participants were requested to complete a questionnaire during the antenatal checkup visit and a mail survey after childbirth. Data were also collected from medical records. The GWG level and associated factors were assessed using the chi-square test or t-test. RESULTS: In total, 252 pregnant women were recruited and completed the questionnaires. Data from 128 pregnant women were analyzed. Overall, 23 (18.0%) women were classified as having inadequate GWG. The factors associated with inadequate GWG were as follows: pre-pregnancy underweight, hospital admission owing to hyperemesis, low body esteem, high Edinburgh Postnatal Depression Scale score, low target GWG, more significant weight loss during pregnancy when compared with that pre-pregnancy, high maximum weight loss during pregnancy, delay in return to pre-pregnancy weight, lower birth weight, and inadequate GWG perception. Pregnant women with inadequate weight gain did not receive any medical advice to avoid being overweight but were rather advised to gain additional weight. CONCLUSION: Target GWG and low body esteem were associated with inadequate GWG and other factors that could be modified. Medical staff should focus on achieving the target GWG and improving the body appreciation level among pregnant women..
8. Naoko Hikita, Ritsuko Iso, Kiyoko Mizuhata, Akemi Isoyama, Ayumi Kobayashi, Rika Muroi, Physical and Mental Effects of Foot Baths Among Women in Labor: Protocol for a Pre-Post Test Experimental Design, JMIR Research Protocols, 10.2196/39985, 12, e39985-e39985, 2023.01, Background

Foot baths are used in complementary and alternative therapy to improve the duration and quality of sleep and reduce tension, anxiety, fatigue, and confusion. They are also known to improve the frequency of labor contractions and to increase their duration in women; thus, they are commonly used by midwives in clinical settings in Japan. However, the physical and mental effects of foot baths during labor are unknown.

Objective

This study aims to assess the physical and mental effects of foot baths based on biomarker levels and self-administered questionnaires.

Methods

A single-arm pre-post test trial design is being used in this study, and the study is being conducted at a general hospital in Tochigi Prefecture, Japan. The target study population is women in the first stage of labor, the phase when the uterus starts to contract and when the cervix dilates to 10 cm, or those undergoing labor induction. Participants who meet the eligibility criteria are recruited, and written informed consent is obtained from them. They are asked to answer the questionnaire and to collect 1.5 mL of saliva in 2 microtubes each, before and after the intervention. The intervention is foot baths for 15-20 minutes using a foot bath device. Data on delivery, such as gestational age, gravidity, parity, diagnosis following the last vaginal examination, and presence or absence of membrane rupture, are retrieved from the medical records. The primary outcomes are salivary cortisol levels before and after the foot baths. The secondary outcomes are levels of relaxation and comfort, labor pain, body warmth, vital signs, and interval of labor pain before and after the foot baths, which are assessed using a numerical rating scale. A paired t test or Wilcoxon signed-rank test will be performed to compare the data for salivary cortisol levels and numerical rating scale scores.

Results

Data collection started on April 1, 2022. As of October 2022, we had enrolled 10 participants. Because of the COVID-19 pandemic in Japan, it is difficult for medical personnel to freely interact with women in labor until the results of the COVID-19 polymerase chain reaction test are available in the research facility, complicating the recruitment process.

Conclusions

This is the first prospective study to assess the effects of foot baths using a biomarker during the first stage of labor. The findings on the effects of foot baths on women in labor will provide novel insights that may improve the outcomes of delivery. A randomized controlled trial to investigate the effects of foot baths to obtain robust evidence should be conducted in the future.

Trial Registration

University Hospital Medical Information Network-Clinical Trial Registry UMIN000046539; https://tinyurl.com/2wwj7dns

International Registered Report Identifier (IRRID)

DERR1-10.2196/39985.
9. Naoko Hikita, Kiyoko Mizuhata, Ritsuko Iso, Akemi Isoyama, Midwives’ perception of the effects of footbaths for women in labor: A cross-sectional study, Journal of Nursing Education and Practice, 10.5430/jnep.v13n4p23, 13, 4, 23-23, 2022.12, Footbaths are generally used for women in labor in clinical settings in Japan. However, it is unclear how their effects are perceived by midwives, or what effects they expect. Therefore, this study aimed to describe midwives’ perception of footbaths’ effects for women in labor. This cross-sectional study was conducted during January–March, 2022. Participants were midwives who worked at perinatal medical centers in the Kanto region. Self-administered questionnaires were used to collect data. A total of 364 midwives were asked to participate; of these, 291 (79.9%) responded to the questionnaires. The participants’ mean age was 35.6 years old, and 120 (41.2%) had graduated from vocational schools. The average clinical experience was 12.1 years. Regarding the effects of footbaths, 274 (94.2%) participants selected “relaxes,” whereas 166 (57.0%) selected “strengthens uterine contractions.” These effects were related to educational attainment and the source of information about the effects of footbaths. Midwives’ perception of footbaths’ effects differed; thus, it is necessary to conduct studies which clarify the effects of footbaths in the future and to disseminate the results..
10. Manami Matsubara, Megumi Haruna, Kaori Yonezawa, Moeri Yokoyama, Emi Tahara-Sasagawa, Naoko Hikita, Yoshie Nakamura, Yoko Mizuno, Hiromi Sanada, Nao Tamai, Masatoshi Abe, Kosuke Kashiwabara, Development and validation of an infant facial skin assessment tool: a prospective observational study, BMC Pediatrics, 10.1186/s12887-022-03691-7, 22, 1, 614-614, 2022.10, Abstract

Background

Severe infant eczema on the face should be treated early because it may lead to allergic diseases in the future. However, caregivers find it difficult to assess. A visual tool for caregivers is needed to easily determine infants’ facial skin condition severity based on the tool’s scores. We developed an infant facial skin assessment tool (IFSAT) and evaluated its reliability and validity.

Methods

The IFSAT draft was developed based on results of a previous literature review and qualitative sketch. Panels including medical professionals and a caregiver checked the draft’s content and face validity, and the IFSAT was finalized. To test the IFSAT’s reliability and validity, caregivers and one-month-old infants were recruited. Two scoring methods were additionally created based on the relation between the items and cure period. The relationships between scores and cure period, and the ability to predict whether the infant needed medical treatment were examined by each scoring method. For the predictive validity, scores for infants requiring medical treatment and those for infants who did not were also compared. For the intra-examiner reliability analysis, two pediatricians rated the scores separately twice using photographs. Inter-rater reliabilities were analyzed among pediatricians, nurses, and caregivers.

Results

Altogether, 113 infant-caregiver pairs participated in the testing phase. Of the two scoring methods created (versions 1 and 2), pediatricians’ and caregivers’ scores using versions 1 and 2 were related to the cure period. These scores predict whether the infant needed medical treatment. We then selected version 2 based on the medical professionals’ opinions. The scores of caregivers of infants requiring medical treatment were higher than those of caregivers of infants not requiring treatment (p 
Conclusions

The proposed IFSAT may be used to assess whether infants need medical treatment and whether to extend the cure period. The tool’s reliability and validity were confirmed..
11. Yokoyama M, Yonezawa K, Matsubara M, Hikita N, Sasagawa E, Haruna M., The factors related to recovery time of diaper dermatitis in infants: A prospective observational study, Jpn J Nurs Sci., 10.1111/jjns.12492, 2022.06.
12. 磯 律子, 疋田 直子, 荒井 洋子, 西岡 啓子, 水畑 喜代子, 赤羽 由美, 礒山 あけみ, 獨協医科大学助産学専攻科修了生におけるキャリア支援のための動向調査:横断観察研究, 獨協医科大学看護学部紀要, 15, 11-21, 2022.03, 【目的】獨協医科大学助産学専攻科修了生の動向を明らかにすることで、キャリア形成に向けたサポート環境を整備するための示唆を得ること。【方法】獨協医科大学助産学専攻科を修了した1~10期生87名を対象に調査を実施した。調査の依頼メールを送付し、Google Formsを用いたweb調査で、属性、現在のキャリアへの満足度、今後のキャリアについての希望、助産学専攻科にあればよいと思う支援のデータを収集した。連続値の項目ではMann-WhitneyのU検定を、名義尺度の項目はχ2検定またはFisherの正確確率検定を用いて分析した。【結果】Web調査回答者54名(62.1%)を分析対象とした。現在のキャリアへの満足度は、「満足」12名(24.5%)、「どちらかといえば満足」25名(51.0%)であった。現在考える今後のキャリアについて、現在の勤務先での就業継続を希望している者は、それ以外の者(進学や転職等を希望・検討している、分からないと回答)と比べて、有意にキャリアへの満足度が高かった(p=0.016)。現在のキャリアで「満足」を選んだ者の理由は「仕事と育児の両立ができている」「大学病院でハイリスクを学ぶことができている」「助産師の資格を活かして、臨床経験を積むことができている」であった。「助産学専攻科にあればよいと思う支援(複数回答可)」では、「研修会」24名(44.4%)、キャリア相談22名(40.7%)、交流会・ネットワーク作り19名(35.2%)であった。【結論】今後のキャリアについて、現在の勤務先での就業継続を希望している者は、それ以外の者(進学や転職等を希望・検討している、分からないと回答)と比べて、有意にキャリアへの満足度が高かった。修了生のニーズをくみ取りながら、助産師基礎教育機関であるからこそ企画できる助産師のキャリアに必要な研修を検討していく必要がある。(著者抄録).
13. Chihiro Sugawara, Hayato Yamana, Emi Sasagawa, Kaori Yonezawa, Naoko Hikita, Kojiro Morita, Hiroki Matsui, Hideo Yasunaga, Megumi Haruna, Factors Associated with Surgical Treatment in Postpartum Women with Mastitis or Breast Abscess: A Retrospective Cohort Study, Breastfeeding Medicine, 10.1089/bfm.2021.0244, 17, 3, 233-238, 2022.03, Objective: The aim of this study was to identify factors associated with requiring surgical treatment for mastitis or breast abscess in postpartum mothers. Materials and Methods: This was a retrospective cohort study using the Japan Medical Data Center Claims Database. Information on pairs of infants born between April 2012 and December 2016 and their mothers were extracted. Data regarding the baseline characteristics, medical history, medical practice, and prescription drugs of mothers and their infants were collected. Multivariable logistic regression analysis was used to examine factors associated with undergoing surgical treatment. Results: The data of 69,363 eligible mothers were analyzed. The proportion of mothers who were diagnosed with mastitis or breast abscess within 1 year after childbirth was 10.8% (7,516/69,363). There were 114 mothers who underwent surgical treatment within 1 year after childbirth. This was 0.2% of all mothers and 1.5% of those diagnosed with mastitis or breast abscess. Surgical treatment was significantly associated with mothers having their first child (adjusted odds ratio [AOR], 2.58; 95% confidence interval [CI], 1.63-4.07) compared to those with a second or later child; it was also significantly associated with the diagnosis of breast abscess (AOR, 10.38; 95% CI, 5.28-20.40). Conclusions: This was the first report of the prevalence of mastitis or breast abscess and the requirement for surgical treatment among postpartum mothers in Japan. A first diagnosis of breast abscess and having a first child were associated with requiring surgical treatment. Health care professionals providing postpartum care should be aware of these factors..
14. Naoko Hikita, Enkhtungalag Batsaikhan, Satoshi Sasaki, Megumi Haruna, Ariunaa Yura, Otgontogoo Oidovsuren, Factors Related to Lacking Knowledge on the Recommended Daily Salt Intake among Medical Professionals in Mongolia: A Cross-Sectional Study., International journal of environmental research and public health, 10.3390/ijerph18083850, 18, 8, 2021.04, In Mongolia, the recommendations are to restrict salt intake to less than 5 g/day to reduce the risk of cardiovascular disease. We aimed to reveal factors associated with not knowing the recommended daily salt intake among medical professionals in Mongolia. Of the recruited 538 medical professionals working at public health facilities in Darkhan-Uul Province, the data from 338 (62.8%), obtained using self-administered questionnaires, were analyzed. Among these, 175 (51.8%) did not know the recommended daily salt intake. Compared with medical doctors, midwives and nurses had higher odds of not knowing the recommendations (adjusted odds ratio (AOR): 4.20, 95% confidence interval (CI): 1.40-12.59; AOR: 2.10, 95% CI: 1.15-3.76, respectively). Compared to participants who consumed more than four cups/day of salted suutei tsai (Mongolian milk tea), those who consumed approximately two cups/week had lower odds of not knowing the recommendations (AOR: 0.21, 95% CI: 0.07-0.63). With most participants lacking accurate knowledge on this topic, and considering that people who are aware of the recommendations are more likely to take action to reduce dietary salt intake, it is imperative to urgently address this knowledge deficit because medical professionals have a responsibility to educate the community by disseminating accurate health information..
15. 中西 愛海, 春名 めぐみ, 米澤 かおり, 笹川 恵美, 疋田 直子, 乳児の皮膚トラブルの評価項目に関する文献レビュー, 日本助産学会誌, https://doi.org/10.3418/jjam.JJAM-2019-0038, 35, 1, 3-10, 2021.03.
16. Shimizu S, Yonezawa K, Haruna M, Sasagawa E, Hikita N, Sanada H, Minematsu T, Relationship between the skin barrier function of 2-week-old infants after bathing and facial skin problems during the first 6 weeks of life: A prospective observational cohort study., Jpn J Nurs Sci., 10.1111/jjns.12408, e12408, 2021.02, AIM: This study aimed to identify the relationship between the skin barrier function after bathing at 2 weeks of age and subsequent facial skin problems during the first 6 weeks of life. METHODS: A prospective observational study was conducted from July 2017 to February 2018 on healthy newborns aged 2 weeks. Skin barrier function was evaluated before bathing and at 30 and 90 min after bathing by measuring transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum secretion, and skin pH. Infantile facial skin problems were assessed using skin condition diaries maintained by a parent for 4 weeks. RESULTS: Analysis of the data from 56 infants showed that 29 infants (51.8%) experienced facial skin problems from 2 to 6 weeks of age. A lesser change in the sebum secretion on the forehead before bathing to 90 min after bathing and a higher SCH of the forehead before bathing were less likely to result in facial skin problems (adjusted odds ratio [AOR] = 0.98, 95% confidence interval [CI]: 0.97-0.99; AOR = 0.96, 95% CI: 0.92-0.99). CONCLUSIONS: A greater change in the sebum secretion on the forehead before bathing to 90 min after bathing and a lower SCH of the forehead before bathing were associated with subsequent infantile facial skin problems, indicating that a better ability to recover after bathing is important to prevent facial skin problems. Future studies should identify factors that enhance the recuperative functions of infantile skin..
17. Kiyoko Mizuhata, Hatsumi Taniguchi, Mieko Shimada, Naoko Hikita, Seiichi Morokuma, Effects of Breastfeeding on Stress Measured by Saliva Cortisol Level and Perceived Stress, Asian/Pacific Island Nursing Journal, 10.31372/20200503.1100, 5, 3, 128-138, 2020.12, Purpose: The effects of breastfeeding on postpartum depression symptoms and stress using physiological measures require investigation.
Background: Breastfeeding suppresses the secretion of cortisol. Oxytocin levels correlate negatively with symptoms of postpartum depression.
Aim: To investigate the effects of breastfeeding on stress and postpartum depression.
Methods: We examined 79 breastfeeding women using the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale-10, and the Breastfeeding Self-Efficacy Scale, and measured the salivary cortisol levels before and after breastfeeding.
Findings: There was a negative correlation between the duration of suckling and changes in salivary cortisol levels following breastfeeding (rs = −0.333, p Breastfeeding mothers had lower perceived stress than mothers using mixed feeding methods (β = −0.260, p Conclusion: Salivary cortisol levels significantly decreased following breastfeeding, with longer suckling times correlating with lower cortisol levels. Breastfeeding reduced stress and increased breastfeeding self-efficacy..
18. Rina Matsubara, Naoko Hikita, Megumi Haruna, Emi Sasagawa, Kaori Yonezawa, Yumi Maeda, Yuka Ikeda, Factors Associated with Time Spent Performing Housework/Childcare by Fathers of Children Aged Under 12 Years: A Cross-Sectional Study in Japan, Asian/Pacific Island Nursing Journal, 10.31372/20200503.1111, 5, 3, 153-164, 2020.12, Objective: The objective of this study is to determine the factors associated with time spent performing housework/childcare by fathers of children under 12 years of age (preschool and elementary school children) in Japan.
Methods: An online survey of employees and employers was conducted in 2017. Of the 7,796 total responses to the survey, those of 621 fathers of children aged 0–12 years were analyzed. Participants were divided into two groups: fathers of children aged 0–6 years, and fathers of children aged 7–12 years. Multiple logistic regression analysis was performed on the items for which there was a significant intergroup difference, setting time spent performing housework as the dependent variable and the survey items as the independent variables.
Results: For fathers of children aged 0–6 years, working 40 hours or less per week and commuting for one hour or less were associated with more time spent performing housework/childcare. For fathers of children aged 7–12 years, working less than 40 hours a week, working from home more than once a week, and having spouses with
full-time jobs were associated with more time spent performing housework/childcare.
Conclusion: This study revealed the factors associated with the time spent by fathers of children under 12 in performing housework/childcare. As several of these factors cannot be altered by the fathers’ efforts alone, companies and society in general must endeavor to improve work styles to better suit the habits and preferences of fathers.
This will promote work–life balance and create better family relationships..
19. 横山 萌莉, 春名 めぐみ, 米澤 かおり, 笹川 恵美, 疋田 直子, 乳幼児のおむつ皮膚炎の有病率とその関連要因に関する文献レビュー, 日本助産学会誌, 34, 2, 194-203, 2020.12, 目的 本研究は,文献レビューを通じて,おむつ皮膚炎を発症しやすい乳幼児の特徴を看護職に対して知識普及がなされることを期待し,乳幼児のおむつ皮膚炎の(1)有病率を明らかにすること,(2)発症と予防に関連する要因を把握することを目的に実施した。対象と方法医学中央雑誌Web版ver.5と検索エンジンPubMedを通じたMEDLINEのデータベースを用いて,「新生児・乳幼児」「おむつ皮膚炎」「infant,newborn」「diaper rash」のキーワードを組み合わせて検索を行った。2019年5月27日から過去30年以内の日本語と英語の原著論文に限定し,著者2名が包含基準・除外基準をもとに論文のスクリーニングを行い,統計学的に有意差の示されたおむつ皮膚炎発症と予防に関連する要因を抽出した。結果 13件の論文が抽出された。おむつ皮膚炎の点有病率は,11.5~70.6%,期間有病率は15.2~90%と幅広い値であった。おむつ皮膚炎の定義は,おむつ皮膚炎の有無のみとする論文と重症度分類した論文があった。おむつ皮膚炎の判断基準は,評価者が症状を定義し,一定の症状があった場合に皮膚炎をありとする方法と,症状を定義せず,症状の種類・重症度を問わず皮膚炎があると認識した場合という方法があった。おむつ皮膚炎発症と予防に関連する要因は,児の属性・皮膚の状態・消化器の状態・健康状態・栄養方法・スキンケア方法・育児環境があった。特に,おむつ皮膚炎発症のリスク要因として消化器症状や皮膚状態との関連を示す論文が多く,保湿剤の種類といったスキンケア方法に関するものが少なかった。結論 おむつ皮膚炎の判断基準の不一致によって幅広い有病率を示したため,今後の研究で判断基準の統一が求められる。また,家庭内で行われるスキンケア方法とおむつ皮膚炎発症との関連性を示す論文は少なったため,さらなる研究が求められる。(著者抄録).
20. Naoko Hikita, Megumi Haruna, Masayo Matsuzaki, Emi Sasagawa, Minoru Murata, Ariunaa Yura, Otgontogoo Oidovsuren, Factors associated with hypertension among men in Darkhan-Uul Province, Mongolia: A cross-sectional study, Asian/Pacific Island Nursing Journal, 10.31372/20190404.1067, 4, 4, 151-158, 2020.01, In Mongolia, cardiovascular disease is the leading cause of death, and prevalence of hypertension is very high. The aim of this study was to investigate the association between hypertension and sociodemographic factors and health-related behaviors among men in Darkhan-Uul Province, Mongolia. This cross-sectional study was conducted between November 2015 and January 2016. Men whose wives were pregnant with ≤20 weeks gestation and had attended antenatal health checkups at public health facilities were recruited in this study. The data were collected as part of a survey of pregnant women and their partners. Data were collected using selfadministered questionnaires, anthropometry, and spot urine samples. A total of 224 men participated in the survey, and data from 209 participants were included in the analysis. Multiple logistic regression analysis showed that men with higher BMI had higher odds of hypertension than those with lower BMI (adjusted odds ratio [AOR]: 1.14, 95% CI: 1.03–1.26). Those with urinary cotinine >100 ng/ml (smokers) had a lower risk of
hypertension (AOR: 0.24, 95% CI: 0.09–0.67) compared to participants with urinary cotinine/ml (nonsmokers). This is the first study to investigate the association between hypertension and sociodemographic factors and health-related behaviors among men in Mongolia. Based on the findings of this study, clinicians responsible for public health in Mongolia should provide health education regarding the importance of weight control in preventing hypertension..
21. Kanako Hisa, Megumi Haruna, Naoko Hikita, Emi Sasagawa, Kaori Yonezawa, Maiko Suto, Erika Ota, Prevalence of and factors related to anemia among Japanese adult women: Secondary data analysis using health check-up database., Scientific reports, 10.1038/s41598-019-52798-y, 9, 1, 17048-17048, 2019.11, The issue of anemia is important in terms of a woman's preconception health. This study aimed to conduct an exploratory investigation of the prevalence of and factors related to anemia in non-pregnant Japanese women. Secondary data analysis was conducted using a database of women aged 20-49 years old who had attended an annual health check-up at a hospital in Tokyo (n = 10,598). A multiple logistic regression analysis was performed to identify factors related to anemia in two age groups: women aged 34 and under and those aged 35 and over. Anemia was defined as hemoglobin concentration levels
22. Naoko Hikita, Megumi Haruna, Massayo Matsuzaki, Emi Sasagawa, Minoru Murata, Ariunaa Yura, Otgontogoo Oidovsuren, Is High Maternal Body Mass Index Associated with Cesarean Section Delivery in Mongolia? A Prospective Observational Study, Asian/Pacific Island Nursing Journal, 10.31372/20190403.1056, 4, 3, 128-134, 2019.09, More than half of women are reported to be overweight or obese in Mongolia, thus becoming a big health issue. Though maternal obesity is a known risk factor for cesarean section (CS), it remains unclear how much a high maternal body mass index (BMI) would influence the risk of CS among pregnant women in Mongolia. This study aimed to investigate whether a higher maternal BMI is related to CS delivery in Darkhan-Uul Province, Mongolia. Pregnant women at 20 weeks' gestation or less who visited public health facilities for antenatal health checkups between November 2015 and January 2016 were recruited. Data were collected using self-administered questionnaires, body weight measurement, and medical records. In total, 508 pregnant women participated, and data from 336 women were analyzed. Multiple logistic regression analysis showed that higher maternal BMI at first antenatal care visit (adjusted odds ratio [AOR] = 1.102, p = .033), higher gestational weight gain (AOR = 1.111, p = .001), older maternal age (AOR = 1.076, p = .030), and gestational age at delivery (AOR = 0.765, p = .005) were associated with CS delivery. This study is the first to demonstrate that higher maternal BMI and higher gestational weight gain are associated with CS delivery in Mongolia. Moreover, older maternal age and lower gestational age at delivery were found to be associated with CS delivery. Preventing obesity among women is important not only from the viewpoint of prevention of lifestyle diseases but also from the obstetric point of view; it is important for medical personnel to communicate the importance of preventing obesity to all women in Mongolia..
23. 笹川 恵美, 春名 めぐみ, 米澤 かおり, 疋田 直子, "Care in Normal Birth"から"Intrapartum care for a positive childbirth experience"へ:WHOの正常出産ガイドラインは、どのように変わったか?, 日本助産学会誌, 33, 1, 50-60, 2019.06, 目的 世界保健機関(World Health Organization:WHO)は、2018年「WHO recommendations:Intrapartum care for a positive childbirth experience」を出版した。このガイドラインは、1996年出版の正常出産ガイドライン「Care in Normal Birth:a practical guide」の改訂版として位置付けられる。本稿の目的は、新旧ガイドラインを比較し、その変化を記述することである。方法 まず、新旧ガイドラインの基本特性を比較した。次に、新旧ガイドラインの推奨項目の内容を理解できる小見出しを和文で作成した。新旧ガイドラインの小見出しは、対比可能な形で一覧表とし、項目別の推奨レベルを示した。また、「新ガイドラインで新たに加わった項目」「旧ガイドラインにあったが新ガイドラインに含まれなかった項目」「新旧ガイドラインで推奨レベルが変わった項目」を調べ、WHOの正常出産ガイドラインはどのように変わったかを表に取りまとめた。結果 新旧ガイドラインは、妊産婦を尊重するケアを推奨している点で、共通している。新ガイドラインの主な改訂点は、分娩経過の多様性を尊重し、分娩第1期・第2期の定義や標準持続時間を見直したこと、硬膜外麻酔中の産婦や新生児へのケアに関する推奨を増やしたことである。清潔な器具の使用の推奨など、出産現場に広く浸透したと考えられる項目は、新ガイドラインには含まれていなかった。推奨レベルが上がったのは、分娩第3期のオキシトシン投与や臍帯牽引、硬膜外麻酔に関する項目であった。助産ケアに関しては、ポジティブな出産体験を促進するようなケアを推奨していたが、その具体的なケア内容は、表現の違いはあるものの、新旧ガイドラインで一貫して変わらない項目であった。(著者抄録).
24. Naoko Hikita, Megumi Haruna, Emi Sasagawa, Minoru Murata, Ariunaa Yura, Otgontogoo Oidovsuren, Comparison of knowledge about smoking and passive smoking and urinary cotinine levels in pregnant women and their partners in Mongolia: A cross-sectional study, Asian/Pacific Island Nursing Journal, 10.31372/20190401.1032, 4, 1, 47-56, 2019.04, This study aimed to compare knowledge about smoking, including passive smoking, and urinary cotinine (UC) levels in pregnant women and their partners in Mongolia. The study was conducted between November 2015 and January 2016 in Darkhan-Uul Province, Mongolia. Pregnant women with less than 20 weeks' gestation were recruited, and their partners were also invited to participate. Self-administered questionnaires and urine samples were used to collect data. Knowledge about smoking including passive smoking was measured using 14 questions. Data were analyzed using a Student's t-test, a chi-squared test, a one-way analysis of variance, and the Tukey-Kramer method for post-hoc analysis. Correlations were measured by computing Pearson's r or Spearman's ρ. A total of 508 pregnant women and 227 partners participated in this study; of these, 221 couples' data were analyzed. Pregnant women's scores on knowledge about smoking and passive smoking were significantly higher than those of their partners (9.4 ± 2.9 and 8.7 ± 3.1, respectively; p = 0.017). Pregnant women's and their partners' scores were slightly correlated (r = 0.163, p = 0.015). Pregnant women's and their partners' UC levels were significantly correlated (ρ = 0.250, p 
25. Sachiko Kita, Megumi Haruna, Naoko Hikita, Masayo Matsuzaki, Kiyoko Kamibeppu, Development of the Japanese version of the Woman Abuse Screening Tool-Short, NURSING & HEALTH SCIENCES, 10.1111/nhs.12298, 19, 1, 35-43, 2017.03, This study develops a Japanese version of the Woman Abuse Screening Tool, comprising two simple questions, to examine its accuracy and validity. A cohort study involving women in the third trimester of pregnancy and one month after childbirth was conducted in an antenatal clinic in a Tokyo suburb. The Japanese versions of the Index of Spouse Abuse and Hospital Anxiety and Depression Scale were used to examine the cut-off point, accuracy, and validity of the Woman Abuse Screening Tool. Results showed that the tool demonstrated good accuracy (sensitivity 66.7-71.4%, specificity 89.7%), using an alternative cut-off point (i.e. responses of "some tension" or "some difficulty" [2 points] for one item and "a lot of tension" or "great difficulty" [1 point] for the other), and good concurrent, convergent, and predictive validity. The results indicated that the Woman Abuse Screening Tool could be useful in Japanese perinatal health settings, as an initial screening tool to detect intimate partner violence efficiently and effectively during pregnancy..
26. Hikita N, Haruna M, Matsuzaki M, Shiraishi M, Takehara K, Dagvadorj A, Sumya N, Bavuusuren B, Baljinnyam P, Ota E, Mori R, Utilisation of maternal and child health handbook in Mongolia: A cross-sectional study. , Health Education Journal, https://doi.org/10.1177/0017896917753649, 77, 4, 458-469, 2018.02.
27. Masana Sannomiya, Emi Sasagawa, Naoko Hikita, Kaori Yonezawa, Megumi Haruna, The Proportions, Regulations, and Training Plans of Male Midwives Worldwide: A Descriptive Study of 77 Countries, International Journal of Childbirth, 10.1891/2156-5287.9.1.5, 9, 1, 5-18, 2019.03, ObjectivesThe proportions of male midwives as well as regulations and training plans targeting male midwives were investigated.

MethodsQuestionnaires were sent to 109 United Nations member countries where midwifery associations had opened their e-mail addresses. Respondents were persons in charge of midwifery education or policy recommended by midwifery associations, researchers, or acquaintances. The questionnaire inquired about the number of midwives and obstetrician-gynecologists by gender in the country, as well as regulations and training plans relevant to male ones. For those countries that either failed to respond or provided insufficient information, supplemental Internet searches were conducted.

ResultsData from 77 countries were analyzed (57 countries returned the questionnaires, and data on another 20 were obtained through Internet searches). Of the 19 countries without male midwives, five did not allow men to become midwives. In 37 countries with male midwives whose proportion data were available, the median proportion was 0.63%. Respondents in 13 countries described regulations respecting women who unwanted care by male midwives and in other two explained training plans for male midwives considering their specific characteristics.

ConclusionThe proportion of male midwives is small, and regulations and training plans for male midwives varied depending on social content in countries.

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28. Naoko Hikita, Megumi Haruna, Masayo Matsuzaki, Emi Sasagawa, Minoru Murata, Otgontogoo Oidovsuren, Ariunaa Yura, Prevalence and risk factors of secondhand smoke (SHS) exposure among pregnant women in Mongolia, SCIENTIFIC REPORTS, 10.1038/s41598-017-16643-4, 7, 1, 16426, 2017.11, This cross-sectional study investigated the prevalence of smoking and secondhand smoking (SHS) among pregnant women in Darkhan-Uul Province, Mongolia, using urinary cotinine (UC) levels, and clarified the factors related to SHS exposure. It targeted pregnant women who underwent antenatal health check-ups from November 2015 to January 2016. Self-administered questionnaires and urine samples were used to collect data. Using UC levels as the criterion, it was found that the prevalence of smokers (>100 ng/ml) among 493 pregnant women was 11.8%, while SHS exposure (>= 5 ng/ml) among nonsmokers was 44.8%. Older and highly educated women had lower odds of SHS exposure (p = 0.006 and 0.002, respectively). Furthermore, nonsmoking pregnant women from homes where smoking was permitted had higher odds of SHS exposure compared to women from homes where smoking was not permitted. These results suggest that community guidance programs, such as home smoking cessation that include families, are necessary..
29. Amarjargal Dagvadorj, Erika Ota, Sadequa Shahrook, Purevdorj Baljinnyam Olkhanud, Kenji Takehara, Naoko Hikita, Bayasgalantai Bavuusuren, Rintaro Mori, Takeo Nakayama, Hospitalization risk factors for children's lower respiratory tract infection: A population-based, cross-sectional study in Mongolia, SCIENTIFIC REPORTS, 10.1038/srep24615, 6, 6, 24615, 2016.04, This study aimed to assess the potential risk factors for lower respiratory tract infection (LRTI)-related hospital admissions in Mongolian children. A population-based cross-sectional study was conducted in rural Mongolia in 2013, and 1,013 mother-child pairs were included. Of the participating children, 38.9% were admitted to hospital with LRTIs. Home smoking, low birthweight, being a male child, exclusive breastfeeding and healthcare-seeking behaviour showed substantial association with LRTI-related hospital admissions. Number of cigarettes smoked by family members showed a dose-response relationship and increased hospital admissions. Strategies to prevent second-hand-smoke exposure from adult smokers, especially inside the home, are crucial to preventing LRTI-related hospital admissions for children in Mongolia. Improving rates of exclusive breastfeeding and increasing birthweight have great potential to decrease the likelihood of children acquiring a LRTI. Educational initiatives are also necessary for women who are less likely to seek out care for their children's symptoms..
30. Kenji Takehara, Amarjargal Dagvadorj, Naoko Hikita, Narantuya Sumya, Solongo Ganhuyag, Bayasgalantai Bavuusuren, Erika Ota, Megumi Haruna, Mikako Yoshida, Sachiko Kita, Hisashi Noma, Rintaro Mori, Maternal and Child Health in Mongolia at 3 Years After Childbirth: A Population-Based Cross-Sectional Descriptive Study, MATERNAL AND CHILD HEALTH JOURNAL, 10.1007/s10995-015-1893-9, 20, 5, 1072-1081, 2016.05, Objectives In recent years Mongolia has made great advances towards Millennium Development Goals to reduce maternal and child mortality, however few studies have investigated maternal and child health status several years after childbirth. Our study aims to describe priority health issues in maternal and child health in Mongolia 3 years after childbirth, and key areas requiring further health policy development. Methods We conducted a population-based cross-sectional study in Bulgan province, Mongolia. Participants were women who gave birth in 2010 and lived in Bulgan in 2013, and their children who were almost 3 years of age. Data was collected using structured interviews, self-administered questionnaires, transcribed records from the Maternal and Child Health Handbook, anthropometric measurements, and a developmental assessment tool. Results Data was obtained from 1,019 women and 1,013 children (recovery rate: 94.1 %). Among women, 171 (17.2 %) were obese and had an average body mass index (BMI) of 25.7, 40 (4.4 %) experienced intimate partner violence (IPV) and 356 (36.2 %) reported urinary incontinence in the past month. Among children, 110 (10.8 %) were assessed as at risk of developmental delay, 131 (13.1 %) were overweight or obese, burns accounted for the highest number of serious accidents at 173 (17.0 %) while lower respiratory tract infections (LRTIs) were the most frequent cause of pediatric hospitalization. Conclusions for Practice Further development in health policy is required in Mongolia to target the significant health challenges of obesity, IPV, and urinary incontinence in women, and obesity, development delay, burns, and LRTIs in children..
31. Sachiko Kita, Mariko Minatani, Naoko Hikita, Masayo Matsuzaki, Mie Shiraishi, Megumi Haruna, A Systematic Review of the Physical, Mental, Social, and Economic Problems of Immigrant Women in the Perinatal Period in Japan, JOURNAL OF IMMIGRANT AND MINORITY HEALTH, 10.1007/s10903-015-0192-2, 17, 6, 1863-1881, 2015.12, The perinatal mortality of immigrants in Japan is higher than that of Japanese women. However, details of the problems of immigrant perinatal women that contribute to worsening of their health are still unknown. This review describes the physical, psychological, social, and economic problems of immigrant women during the perinatal period in Japan. Medline, CINAHL, PsycINFO, and Igaku-Chuo Zasshi were searched and 36 relevant articles were reviewed. The related descriptions were collected and analyzed by using content analysis. The results showed that immigrant perinatal women in Japan experienced the following problems: language barriers, a problematic relationship with a partner, illegal residency, emotional distress, physical distress, adjustment difficulties, lack of utilization of services, social isolation, lack of support, lack of information, low economic status, unsatisfactory health care, and discrimination. These results indicated that multilingual services, strengthening of social and support networks, and political action are necessary to resolve their problems..

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pure2017年10月2日から、「九州大学研究者情報」を補完するデータベースとして、Elsevier社の「Pure」による研究業績の公開を開始しました。