OBJECTIVESThe purpose of this study was to assess the validity of the candidate indicators secretory immunoglobulin A (s-IgA) and sense of coherence (SOC) as predictors of threatened premature birth.

METHODSThis was a panel study conducted on women in their first and latter half of pregnancy during survey period. The survey period was from December 2005 to June 2006 and from December 2007 to June 2008. The women enrolled in the study were asked to complete the survey questionnaire and provide blood samples for the determinations of physiological indicators. The questionnaire consisted of questions related to the stress perception scale (SPS), SOC score as an indicator of modifiers of stress, demographic data, complications in a previous pregnancy, and the course of the current pregnancy. We used s-IgA and high-sensitivity C-reactive protein as a physiological stress indicator and a marker of infection, respectively. Seventy-two eligible subjects were included in the analysis.

RESULTSTwenty-eight (38.9%) subjects had undergone treatment for threatened premature birth, and 44 (61.1%) subjects had not. In the logistic analysis, we set the course of pregnancy as a dependent variable, and age, birth history, smoking habits, a history of miscarriage, premature birth or threatened premature birth, SPS, SOC, and s-IgA in the first half of pregnancy as independent variables. We found that low serum s-IgA levels and low SOC scores in the first half of pregnancy were associated with threatened premature birth.

CONCLUSIONSOur results suggest that low serum s-IgA level and SOC score at an early gestational stage are significant indicators for a threatened premature birth.

OBJECTIVEThe aim of our study was to explore the relationship between a medium-scale earthquake and maternal depression and child-rearing in a depopulated community in the Noto Peninsula of Japan.

METHODSThree months after a major earthquake, self-rating questionnaires were distributed to women who were pregnant at the time of the earthquake or who became pregnant immediately thereafter, and who were receiving care at any of four major hospitals in the most devastated area. A total of 155 women who had given birth returned the completed questionnaire for analysis. Maternal postnatal depression among the participants was assessed using the Edinburgh Postnatal Depression Scale (EPDS).

RESULTSThe EPDS score was significantly associated with decreased "satisfaction with delivery" (beta = -0.28, p = 0.01), increased artificial "lactation" (beta = 0.31, p = 0.002), and increased "trouble with infant care" (beta = 0.47, p < 0.001) in multivariate analysis. It was also significantly associated with increased "anxiety about earthquakes" (beta = 0.30, p = 0.001), and "anxiety about earthquakes" was significantly associated with increased "fear of the earthquake" (beta = 0.20, p = 0.04).

CONCLUSIONSEarthquake-related factors such as "anxiety about earthquakes" and "fear of the earthquake" did not have a direct effect on child-rearing factors; however, they did have a significant relationship with increased EPDS. Based on these results, we conclude that screening strategies for maternal depression in peri- and postnatal women under emergency circumstances are necessary.

OBJECTIVEIn this study, we evaluated postpartum stress using a postpartum depression scale and by measuring the level of a stress-related substance, to clarify the relationship between the stresscoping capabilities of women in the final stage of pregnancy and their postpartum stress reactions.

METHODSBetween April 2004 and October 2004, 54 women participated in a question naire survey and the measurement of their secretory immunoglobulin A (s-IgA) level as a stress-related substance two times in the final stage of their pregnancy (prepartum) and in their early puerperium (postpartum) was carried out. The questionnaire used in the prepartum stage included the following parameters: "basic features", "Sense of Coherence (SOC)" and "Japanese version of the self-assessment depression scale" of Zung. The questionnaire employed in the postpartum stage included the following parameters: "course of delivery", "Self-evaluation of delivery experience", and "Postpartum depression scale".

RESULTSThe depression score was higher and the s-IgA level was lower in the low-SOC score group than in the high-SOC score group, indicating that stress reactions were more intense in the low-SOC score group.

CONCLUSIONIt was revealed that stress reactions were more intense for women with a low SOC score. Moreover, the finding of a relationship between the low SOC score in the prepartum stage and depressive tendency suggests that women who are likely to develop depressive tendency can be predicted in the prepartum stage, and the significance of measuring SOC in the prepartum stage is thus suggested.