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Last Updated :2024/09/04

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Master

Affiliation (Master)

  • Faculty of Medicine　Social Medicine　Social Medicine

Affiliation (Master)

  • Faculty of Medicine　Social Medicine　Social Medicine

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Profile and Settings

Affiliation

  • Hokkaido University

Profile and Settings

  • Name (Japanese)

    Maeda

  • Name (Kana)

    Eri

  • Name

    201701015688350164

Affiliation

  • Hokkaido University

Achievement

Research Interests

  • プレコンセプションケア   妊孕性   ヘルスリテラシー   母子保健   

Research Areas

  • Life sciences / Hygiene and public health (non-laboratory)
  • Life sciences / Hygiene and public health (laboratory)
  • Life sciences / Healthcare management, medical sociology

Research Experience

  • 2023/04 - Today Hokkaido University
  • 2020/02 - 2023/03 Akita University Graduate School of Medicine
  • 2019/04 - 2020/01 Akita University Graduate School of Medicine
  • 2018/04 - 2019/03 Akita University Graduate School of Medicine
  • 2016/04 - 2018/03 Akita University Graduate School of Medicine
  • 2014/04 - 2016/03 日本学術振興会特別研究員 DC2
  • 2016/03 東京大学大学院医学系研究科博士課程修了
  • 2004/03 The University of Tokyo School of Medicine, Faculty of Medicine

Awards

  • 2023/03 日本衛生学会 奨励賞
  • 2019/12 女性研究者支援コンソーシアムあきた賞
     若手研究者学術研究部門 
    受賞者: 前田 恵理
  • 2018/11 秋田わか杉科学技術奨励賞
     
    受賞者: 前田 恵理

Published Papers

  • Mojgan Mirghafourvand, Mohammad Asghari Jafarabadi, Maryam Gharacheh, Eri Maeda, Shima Haghani, Fahimeh Ranjbar
    Heliyon 10 (9) 2405-8440 2024/05/15 
    Background: The level of fertility knowledge of reproductive-age people is low to moderate, and the inadequate knowledge of infertility-related factors may cause some people to unconsciously engage in activities that reduce their fertility. Given the significance of fertility knowledge, and the lack of standard instruments to evaluate it in Iran, the present study aimed at determining psychometric properties of the Persian version of the Cardiff Fertility Knowledge Scale (CFKS–P) in Iranian population. Materials and methods: In this cross-sectional study, a total of 280 participants (comprising 140 couples) attending mandatory pre-marriage educational sessions at two public health centers in Tehran were consecutively sampled from July to September 2021. The study examined the face, content, and structural validity (through confirmatory factor analysis) of the questionnaire. The reliability of the questionnaire was assessed using measures of internal consistency. Results: The structural validity of CFKS-P was approved with 13 items and two factors (basic knowledge of fertility and misconception about fertility) based on confirmatory factor analysis (RMSEA = 0.023, 90 % CI = 0.053–0.082, TLI = 0.916 and CFI = 0.972, χ 2 = 148.345). Kuder–Richardson coefficient of the scale was calculated to be 0.85. The overall percentage of correct answers for fertility knowledge was 50.76 %. Conclusion: The CFKS-P is a valid and reliable instrument for measuring the fertility knowledge in Iranian men and women. This scale can help the health care providers to assess the fertility knowledge of their clients or the quality of health education provided.
  • Akiko Fujishima, Eri Maeda, Koki Sato, Hidekazu Saito, Chihiro Ozeki, Yukihiro Terada
    Journal of occupational health 2024/04/29 
    OBJECTIVES: Despite the recent increase in infertility and perinatal complications, preconception care is not commonly available in Japan. Working women are considered to have the greatest need for preconception care, as they increasingly marry and have children later in life. This study aimed to assess the feasibility and effectiveness of preconception check-ups in the workplace. METHODS: We provided 51 female employees aged 18-39 years with free preconception check-ups, including additional blood tests and an online medical questionnaire, during mandatory health check-ups at their workplace. A doctor provided online counselling based on the check-up results. We assessed fertility knowledge using the Cardiff Fertility Knowledge Scale (CFKS-J) and childbearing desire pre- and post-intervention. RESULTS: Preconception check-ups revealed various potential risk factors for future pregnancies, including underweight (12%), obesity (20%), Chlamydia trachomatis IgG antibody positivity (22%), low Rubella IgG antibody levels (47%), iron deficiency (12%), and 25-hydroxyvitamin D levels <30 ng/mL (98%). Post-intervention, the participants reported high satisfaction with the check-ups and significantly advanced their reproductive plans (P=0.008). Further, 95% of the participants indicated an intention to seek medical attention or make lifestyle changes. The post-intervention CFKS-J score (mean ± SD) was higher than the pre-intervention score (71.7 ± 19.3 versus 63.0 ± 22.0, P=0.006). CONCLUSIONS: We developed a preconception check-up package that can be integrated into workplace health examinations, complemented by tailored counselling. This novel check-up package is a feasible and effective approach for improving preconception health and fertility awareness.
  • Chihiro Ozeki, Eri Maeda, Osamu Hiraike, Kyoko Nomura, Yutaka Osuga
    BMC women's health 24 (1) 242 - 242 2024/04/15 
    BACKGROUND: Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity. METHODS: In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time. RESULTS: During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism. CONCLUSION: Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information. TRIAL REGISTRATION: UMIN Clinical Trials Registry number: UMIN000038917.
  • 前田恵理
    社会保障研究 (株)毎日学術フォーラム 8 (31) 464 - 478 0387-3064 2024/03 [Not refereed][Invited]
  • Mariana V Martins, Emily Koert, Randi Sylvest, Eri Maeda, Mariana Moura-Ramos, Karin Hammarberg, Joyce Harper
    Human reproduction (Oxford, England) 2023/12/13 
    Many recent societal trends have led to the need for fertility education, including the age at which individuals become parents, the development of new reproductive technologies, and family diversity. Fertility awareness has emerged as a concept very recently and is increasingly gaining recognition. However, fertility education is often neglected as there is no consensus on the appropriate content, target populations, or on who should provide it. This article attempts to provide an overview of the use of interventions to improve fertility education. We emphasize the importance of delivering evidence-based information on fertility and reproductive health through various methods while providing guidelines for their standardization and systematization. Recommendations are provided to aid the development and implementation of fertility education tools, including: the establishment of a comprehensive understanding of the target populations; the incorporation of theories of behavioural change; the inclusion of the users' perspectives and the use of participatory research; and the use of specific guidelines for increasing engagement. By following these recommendations, it is expected that fertility education resources can contribute to improving fertility literacy, empowering individuals and couples to make informed reproductive decisions, and ultimately reducing the incidence of infertility and need for fertility treatment.
  • Hiromitsu Shirasawa, Yukiyo Kumazawa, Wataru Sato, Takuya Iwasawa, Kazue Togashi, Natsuki Ono, Ayaka Fujishima, Kazumasa Takahashi, Maeda Eri, Yukihiro Terada
    Heliyon 9 (8) e19074 - e19074 2405-8440 2023/08 
    RESEARCH QUESTION: How does the cost-related oocyte cryopreservation (OoC) vary by the facility in Japan, and what data is provided on the websites about OoC procedures? DESIGN: Website survey. The websites of all 621 facilities that provide assistive reproductive technology registered in Japan were surveyed in 2021. Data included the rates of explicit statements regarding the provision of OoC for only medical reasons (medical only group) or non-medical reasons (non-medical group). Based on whether or not facilities that perform OoC clearly stated the cost on their websites, we compared the costs of OoC and annual storage cost between medical only and non-medical groups. Furthermore, we examined the stated number of OoC procedures performed and their clinical outcomes. RESULTS: Of the 621 facilities, 146 (23.5%) clearly stated that they offer OoC on their websites. Of the 88 medical only groups and 58 non-medical groups, 24 (27.3%) and 42 (72.4%) clearly stated the OoC cost, and 27 (30.7%) and 44 (75.9%) clearly states the annual oocyte storage cost, respectively. The OoC costs were significantly higher for the non-medical group than in the medical group. In the medical only group, the annual storage cost remained almost the same regardless of the number of oocytes, while in the non-medical group, the annual storage cost was 2-3 times higher than in the medical only group. Only 16 facilities (16/146, 11.0%) had mentioned the number of OoC procedures, and five facilities (3.4%) provided information on the clinical outcomes after OoC. CONCLUSION: Costs related to OoC are higher for the non-medical group in Japan. In addition, the websites contain scant information on the costs and clinical outcomes of OoC.
  • Seung Chik Jwa, Rei Goto, Eri Maeda, Takeshi Kajihara, Osamu Ishihara
    The journal of obstetrics and gynaecology research 2023/05/16 
    AIM: From April 2022, the Japanese government funding system for assisted reproductive technology (ART) has shifted from government subsidies to universal health insurance. To date, studies estimating the health care expenditure for ART are scarce. We estimated health care expenditures for ART cycles and compared the proportion of patients' out-of-pocket payment by ovarian stimulation protocols under the Japanese government subsidy system. METHODS: We linked payment information for government subsidies in Saitama Prefecture during 2016 and 2017 with the Japanese ART registry. Health care expenditures for all treatment cycles in Japan during 2017 among women aged <43 years (n = 369 757) were estimated using a generalized linear model. RESULTS: We linked 6269 subsidy applications to the Japanese ART registry. The average treatment fee for a fresh cycle was 376 434 JPY (standard deviation = 159 581). However, significant variation was observed across ovarian stimulation protocols. The estimated health care expenditure for ART during 2017 was 101 278 629 888 JPY (920 714 817 USD), leading to a 0.24% increase in the national health care expenditure for fiscal year 2017. Fresh cycles accounted for 70% of the expenditure. The proportion of the average patient out-of-pocket payment for one treatment cycle was smaller for natural (0%) and mild ovarian stimulation using clomiphene citrate (4.5%-20.7%) than those of conventional stimulation (30.3%-32.4%). CONCLUSIONS: Health insurance coverage for ART would increase national health care expenditure by 0.24%. Under the subsidy system, the proportion of the average patient out-of-pocket payment was smaller for natural and mild ovarian stimulation than conventional stimulations.
  • Yusuke Sato, Akiyuki Wakita, Eri Maeda, Yushi Nagaki, Ryohei Sasamori, Kohei Kemuriyama, Shu Nozaki, Satoru Ito, Kaori Terata, Kazuhiro Imai, Hiroshi Nanjo, Kyoko Nomura, Yoshihiro Minamiya
    Current oncology (Toronto, Ont.) 30 (5) 4724 - 4735 2023/05/04 
    Most so-called "beneficial bacteria" in gut microbiota are Gram-positive, and TLR6 recognizes the peptidoglycan (PGN) present in their cell walls. We hypothesized that a high TLR6 expression status predicts a more favorable prognosis after esophagectomy. We used an ESCC tissue microarray (TMA) to examine TLR6 expression status in ESCC patients and to determine whether TLR6 expression status correlates with prognosis after curative esophagectomy. We also examined whether PGN influences the cell proliferation activity of ESCC lines. Clinical ESCC samples from 177 patients tested for the expression of TLR6 were categorized as 3+ (n = 17), 2+ (n = 48), 1+ (n = 68), or 0 (n = 44). High TLR6 expression (3+ and 2+) correlated with significantly more favorable 5-year overall survival (OS) and disease-specific survival (DSS) after esophagectomy than a lower TLR6 expression (1+ and 0). Univariate and multivariate analyses showed that TLR6 expression status is an independent prognostic factor that affects 5-year OS. PGN significantly inhibited the cell proliferation activity of ESCC lines. This is the first study to show that high TLR6 expression status predicts a more favorable prognosis in locally advanced thoracic ESCC patients after curative esophagectomy. PGN released from "beneficial bacteria" seems to have potential to inhibit the cell proliferation activity of ESCC.
  • 前田恵理
    日本産科婦人科学会雑誌 75 (3) 0300-9165 2023 [Not refereed][Invited]
  • Yuri Akizuki, Shoko Kusunoki, Eri Maeda
    Sex Education 1468-1811 2023 
    This study aimed to assess the fertility knowledge of Japanese education undergraduates who plan to become schoolteachers and examine related factors. A cross-sectional questionnaire survey was conducted with 252 first-year education undergraduates at a Japanese university. The Cardiff Fertility Knowledge Scale (CFKS) was used to measure fertility knowledge, and other items inquiring about basic reproductive knowledge were included. We assessed the relationship between fertility knowledge and gender and the experience of future life planning, among other factors. We found that fertility knowledge varied. Participants possessed a relatively good knowledge of the relationships between fertility and female ageing, and smoking, but limited knowledge about the effect of sexually transmitted infections on fertility. Male participants answered more correctly than female participants (p < 0.01) regarding ‘sperm production’; however, female respondents answered more accurately than male respondents (p < 0.01) regarding 'timing of menopause. In Japan, the national curriculum standard for upper secondary schools was revised in 2018, and fertility was added to the Health and Physical Education curriculum. The study results suggested that it is important to include fertility in a sex education teaching curriculum for education undergraduates to enable them to deliver fertility education as teachers in the future.
  • Eri Maeda, Seung Chik Jwa, Yukiyo Kumazawa, Kazuki Saito, Arisa Iba, Ayako Yanagisawa-Sugita, Akira Kuwahara, Hidekazu Saito, Yukihiro Terada, Takashi Fukuda, Osamu Ishihara, Yasuki Kobayashi
    BMC health services research 22 (1) 1093 - 1093 2022/08/27 
    BACKGROUND: Economic disparities affect access to assisted reproductive technology (ART) treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment only for those in low- or middle-income classes due to limited governmental budgets. However, the optimal level of financial support by income class remains unclear. METHODS: We conducted a conjoint analysis of ART in Japan in January 2020. We recruited 824 women with fertility problems aged 25 to 44 years via an online social research panel. They completed a questionnaire of 16 hypothetical scenarios measuring six relevant ART attributes (i.e., out-of-pocket payment, pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours and kindness of staff) and their relations to treatment choice. RESULTS: Mixed-effect logistic regression models showed that all six attributes significantly influenced treatment preferences, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. Significant interactions occurred between high household income (≥ 8 million JPY) and high out-of-pocket payment (≥ 500,000 JPY). However, the average marginal probability of the highest-income patients (i.e., ≥ 10 million JPY, ineligible for the subsidy) receiving ART treatment at the average cost of 400,000 JPY was 47%, compared to 56 - 61% of other income participants, who opted to receive ART at an average cost of 100,000 JPY after a 300,000 JPY subsidy. CONCLUSION: Our results suggest that out-of-pocket payment is the primary determinant in patients' decision to opt for ART treatment. High-income patients were more likely to choose treatment, even at a high cost, but their income-based ineligibility for government financial support might discourage some from receiving treatment.
  • Yu Ota, Kyoko Nomura, Junko Hirayama, Eri Maeda, Junko Komatsu, Mio Nakamura, Rouko Yamada, Hitomi Ishikawa, Teiko Kobayashi, Hideko Shirakawa, Kozo Aisaka, Mariko Ono, Haruko Hiraike, Osamu Hiraike, Hiroko Okinaga
    International archives of occupational and environmental health 96 (1) 155 - 166 2022/08/01 
    PURPOSE: This study investigated the association between menstrual symptoms and the intention to leave work among female nurses in Japan. METHODS: This cross-sectional study investigated female nurses (n = 317) at two university hospitals. The items measured were their characteristics (e.g., age, body mass index), "intention to leave" work, somatic symptoms related with menstruation, self-reported menstrual characteristics (e.g., pain), physical workloads (e.g., working hours and night shifts) and psychological workloads, measured with the Copenhagen Burnout Inventory (CBI), and the Job Content Questionnaire (JCQ). Participants with at least four somatic symptoms (e.g., cold, fatigue) which are present during their menstrual cycles were considered to have "somatic symptoms associated with menstruation." We also measured serum ovarian and gonadotropin-releasing hormones. RESULTS: Approximately 40% of women answered "intention to leave" work, and 17% had "somatic symptoms associated with menstruation." Multiple logistic regression analysis suggested that nurses reporting "somatic symptoms associated with menstruation" were more likely to have "intention to leave" work: the adjusted odds ratios (AOR, 95% confidence interval [CI]) were 2.15 (1.12-4.11) in the personal-burnout model, 2.23 (1.16-4.31) in the work-related burnout model, 2.91 (1.52-5.56) in the client-related burnout model; 2.96 (1.50-5.82) in the JCQ model. There was no association between serum and gonadotropin hormones and the intention to leave. CONCLUSION: Somatic symptoms with menstruation were associated with intention to leave work among female Japanese nurses. Intervention for somatic symptoms with menstruation might support nurses to continue work.
  • Eri Maeda, Osamu Hiraike, Hiroki Sugimori, Asako Kinoshita, Maki Hirao, Kyoko Nomura, Yutaka Osuga
    Reproductive BioMedicine Online 1472-6483 2022/07
  • Satoru Motoyama, Eri Maeda, Katsunori Iijima, Yusuke Sato, Shigeto Koizumi, Akiyuki Wakita, Yushi Nagaki, Hiromu Fujita, Takatoshi Yoneya, Kazuhiro Imai, Kaori Terata, Yoshihiro Minamiya, Takahiro Higashi
    ANNALS OF SURGERY 276 (1) E16 - E23 0003-4932 2022/07 
    OBJECTIVE: To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer. SUMMARY BACKGROUND DATA: Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival. METHODS: We retrieved the 2008-2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Center in Japan, divided the patients into a ≥75 group (75-79 years; n = 2,935) and a ≥80 group (80 years or older; n = 2,131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the two groups. RESULTS: A significantly greater percentage of patients were treated with esophagectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥75 group and 39.0% in the ≥80 group (P < 0.001). However, among patients who received chemoradiotherapy, there was no difference in survival curve between the two groups (P = 0.17). Multivariable Cox proportional hazard analysis revealed that esophagectomy for clinical Stage II-III patients was significantly associated to better survival (adjusted HR: 0.731) (95%CI: 0.645-0.829, p < 0.001) in the ≥75 group but not the ≥80 group when compared with CRT. CONCLUSIONS: Many octogenarians do not necessarily get a survival benefit from esophagectomy. However, patients should be evaluated based on their overall health before ruling out surgery based on age alone.
  • Kyoko Nomura, Teiichiro Yamazaki, Eri Maeda, Junko Hirayama, Kyoichi Ono, Masahito Fushimi, Kazuo Mishima, Fumio Yamamoto
    Frontiers in psychology 13 863300 - 863300 1664-1078 2022 
    While changes in response to the different stages of the pandemic remain unknown, this study investigated the longitudinal impact of the COVID-19 pandemic on depressive symptoms in Japanese university students and identified factors associated with new onset of depression and suicidal ideation. Two surveys were conducted at one university in Akita, Japan, during the first COVID-19 outbreak period (T1: May-June 2020) and 1 year later (T2: March-May 2021). Moderate depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥ 10 and suicide-related ideation score ≥ 1 on question 9 of the questionnaire. Among 985 students who completed surveys in T1 and T2, participants with moderate depressive symptoms and suicide-related ideation increased from 11 to 17% and from 5.8 to 11.8%, respectively. Among 872 students at risk after excluding those with moderate depressive symptoms at T1, 103 students (11.8%) developed moderate depressive symptoms at T2. Among the 928 students at risk, after excluding those who had suicidal ideation at T1, 79 (8.5%) developed suicidal ideation. Multivariate logistic modeling revealed financial insecurity and academic performance as risk factors (ps < 0.01), while having someone to consult about worries was a coping factor for depressive symptoms and suicidal ideation (ps < 0.001). Our findings demonstrated that socioenvironmental factors may determine depressive symptoms of university students.
  • 韓国における人工授精および生殖補助医療の公費負担状況―保険適用の背景と影響に関する訪問調査
    前田恵理, 石原理, 左勝則, 李廷秀, 小林 廉毅
    公衆衛生 86 (1) 84 - 90 2022/01 [Refereed]
  • がん患者の主観的医療満足度の相関する因子の分析
    今野麻衣子, 瀬田川美香, 三浦京子, 山田楼子, 本山悟, 井岡亜希子, 前田恵理, 羽渕友則, 南谷佳弘, 小松順子
    秋田医学 48 37 - 45 2021/12 [Refereed]
  • Seung Chik Jwa, Osamu Ishihara, Akira Kuwahara, Kazuki Saito, Hidekazu Saito, Yukihiro Terada, Yasuki Kobayashi, Eri Maeda
    SSM - Population Health 16 100995 - 100995 2021/12 
    Background: Assisted reproductive technology (ART) is a globally established treatment; however, large disparities exist in ART use among young couples. We investigated regional-level factors associated with ART use in Japan. Methods: We calculated the use rate of ART using the number of women aged <35 years who applied for government subsidies in 2017; we divided that figure by the number of women aged 20-35 years in each prefecture. Prefectural-level average household income; social capital indicators including voting rate, volunteer rate, and move-in rate; and Gini coefficients as indicators of income inequality were linked to ART use, adjusting for prefectural size, the mean age of women at first marriage, number of ART facilities, and additional prefectural subsidies. Results: The rate of ART use (per 10,000 women) varied significantly from 22.0 to 58.8 across Japan's 47 prefectures. Multivariate analysis demonstrated that the use rate increased by 0.048 (95% confidence interval [CI], 0.007 to 0.088) for each 10,000-yen increase in average household income and 1.5 (95% CI, 0.65 to 2.3) for each 1% increase in volunteer rate. Conversely, the use rate decreased by 18.4 (95% CI, -28.6 to -8.1) for each 1% increase in the move-in rate. There was no significant association between ART use and income inequality. Conclusion: Although we cannot infer causal relationships, the findings suggest that improving financial access and enhancing social capital may increase access to ART. Further research, particularly multilevel analysis using individual data, is required to confirm these findings.
  • Development of a health literacy scale for preconception care: a study of the reproductive age population in Japan
    Suto M, Mitsunaga H, Honda Y, Maeda E, Ota E, Arata N
    BMC Public Health 2021/11 [Refereed][Not invited]
  • Seung Chik Jwa, Osamu Ishihara, Akira Kuwahara, Kazuki Saito, Hidekazu Saito, Yukihiro Terada, Yasuki Kobayashi, Eri Maeda
    Reproductive medicine and biology 20 (4) 451 - 459 2021/10 
    Purpose: We investigated the cumulative live birth rate (CLBR) in women receiving governmental subsidies for assisted reproductive technology (ART) in Saitama Prefecture, Japan. Methods: Women who applied for subsidies from Saitama Prefectural Government for the first time in 2016 were enrolled and followed up until the end of 2017. Treatment information, including live birth, was obtained from the Japanese ART registry by linking it with unique identification numbers for treatment. Patients' factors associated with having a live birth were investigated. Results: Of 1,072 women (2,513 applications), 495 (46.2%) had a live birth with 8 (1.6%) twin pregnancies. The CLBR over six subsidized cycles was 53.7% for women aged <40 years, and 17.2% over three subsidized cycles for women 40-42 years; highest among women <35 years (58.4%), followed by those aged 35-39 years (49.3%). Multivariate analysis revealed patient age as the only independent factor for having a live birth. Conclusions: The CLBR of women receiving subsidies for ART was greatest in women aged <35 years. Effective policies for promoting ART among younger couples who seek infertility treatment are essential.
  • Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Kohei Kemuriyama, Yoshihiro Sasaki, Kazuhiro Imai, Eri Maeda, Yoshihiro Minamiya
    Annals of surgical oncology 29 (2) 1336 - 1346 2021/08/05 
    BACKGROUND: Patients with 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)-positive lymph nodes before treatment have a poor prognosis after esophagectomy. This study investigated whether FDG uptake into lymph nodes on FDG-PET (PET-N) during the pre- or posttreatment stage is more predictive of survival for thoracic esophageal squamous cell carcinoma (TESCC) patients who received neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy. METHODS: Of 129 TESCC patients with clinical lymphatic metastasis who underwent curative-intent esophagectomy after NACRT between 2010 and 2018, 97 who received PET before and after NACRT were enrolled in the study. The study defined lymph nodes with a maximum standardized uptake value (SUVmax) greater than 2.5 on FDG-PET before NACRT as cPET-N(+) and after NACRT as CRT-cPET-N(+). Both the cPET-N(+) and CRT-cPET-N(-) patients were defined as PET-N responders. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. RESULTS: No significant difference in survival was detected between the cPET-N(+) and cPET-N(-) patients. However, the CRT-cPET-N(-) patients had significantly better 5-year overall survival (OS) and disease-specific survival (DSS) than the CRT-cPET-N (+) patients. The PET-N responders had significantly better 5-year OS and DSS than the PET-N non-responders, and PET-N response was an independent prognostic factor for 5-year DSS. CONCLUSION: The PET-N response is a highly predictive prognostic marker for TESCC patients who undergo NACRT followed by esophagectomy. The PET-N response may help clinicians to establish a strategy for perioperative treatments that improves survival for patients with lymph node metastasis in TESCC.
  • Arisa Iba, Eri Maeda, Seung Chik Jwa, Ayako Yanagisawa-Sugita, Kazuki Saito, Akira Kuwahara, Hidekazu Saito, Yukihiro Terada, Osamu Ishihara, Yasuki Kobayashi
    Reproductive health 18 (1) 165 - 165 2021/08/03 
    BACKGROUND: Fertility treatments help many infertile couples to have children. However, disparities exist in access to fertility tests and treatments. We investigated the association between household income and medical help-seeking for fertility in Japan. METHODS: We conducted a cross-sectional study using nationally representative data from the National Fertility Survey 2015. Respondents were 6598 married women younger than 50 years old. The primary outcome was medical help-seeking for fertility among those who experienced fertility problems. Multiple logistic regression models were used to assess the association between household income and medical help-seeking, adjusting for age, length of marriage, educational level, employment status, number of children, childbearing desires, living with parents, and region of residence. RESULTS: Among 2253 (34%) women who experienced fertility problems, 1154 (51%) sought medical help. The proportion of help-seekers increased linearly from 43% in the low-income group (< 4 million Japanese yen [JPY]) to 59% in the high-income group (≥ 8 million JPY) (P for trend < 0.001). Respondents with upper-middle (6-8 million JPY) or high household income were more likely to seek medical help, compared to those with low household income: adjusted odds ratio [aOR] 1.37 (95% confidence interval [CI]: 1.00-1.86) and aOR 1.78 (95% CI: 1.29-2.47), respectively. CONCLUSIONS: We found that higher household income was associated with a higher probability of seeking medical help among Japanese women who experienced fertility problem. Along with policy discussion about additional financial support, further studies from societal, cultural, or psychological views are required.
  • Satoru Motoyama, Eri Maeda, Katsunori Iijima, Akira Anbai, Yusuke Sato, Akiyuki Wakita, Yushi Nagaki, Hiromu Fujita, Yoshihiro Minamiya, Takahiro Higashi
    Cancer science 112 (10) 4281 - 4291 2021/07/19 
    To address the major issue of regional disparity in the treatment for elderly cancer patients in an aging society, we compared the treatment strategies used for elderly patients with thoracic esophageal cancer and their survival outcomes in metropolitan areas and other regions. Using the national database of hospital-based cancer registries in 2008-2011, patients aged 75 years or older who had been diagnosed with thoracic esophageal cancer were enrolled. We divided the patients into two groups: those treated in metropolitan areas (Tokyo, Kanagawa, Osaka, Aichi, Saitama, and Chiba prefectures) with populations of 6 million or more and those treated in other areas (the other 41 prefectures). Compared were patient backgrounds, treatment strategies, and survival curves at each cancer stage. In total, 1236 (24%) patients from metropolitan areas and 3830 (76%) patients from nonmetropolitan areas were enrolled. Patients in metropolitan areas were treated at more advanced stages. There was also a difference in treatment strategy. The 3-year survival rate among cStage I patients was better in metropolitan areas (71.6% vs. 63.7%), and this finding mainly reflected the survival difference between patients treated with radiotherapy alone. For cStage II-IV patients, there were no differences. Multivariable Cox proportional hazard analysis including interaction terms between treatment areas, cStage, and the first-line treatments revealed that treatments in the metropolitan areas were significantly associated with better survival among patients treated with radiotherapy alone for cStage I cancer. Treatment strategies for elderly patients with thoracic esophageal cancer and its survival outcomes differed between metropolitan areas and other regions.
  • コンジョイント分析による生殖補助医療の費用と受療意思の関連の検討
    前田 恵理, 左 勝則, 熊澤 由紀代, 齊藤 和毅, 射場 有紗, 柳澤 綾子, 桑原 章, 齊藤 英和, 寺田 幸弘, 福田 敬, 石原 理, 小林 廉毅
    東北公衆衛生学会誌 東北公衆衛生学会 (70) 36 - 36 0915-549X 2021/07
  • 大学病院に勤務する女性看護師における性周期に伴う身体不定愁訴の離職意向に及ぼす影響
    太田 友, 野村 恭子, 平山 純子, 前田 恵理, 小松 順子, 中村 美央, 山田 楼子, 石川 ひとみ, 小林 禎子, 白川 秀子, 土谷 明子, 平池 春子, 合阪 幸三, 平池 修, 冲永 寛子
    東北公衆衛生学会誌 東北公衆衛生学会 (70) 10 - 10 0915-549X 2021/07
  • Eri Maeda, Osamu Ishihara, Jun Tomio, Hiroshi Miura, Yasuki Kobayashi, Yukihiro Terada, Katsuyuki Murata, Kyoko Nomura
    Journal of Obstetrics and Gynaecology Research 47 (6) 2099 - 2109 2021/06/28 
    AIM: Due to the lack of national perinatal registries, population-wide descriptive statistics on cesarean deliveries in Japan are unknown. We aim to describe cesarean deliveries for overall and multiple pregnancies using the Japan National Database of health insurance claims. METHODS: We calculated the national and prefectural cesarean delivery rates for overall and multiple pregnancies in 2014. We described maternal morbidities (e.g., blood transfusion) and the place and type of the institutions providing prenatal and perinatal care. RESULTS: The national cesarean delivery rates were 18.6% overall and 82.7% for women with multiple pregnancies. Prefectural cesarean delivery rates for overall and multiple pregnancies varied from 12.5% to 24.2% and from 49.2% to 100%, respectively, showing a moderate positive correlation (r = 0.59, p < 0.001). Overall, 1.4% of cesarean patients received an allogeneic blood transfusion, compared to 3.2% for those with multiple pregnancies. In addition, 65.9% of overall cesarean deliveries occurred at hospitals with ≥20 beds, whereas 94.6% of cesarean patients with multiple pregnancies delivered at hospitals. Older patients were more likely to receive their cesarean section at a different institution than their first visit within the same prefecture, but trans-prefectural movement during pregnancy covered by health insurance was most frequent among those in their early thirties: 7.0% overall and 10.7% for multiple pregnancies. CONCLUSIONS: The overall cesarean delivery rate in Japan was optimal, but the rate was high for multiple pregnancies, with large regional differences. Data on patient movement across institutions and areas would help to improve the perinatal care system.
  • Takuya Iwasawa, Toshifumi Takahashi, Eri Maeda, Koichi Ishiyama, Satoshi Takahashi, Ryota Suganuma, Koki Matsuo, Masahito Tachibana, Rie Fukuhara, Hiromitsu Shirasawa, Wataru Sato, Yukiyo Kumazawa, Yukihiro Terada
    Reproductive biology and endocrinology : RB&E 19 (1) 84 - 84 2021/06/04 
    BACKGROUND: Uterine adenomyosis is a benign disease, common among women in their 40 and 50 s, characterised by ectopic endometrial tissue in the uterine myometrial layer. Adenomyosis causes infertility and has a negative effect on the outcomes of in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) embryo transfer (ET) cycles. It has also been reported to have different characteristics depending on the adenomyotic lesion localisation. The effect of its localisation on IVF/ICSI-ET outcomes is unclear. This study aimed to investigate whether adenomyotic lesion localisation, assessed using magnetic resonance imaging (MRI), was associated with outcomes of IVF/ICSI-ET cycles. METHODS: This multicentre, joint, retrospective cohort study analysed the medical records of 67 infertile patients with adenomyosis who underwent IVF/ICSI with fresh and frozen-thawed ET at five participating facilities from January 2012 to December 2016 and for whom MRI data were available. Fifteen patients were excluded; therefore, the MRI data of 52 patients were evaluated by two radiologists. We assessed the localisation of and classified adenomyotic lesions into advanced (invades the full thickness of the uterine myometrium), extrinsic (localised on the serosal side), and intrinsic (localised on the endometrial side) subtypes. RESULTS: There were 40 advanced, nine extrinsic, and three intrinsic cases, and the outcomes of 100, 27, and nine ET cycles, respectively, were analysed. Pregnancy loss/clinical pregnancy and live birth rates of the advanced, extrinsic, and intrinsic groups were 64 % (16/25) and 9 % (9/100), 33.3 % (3/9) and 22.2 % (6/27), and 50 % (1/2) and 11.1 % (1/9), respectively. A logistic regression analysis adjusted for age, prior miscarriage, and body mass index showed that the extrinsic group had fewer pregnancy losses (odds ratio 0.06; 95 % confidence interval [CI]: 0.00-0.54, p = 0.026) and more live births (odds ratio 6.05; 95 % CI: 1.41-29.65, p = 0.018) than the advanced group. CONCLUSIONS: Adenomyotic lesions exert different effects on IVF/ICSI-ET outcomes. Thus, MRI assessments of adenomyosis in infertile patients are beneficial. Establishment of treatment plans based on adenomyotic lesion localisation should be considered.
  • Kyoko Nomura, Sachiko Minamizono, Eri Maeda, Roseline Kim, Toyoto Iwata, Junko Hirayama, Kyoichi Ono, Masahito Fushimi, Takeshi Goto, Kazuo Mishima, Fumio Yamamoto
    Environmental health and preventive medicine 26 (1) 30 - 30 1342-078X 2021/03/05 
    BACKGROUND: We aimed to estimate the prevalence of depressive symptoms as well as suicide-related ideation among Japanese university students during the stay-home order necessitated by the coronavirus disease 2019 pandemic in Japan, and offer evidence in support of future intervention to depression and suicide prevention strategies among college and university students. METHODS: The data for this cross-sectional study were derived from the Student Mental Health Survey conducted from May 20 to June 16, 2020 at a national university in Akita prefecture. Among the 5111 students recruited, 2712 participated in this study (response rate, 53%; mean age ± standard deviation, 20.5 ±3.5 years; men, 53.8%). Depressive symptoms were identified by using the Patient Health Questionnaire-9 (PHQ-9). RESULTS: The prevalence of moderate depressive symptoms based on a PHQ-9 score ≥10 and suicide-related ideation based on question 9 of PHQ-9 ≥1, which encompasses thoughts of both suicide and self-harm, was 11.7% and 6.7%, respectively. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both depressive symptoms and suicide-related ideation. CONCLUSIONS: Negative lifestyles of smoking and drinking, and being a woman, may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be protective factors.
  • Akiyuki Wakita, Satoru Motoyama, Yusuke Sato, Yushi Nagaki, Hiromu Fujita, Kaori Terata, Kazuhiro Imai, Eri Maeda, Yoshihiro Minamiya
    The Journal of surgical research 259 137 - 144 2021/03 
    BACKGROUND: Insulin-like growth factor-II mRNA binding protein 3 (IGF2BP3) is an oncofetal RNA-binding protein normally involved in cell growth and migration during the early stages of embryogenesis. However, it is also expressed in various cancers, and the relationship between IGF2BP3 and the clinicopathological features and prognosis of esophageal squamous cell carcinoma patients is not fully understood. Our aim in this study was to determine whether IGF2BP3 expression status correlates with prognosis in patients with advanced thoracic esophageal squamous cell carcinoma. METHODS: The IGF2BP3 expression statuses of 177 patients treated with esophagectomy without preoperative therapy were evaluated immunohistochemically using tissue microarray analysis. The relationships between IGF2BP3 expression status and clinicopathological features and survival were then assessed using appropriate statistics. RESULTS: Among 177 esophageal tumors, 122 (68.9%) expressed high levels of IGF2BP3. In patients undergoing surgery alone, IGF2BP3-high expression was significantly associated with a poorer prognosis. By contrast, there were no significant associations between IGF2BP3 expression and clinicopathological features or outcomes in patients treated with surgery plus postoperative adjuvant chemotherapy. CONCLUSIONS: IGF2BP3 positivity in advanced thoracic esophageal squamous cell carcinoma is associated with adverse clinical outcomes in patients treated with surgery alone.
  • 【QOLを考える】不妊症とQOL
    前田 恵理
    産科と婦人科 (株)診断と治療社 88 (3) 325 - 329 0386-9792 2021/03 [Not refereed][Invited]
     
    FertiQoLは、世界保健機関の示すQOLの概念に基づいて、不妊に悩むすべての人を対象とした疾患特異的QOL尺度であり、妥当性と信頼性の高い国際尺度である。FertiQoLの36項目により、不妊の問題に伴う否定的な感情や心身の症状、夫婦関係、社会とのかかわり、治療への忍容性、治療環境を評価する。日常診療、臨床研究、政策提言と幅広く用いることができるため、多くの医療関係者にそれぞれの現場で活用していただき、国内の知見が一層蓄積されていくことを期待する。(著者抄録)
  • Yuko Takayama, Yuko Masuzaki, Futoshi Mizutani, Toyoto Iwata, Eri Maeda, Mikako Tsukada, Kyoko Nomura, Yasunori Ito, Yoichi Chisaki, Katsuyuki Murata
    The Science of the total environment 750 141517 - 141517 2021/01/01 
    Blood arsenic has various toxicities including carcinogenicity, but urinary concentrations are often substituted to determine the exposure level. Since there is little information on the relation of urinary arsenic species to blood arsenic, the aim was to investigate relationships between blood total arsenic (T-As) and the urinary species adjusted by creatinine and specific gravity (SG). Blood and spot urine samples were collected from 109 Japanese subjects aged 18-66 years without occupational exposure. Positive correlations of blood T-As (median, 3.49 μg/L) with urinary creatinine-adjusted and SG-adjusted T-As and arsenobetaine were statistically significant and greater than those with the unadjusted ones. The magnitude of associations of blood T-As with creatinine-adjusted arsenic species was significantly larger than those with unadjusted or SG-adjusted ones. Most of the correlation coefficients among urinary arsenic species concentrations were significant in three adjustment methods, but there was not a significant correlation between monomethylarsonic acid and arsenobetaine after urinary creatinine and SG corrections. Given multiple regression analysis, plasma T-As concentrations showed significant relations to creatinine-adjusted T-As, dimethylarsinic acid, and arsenobetaine concentrations, but erythrocyte T-As did hardly reflect the variation of urinary arsenic species. In conclusion, creatinine-adjusted arsenic concentrations are suggested to be the most appropriate predictor of blood T-As; by contrast, use of the urinary unadjusted arsenic concentration may result in a misleading interpretation of inorganic arsenic toxicity because the associations between inorganic and organic arsenic species based on the unadjusted concentration were mutually close. Plasma T-As appeared to be the best indicator of low-level exposure in blood samples.
  • Akiko Fujishima, Kazumasa Takahashi, Mayumi Goto, Takeo Hirakawa, Takuya Iwasawa, Kazue Togashi, Eri Maeda, Hiromitsu Shirasawa, Hiroshi Miura, Wataru Sato, Yukiyo Kumazawa, Yukihiro Terada
    PloS one 16 (1) e0246337  2021 
    Studies have shown that some electrolytes, including Na+ and K+, play important roles in embryonic development. However, these studies evaluated these electrolytes by using inhibitors or knockout mice, with no mention on the changes in the intracellular electrolyte concentrations during embryogenesis. In this study, we used the electrolyte indicators CoroNa Green AM and ION Potassium Green-2 AM to directly visualise intracellular concentrations of Na+ and K+, respectively, at each embryonic developmental stage in mouse embryos. We directly observed intracellular electrolyte concentrations at the morula, blastocyst, and hatching stages. Our results revealed dynamic changes in intracellular electrolyte concentrations; we found that the intracellular Na+ concentration decreased, while K+ concentration increased during blastocoel formation. The degree of change in intensity in response to ouabain, an inhibitor of Na+/K+ ATPase, was considered to correspond to the degree of Na+/K+ ATPase activity at each developmental stage. Additionally, after the blastocyst stage, trophectoderm cells in direct contact with the blastocoel showed higher K+ concentrations than in direct contact with inner cell mass, indicating that Na+/K+ ATPase activity differs depending on the location in the trophectoderm. This is the first study to use CoroNa Green AM and ION Potassium Green-2 AM in mouse embryos and visualise electrolytes during embryonic development. The changes in electrolyte concentration observed in this study were consistent with the activity of Na+/K+ ATPase reported previously, and it was possible to image more detailed electrolyte behaviour in embryo cells. This method can be used to improve the understanding of cell physiology and is useful for future embryonic development studies.
  • Eri Maeda, Akane Miyata, Jacky Boivin, Kyoko Nomura, Yukiyo Kumazawa, Hiromitsu Shirasawa, Hidekazu Saito, Yukihiro Terada
    Reproductive biomedicine online 41 (6) 1133 - 1143 1472-6483 2020/12 [Refereed][Not invited]
     
    RESEARCH QUESTION: What are the effects of using a fertility education chatbot, i.e. automatic conversation programme, on knowledge, intentions to improve preconception behaviour and anxiety? DESIGN: A three-armed, randomized controlled trial was conducted using an online social research panel. Participants included 927 women aged 20-34 years who were randomly allocated to one of three groups: a fertility education chatbot (intervention group), a document about fertility and preconception health (control group 1) or a document about an irrelevant topic (control group 2). Participants' scores on the Cardiff Fertility Knowledge Scale and the State-Trait Anxiety Inventory, their intentions to optimize preconception behaviours, e.g. taking folic acid, and the free-text feedback provided by chatbot users were assessed. RESULTS: A repeated-measures analysis of variance showed significant fertility knowledge gains after the intervention in the intervention group (+9.1 points) and control group 1 (+14.9 points) but no significant change in control group 2 (+1.1 points). Post-test increases in the intentions to optimize behaviours were significantly higher in the intervention group than in control group 2, and were similar to those in control group 1. Post-test state anxiety scores were significantly lower in the intervention group than in control group 1 and control group 2. User feedbacks about the chatbot suggested technical limitations, e.g. low comprehension of users' words, and pros and cons of using the chatbot, e.g. convenient versus coldness. CONCLUSIONS: Providing fertility education using a chatbot improved fertility knowledge and intentions to optimize preconception behaviour without increasing anxiety, but the improvement in knowledge was small. Further technical development and exploration of personal affinity for technology is required.
  • 前田 恵理
    産科と婦人科 (株)診断と治療社 87 (8) 881 - 886 0386-9792 2020/08 [Not refereed][Invited]
     
    プレコンセプションケアは「前思春期から生殖可能年齢にあるすべての人々の身体的・心理的および社会的な健康の保持および増進」と定義される。成人疾病胎児起源仮説にはじまるライフコース研究から発展してきた概念で、次世代を視野に入れたヘルスプロモーションの一分野である。本稿では米国、オーストラリア、スウェーデンにおけるプレコンセプションケアの取り組みを紹介し、わが国におけるプレコンセプションケア推進について考えてみたい。(著者抄録)
  • Yuto Maeda, Eri Maeda, Naoko Arata
    Congenital anomalies 60 (3) 100 - 100 2020/05 [Refereed][Not invited]
  • 前田 恵理, 平池 修, 杉森 裕樹, 野村 恭子, 大須賀 穣
    日本衛生学雑誌 (一社)日本衛生学会 75 (Suppl.) S153 - S153 0021-5082 2020/03
  • Satoru Motoyama, Eri Maeda, Masahiko Yano, Takushi Yasuda, Masaichi Ohira, Yoshiaki Kajiyama, Takahiro Higashi, Yuichiro Doki, Hisahiro Matsubara
    Esophagus : official journal of the Japan Esophageal Society 17 (2) 141 - 148 2020/01/14 [Refereed][Not invited]
     
    BACKGROUND: It will be important for the Japan Esophageal Society (JES) to show an evident advantage of its institution certification system. To achieve this essential task, we used nationally acquired big data to re-analyze 5-year survival information. METHODS: In 2008-2009, there were 4897 thoracic esophageal cancer patients who underwent esophagectomy and were registered in the National Database of Hospital-based Cancer Registries. We divided these patients into two groups, those who underwent surgery at an Authorized Institute for Board Certified Esophageal Surgeons (AIBCES) or a Non-AIBCES. We then compared the patient backgrounds and 5-year survival rates between these two groups, with and without propensity score matching. RESULTS: There were 3080 (63%) patients who underwent esophagectomy at an AIBCES and 1817 (37%) who underwent surgery at a Non-AIBCES. Comparison of the Kaplan-Meier survival curves using log-rank tests indicated a significant difference between the AIBCES and Non-AIBCES groups at all cStages (cStages I-IV). Multivariable Cox proportional hazard analysis stratified by clinical stage and adjuvant treatment revealed that AIBCES vs. Non-AIBCES is a significant independent factor (adjusted HR 0.78) for survival. After propensity score matching ensuring the backgrounds of the two groups being equivalent, there were significant differences in the 5-year survival rates for patients with cStages I-III disease between the AIBCES and Non-AIBCES groups. CONCLUSIONS: There is a survival advantage to undergoing esophagectomy at an AIBCES. The institute certification system from the JES will contribute to the future establishment of a more appropriate surgery delivery system for thoracic esophageal cancer.
  • Eri Maeda, Kyoko Nomura, Osamu Hiraike, Hiroki Sugimori, Asako Kinoshita, Yutaka Osuga
    Environmental Health and Preventive Medicine 24 (1) 75 - 75 1342-078X 2019/12/17 [Refereed][Not invited]
     
    BACKGROUND: Despite the huge burden of domestic work on women in Japan, its effects on their health have been poorly investigated. We aimed to assess the association between domestic work stress and self-rated psychological health among women. METHODS: We conducted a cross-sectional survey using an online social research panel in February 2018. Participants were 2,000 women with paid work (the "workers" group) and 1,000 women without paid work (the "homemakers" group), aged between 25 and 59 years old and living with a partner. Self-rated psychological health (Mental Health and Vitality scales of the Japanese SF-36), occupational and domestic work stress (the Brief Job Stress Questionnaire), the 10-item Work-Family Conflict Scale, and sociodemographic factors were assessed. RESULTS: The workers had lower domestic job control and higher support from a partner and their parents than the homemakers (p < 0.001), whereas domestic job demand and psychological health were similar between the groups. After adjustment for the covariates using multiple linear regression models, better psychological health was significantly associated with lower domestic job demand, higher domestic job control, and having a young child in both groups. In addition, work-family conflicts and occupational job stress among the workers and caregiving among the homemakers showed negative associations with psychological health. CONCLUSION: Self-rated psychological health in women was associated with domestic work stress regardless of employment status. To promote women's health, we need to take into account the effects of domestic work, work-family conflicts, and social support from families, as well as occupational factors.
  • 楠木祥子, 秋月百合, 前田恵理
    熊本大学教育学部紀要 熊本大学 68 (68) 173 - 179 2188-1871 2019/12 [Refereed][Not invited]
     
    type:論文(Article) 【目的】本研究では，大学生向けの妊孕性・不妊に関する知識を高める授業プログラムを作成し，その効果を検討することを目的とした．【方法】2017年4～5月，A大学教育学部1年生33名を介入群として授業プログラムを実施した．介入群を除く同学部1年生219名を対照群とし，Cardiff Fertility Knowledge Scale（CFKS）13項目および独自に作成した｢生殖に関する知識｣4項目を含むアンケートを，授業前は介入群および対照群に，授業後は介入群に実施した．分析には，χ2検定およびMcNemar検定，マンホイットニーU 検定，ウィルコクソン符号付順位検定を用いた．【結果】CFKS13項目中7項目で，対照群に比べ授業後の介入群の方が有意に正答率が高く，平均正答数も対照群より授業後の介入群が有意に高かった．介入群における授業前後のCFKSの正答率は，先述の7項目中5項目において授業後に有意に高まり，平均正答数も授業前より授業後のほうが有意に高かった．「生殖に関する知識」では4項目すべてにおいて，対照群より授業後の介入群が，また介入群の授業前より授業後の方が，有意に高い正答率であった．【結論】本研究で作成した妊孕性・不妊に関する知識を高める授業プログラムは，教育学部生の妊孕性・不妊に関する知識を高める可能性が示唆された．
  • プレコンセプションケアにおける教育・啓発の意義
    前田 恵理
    産婦人科の実際 68 (10) 1249 - 1254 2019/10 [Not refereed][Invited]
  • Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Kanno H, Maeda E, Saito H
    Surgery today 49 (7) 580 - 586 0941-1291 2019/07 [Refereed][Not invited]
  • 前田 恵理, 村田 勝敬, 熊澤 由紀代, 佐藤 亘, 白澤 弘光, 岩澤 卓也, 出雲 公子, 龍田 希, 坂本 峰至, 寺田 幸弘
    日本衛生学雑誌 (一社)日本衛生学会 74 (Suppl.) S141 - S141 0021-5082 2019/02
  • Eri Maeda, Katsuyuki Murata, Yukiyo Kumazawa, Wataru Sato, Hiromitsu Shirasawa, Takuya Iwasawa, Kimiko Izumo, Nozomi Tatsuta, Mineshi Sakamoto, Yukihiro Terada
    Environmental Research 168 357 - 363 0013-9351 2019/01 [Refereed][Not invited]
     
    BACKGROUND: Methylmercury exposure is a common health risk resulting from daily fish intake. However, studies addressing the link between methylmercury and infertility are limited and also inconsistent. In addition, no previous epidemiological studies have accounted for the interaction between methylmercury and selenium. We aimed to investigate the association between environmental exposures to metals and female fertility. METHODS: This case-control study included 98 infertile women receiving fertility treatment (infertile group) and 43 female workers in their thirties (control group) who provided blood samples and returned a questionnaire on lifestyles and dietary characteristics. Blood levels of mercury, lead, cadmium, arsenic, manganese, zinc, and selenium were compared between the groups. Spearman correlation analyses between anti-Müllerian hormone and the metals were conducted. RESULTS: The mean selenium level in blood (± SD) and the selenium/mercury molar ratio were significantly lower in the infertile group (189 ± 25 μg/L and 94.6 ± 44.3, respectively) than in the control group (200 ± 25 μg/L and 118.4 ± 70.5). By contrast, blood mercury levels after adjusting for blood selenium and age were significantly higher in the infertile group than in the control group. Multiple logistic regression analyses with the adjustment for the other metals and potential confounders confirmed significant associations of infertility with elevated mercury and reduced selenium levels. No significant correlations were observed between anti-Müllerian hormone and metals. CONCLUSIONS: Methylmercury and selenium exposures appear to have adverse and protective effects on female fertility, respectively. This is the first report to suggest the antagonistic interaction between methylmercury and selenium in relation to human female fertility.
  • Motoyama S, Maeda E, Yano M, Yasuda T, Ohira M, Doki Y, Toh Y, Higashi T, Matsubara H, Japan Esophageal Society
    Esophagus : official journal of the Japan Esophageal Society 16 (1) 114 - 121 1612-9059 2018/10 [Refereed][Not invited]
     
    BACKGROUND: Since 2013, The Japan Esophageal Society has been certifying "Authorized Institute for Board Certified Esophageal Surgeon (AIBCES)" to contribute to improving national medical care by enhancing the professional knowledge and skills of esophageal surgeons. However, the appropriateness on this certification system has not yet been verified. Our aim was to assess the appropriateness of the institute certification system for esophageal surgeries used by the medical society. METHODS: Using data from the National Database of Hospital-based Cancer Registries, we analyzed the 5-year overall survival rates among 2135 patients with thoracic esophageal cancer who underwent an esophagectomy at 53 AIBCES or 141 non-AIBCES. RESULTS: There were 1343 (63%) patients who underwent surgery at an AIBCES and 792 (37%) who underwent surgery at a non-AIBCES. Registered patients were followed up for a median of 53 (range 1-88) months. Over the followed-up period examined, 670 (50%) patients treated at an AIBCES died and 455 (57%) treated at a non-AIBCES died. Comparison of the Kaplan-Meier survival curves indicated that patients with cStage II or cStage III disease treated at an AIBCES had significantly better 5-year survival rates than those treated at a non-AIBCES (55.4% vs. 44.9% and 38.0% vs. 30.3%, respectively). Univariate and multivariate analyses stratified based on stages and adjuvant therapies revealed that institute certification (AIBCES vs. non-AIBCES) is a significant independent factor for 5-year survival. CONCLUSIONS: The institute certification system used by the Japan Esophageal Society may be appropriate, as indicated by improved 5-year survival outcomes. The institute certification system has the potential to contribute to a more appropriate medical delivery system in the future.
  • Maeda E, Boivin J, Toyokawa S, Murata K, Saito H
    Human reproduction (Oxford, England) 33 (11) 2035 - 2042 0268-1161 2018/09 [Refereed][Not invited]
  • Karita K, Iwata T, Maeda E, Sakamoto M, Murata K
    Toxics 6 (3) 2018/07 [Refereed][Not invited]
  • Eri Maeda, Osamu Ishihara, Jun Tomio, Aya Sato, Yukihiro Terada, Yasuki Kobayashi, Katsuyuki Murata
    Journal of Obstetrics and Gynaecology Research 44 (2) 208 - 216 1447-0756 2018/02/01 [Refereed][Not invited]
     
    Aim: High cesarean section (CS) rates in middle and high-income countries are partly attributable to provider factors, such as staffing patterns and fear of litigation. However, the relationship between CS rates and healthcare resources in the community is poorly understood. Official data on CS rates has been particularly limited in Japan. In this study, we examined nationwide CS statistics and evaluated the association with local resources for perinatal care. Methods: We used accumulated data for CS registered in the Japan National Database of health insurance claims in 2013 and calculated crude and age-standardized CS rates at national and prefectural levels. We analyzed the ecological associations with supply of obstetricians and institution and scale of obstetric facilities using multiple regression models. Results: There were 190 361 cesarean deliveries in 2013, giving an overall CS rate of 18.5% (elective CS rates 11.0%), which varied by prefecture from 14.0% to 25.6%. In multiple regression analyses, the areal number of obstetricians (standardized regression coefficient [β] = −0.58), the proportion of births at small-scale institutions (β = 0.36) and the number of beds at neonatal intensive care units per birth (β = −0.20) were significantly associated with the age-standardized elective CS rate after adjusting for socioeconomic factors (R2 for the model = 0.40). Conclusions: Higher elective CS rates might be associated with limited or unconsolidated medical resources. Policymakers should be aware of regional differences and the possible effects of perinatal care resources on CS rates.
  • MURATA Katsuyuki, IWATA Toyoto, MAEDA Eri, KARITA Kanae
    Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene) 一般社団法人日本衛生学会 73 (2) 148 - 155 0021-5082 2018 [Not refereed][Not invited]
     

    This article presents not only a brief overview of birth cohort studies focusing on environmental health in which the associations between health and environment were examined, but also a tentative plan to apply epidemiological data to benchmark dose calculation. According to the preceding studies, the checkpoints to be scrutinized when a result is not consistent with those of other researchers are as follows: (1) whether the study included all crucial confounders, (2) whether it included any exposure marker or confounder with a U-shaped dose-response curve, (3) whether the outcome measure was conducted by two or more examiners that might lead to measurement bias, (4) whether such examiners picked up information about exposure levels of the subjects before measuring the endpoints, and (5) whether subjects with different genetic factors were included in the analysis. In addition, (6) researchers conducting a children's study on developmental effects due to toxic substances must keep in mind that the impact of prenatal methylmercury exposure, independent of postnatal exposure, may continue for at least seven years. (7) When an environmental health research emphasizes to be population-based study, the levels of exposure to environmental chemical substances in developed countries with strict environmental regulations may be too low to examine a dose-response relationship for critical dose estimation. Such risk assessment should be carried out among the subjects with a wide range of exposure levels.

  • Mamiko Enoki, Eri Maeda, Toyoto Iwata, Katsuyuki Murata
    Tohoku Journal of Experimental Medicine 243 (4) 321 - 328 1349-3329 2017/12/01 [Refereed][Not invited]
     
    There is little epidemiological evidence linking subjective stress to objective etiologic indicators. To clarify an association between work-related stress and autonomic nervous function, we examined call center employees (167 males and 371 females) undergoing electrocardiography (ECG) at the time of annual health checkups. The questionnaire was composed of the Brief Job Stress Questionnaire based on the demand-control-support model and the Social Readjustment Rating Scale including detailed contents of home stress. The Bazett’s corrected QT (QTc) interval, QT index, and heart rate were obtained from the ECG data. The male employees showed significantly higher scores of job demand, job control, and supervisor support than the female ones. In the male employees, QT index indicating the extent of autonomic imbalance and heart rate were associated with high score of supervisor support and low score of coworker support (P < 0.05), but no significant relationships were seen between QTc interval and either job strain (i.e., job demand and job control) or home stress. By contrast, the female employees showed no significant links between any autonomic indicators and either work-related stress or home stress. These data suggest that work-related stress affected QT index in male employees suffering specific occupational stressors such as emotional abuse from unsatisfied customers. Specifically, supports from supervisors and coworkers were paradoxically associated with QT index, implying that supervisors may have failed to effectively support such male employees. Also, autonomic nervous function in male employees appears to be more vulnerable to work-related stress than that in female ones.
  • Oa Tanaka, Eri Maeda, Masahito Fushimi, Toyoto Iwata, Tetsuo Shimizu, Seiji Saito, Katsuyuki Murata
    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 243 (1) 19 - 26 0040-8727 2017/09 [Refereed][Not invited]
     
    Some epidemiological studies with a large number of subjects, like a national health study, reported that precarious employment was associated with increased depressive symptoms, but this hypothesis may not be applicable to precarious workers of all industry types. We examined the association between precarious employment and depressive symptoms in light of work-related stress in care work environments. The self-administered questionnaire, composed of the Job Content Questionnaire based on the demand-control support model and the Center of Epidemiological Studies Depression Scale (CES-D), was distributed, and a total of 1,338 permanent and 531 precarious employees responded to it with complete forms. In the precarious employees, scores of CES-D, job demand and job control were lower and supervisor support score was higher compared with the permanent employees, though there was no significant difference in the proportion of CES-D score >= 16 between the two groups. Multivariate analysis with adjustment for possible confounders revealed that increased depressive symptoms were associated with low coworker support in the precarious employees and with high demand and low control at work, low support from supervisors and coworkers in the permanent employees. However, precarious employment was not significantly associated with depressive symptoms in the male or female employees. In conclusion, our results do not support the above hypothesis at least in care service workers. Such a hypothesis should be verified in employees of each industry separately. Instead, coworker support within each workplace appears to be important for the preventive strategy of depression in workers including precarious employees.
  • Satoshi Toyokawa, Eri Maeda, Yasuki Kobayashi
    DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY 59 (3) 317 - 321 0012-1622 2017/03 [Refereed][Not invited]
     
    AIM Japan lacks a population-based registration system for cerebral palsy (CP), therefore the nationwide prevalence of CP is unknown. Our aim was to estimate the number of children with CP using the National Database of Health Insurance Claims and Specific Health Checkups of Japan, which has been recently developed by the government. METHOD Study participants were children and adolescents aged below 20 years, who had been assigned CP diagnosis codes more than once in claims issued between June 2012 and May 2013 from all health insurance schemes in Japan, except for Social Welfare and Elderly Health Insurance. RESULTS The number of participants with diagnosed CP was 44 381. The number of males with CP (25 237) was greater than the number of females (19 144). Peak CP prevalence per 1000 population was 2.39 at age 4 years, and this gradually declined with age. The prevalence of CP per 1000 population was 2.27 at age 5 to 9 years. The numbers of inpatients and outpatients with CP were 9126 (20.6%) and 35 255 (79.4%) respectively. INTERPRETATION Our estimation of CP prevalence per 1000 population at age 5 to 9 years lay in the higher range of figures from previous studies in Japan, and was close to figures reported by European countries.
  • Toyoto Iwata, Shigeru Takaoka, Mineshi Sakamoto, Eri Maeda, Masaaki Nakamura, Xiao-Jie Liu, Katsuyuki Murata
    JOURNAL OF TOXICOLOGICAL SCIENCES 41 (6) 757 - 763 0388-1350 2016/12 [Refereed][Not invited]
     
    About forty certified patients aged around 50 years old existed as living witnesses to fetal-type Minamata disease (methylmercury poisoning due to in utero exposure) in Minamata, Japan in 2006. Computerized hand tremor and postural sway tests with spectral analysis were conducted for 24 of them and in matched control subjects to examine the pathophysiological feature of neuromotor function. The tremor intensities of the patients with fetal-type Minamata disease were significantly larger than those of the 67 controls at every frequency band for both hands. In the patients, proportions for intensity at 1-6 Hz of both hands were larger, but those of the intensity at 6-10 Hz were smaller compared with the controls. The center frequency of a tremor was significantly lower in the patients than in the controls. Only eight males of the 24 patients were examined to evaluate postural sway because of extremely low scores in activities of daily living in the remaining. Most of the postural sway parameters obtained with eyes open and closed were significantly larger in the patients than in the male controls. Likewise, Romberg quotients of postural sway in anterior-posterior direction were significantly higher in the patients. In conclusion, the patients with fetal-type Minamata disease of our study showed a larger tremor of low frequency at less than 6 Hz and postural instability. Spectral analyses of computerized hand tremor and postural sway are suggested to be useful for assessing the pathophysiological change, related to a lesion of the cerebellum, resulting from prenatal methylmercury exposure.
  • Eri Maeda, Takahiro Higashi, Tomonobu Hasegawa, Susumu Yokoya, Takahiro Mochizuki, Tomohiro Ishii, Junko Ito, Susumu Kanzaki, Akira Shimatsu, Koji Takano, Toshihiro Tajima, Hiroyuki Tanaka, Yusuke Tanahashi, Akira Teramoto, Toshiro Nagai, Kunihiko Hanew, Reiko Horikawa, Toru Yorifuji, Naohiro Wada, Toshiaki Tanaka
    BMC HEALTH SERVICES RESEARCH 16 (1) 602  1472-6963 2016/10 [Refereed][Not invited]
     
    Background: Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation. Methods: A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects. Results: Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P < 0.001). The odds ratios of financial support to continuing treatment were 4.04 (95 % confidence interval [CI]: 1.86-8.78) in boys and 1.72 (95 % CI: 0.80-3.70) in girls, after adjusting for demographic characteristics and clinical factors. Conclusions: Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.
  • メチル水銀、水銀およびセレンに関する研究動向 疫学研究を中心に
    苅田 香苗, 坂本 峰至, 吉田 稔, 龍田 希, 仲井 邦彦, 岩井 美幸, 岩田 豊人, 前田 恵理, 柳沼 梢, 佐藤 洋, 村田 勝敬
    日本衛生学雑誌 (一社)日本衛生学会 71 (3) 236 - 251 0021-5082 2016/09 [Not refereed][Not invited]
  • E. Maeda, F. Nakamura, Y. Kobayashi, J. Boivin, H. Sugimori, K. Murata, H. Saito
    HUMAN REPRODUCTION 31 (9) 2051 - 2060 0268-1161 2016/09 [Refereed][Not invited]
     
    STUDY QUESTION: What are the effects of fertility education on knowledge, childbearing desires and anxiety? SUMMARY ANSWER: Providing fertility information contributed to greater knowledge, but increased anxiety. WHAT IS KNOWN ALREADY: Past studies have found that exposure to educational material improved fertility awareness and changed desires toward childbearing and its timing. Existing educational websites with evidence-based medical information provided in a non-judgmental manner have received favorable responses from reproductive-aged men and women. STUDY DESIGN, SIZE, DURATION: This three-armed (one intervention and two control groups), randomized controlled trial was conducted using online social research panels (SRPs) in Japan in January 2015. PARTICIPANTS/MATERIALS, SETTING,METHODS: A total of 1455 participants (726 men and 729 women) between 20 and 39 years of age who hoped to have (more) children in the future were block-randomized and exposed to one of three information brochures: fertility education (intervention group), intake of folic acid during pregnancy (control group 1) or governmental financial support for pregnancy and childbirth (control group 2). Fertility knowledge was measured with the Japanese version of the Cardiff Fertility Knowledge Scale (CFKS-J). Knowledge, child-number and child-timing desires, subjective anxiety (i.e. whether participants felt anxiety [primary outcome]), and scores on the State-Trait Anxiety Inventory were assessed immediately after exposure. Non-inferiority comparisons were performed on subjective anxiety with non-inferiority declared if the upper limit of the two-sided 95% confidence interval (CI) for risk difference did not exceed a margin of 0.15. This test for non-inferiority was only performed for subjective anxiety; all the other variables were tests of superiority. MAIN RESULTS AND THE ROLE OF CHANCE: Posttest scores on the CFKS-J (mean, SD) were higher in the intervention group than that of the control groups: intervention versus Control 1 and versus Control 2: 52.8 (28.8) versus 40.9 (26.2) (P < 0.001) versus 45.1 (27.1) (P = 0.003) among men and 64.6 (26.0) versus 50.8 (26.9) (P < 0.001) versus 53.0 (26.4) (P < 0.001) among women. The percentage of participants who felt subjective anxiety after exposure to the intervention brochure was significantly higher than that of the control groups: intervention versus Control 1 and versus Control 2: 32.6 versus 17.8% (risk difference [RD] = 0.149, 95% CI: 0.0730.225) versus 14.5% (RD = 0.182, 95% CI: 0.1080.256) among men, and 50.2 versus 26.3% (RD = 0.239, 95% CI: 0.1550.322) versus 14.0% (RD = 0.362, 95% CI: 0.2860.439) among women. Non-inferiority of the intervention was inconclusive (i.e. the CI included 0.15) among men whereas inferiority was declared among women. The incidence of anxiety was higher in the intervention group than that of the control groups especially among men aged 30 and older and among women aged 25 and older. No difference existed in childbearing desires between groups after exposure. LIMITATIONS: REASONS FOR CAUTION: The possibility of selection bias associated with the use of SRPs (higher socioeconomic status and education) and volunteer bias toward those more interested in fertility may limit the generalizability of these findings. WIDEN IMPLICATIONS OF THE FINDINGS: In addition to education targeting a younger generation, psychological approaches are needed to alleviate possible anxiety caused by fertility information. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by National Center for Child Health and Development, Seiiku Medical Study Grant (24-6), the Daiwa Foundation Small Grants and Grant-in-Aid for JSPS Fellows (26-1591). No competing interest declared.
  • Eri Maeda, Fumiaki Nakamura, Jacky Boivin, Yasuki Kobayashi, Hiroki Sugimori, Hidekazu Saito
    HUMAN FERTILITY 19 (4) 275 - 281 1464-7273 2016 [Refereed][Not invited]
     
    Although fertility educational initiatives have increased in developed countries to prevent infertility and to broaden fertility choices, the relationship between knowledge and behaviour is still poorly understood. In order to investigate the association between fertility knowledge and timing of childbearing, we investigated male and female participants between 35 and 44 years of age who had children (n = 640) from an online survey conducted in Japan in 2013. The age at which participants actually gave birth to or fathered their first child was compared between those who were aware for at least a decade of age-related decline in female fertility (hereinafter, those with past fertility knowledge) and those without. Age at first birth was significantly younger and more narrowly distributed among women with past fertility knowledge than among those without: 28.2 +/- 3.4 vs. 29.8 +/- 4.6 (mean +/- SD). A multivariate linear regression analysis showed that women with past fertility knowledge gave birth to their first child 2.34 [95% confidence interval (CI): 1.09-3.59] years earlier compared to those without such knowledge. No significant relation existed among men. Being informed in young adulthood about the facts of fertility might be related to starting a family at an earlier age, although further longitudinal evaluation will be necessary.
  • KARITA Kanae, SATOH Hiroshi, MURATA Katsuyuki, SAKAMOTO Mineshi, YOSHIDA Minoru, TATSUTA Nozomi, NAKAI Kunihiko, IWAI-SHIMADA Miyuki, IWATA Toyoto, MAEDA Eri, YAGINUMA-SAKURAI Kozue
    Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene) 一般社団法人日本衛生学会 71 (3) 236 - 251 0021-5082 2016 [Not refereed][Not invited]
     

    More than sixty years has passed since the outbreak of Minamata disease, and high-level methylmercury contaminations now seem nonexistent in Japan. However, mercury has been continuously discharged from natural sources and industrial activities, and the health effects on children susceptible to methylmercury exposure at low levels, in addition to mercury contamination from mercury or gold mining areas in developing countries, become a worldwide concern. In this article, we provide a recent overview of epidemiological studies regarding methylmercury and mercury. The following findings were obtained. (1) Many papers on exposure assessment of methylmercury/mercury have been published since the Minamata Convention on Mercury was adopted in 2013. (2) The most crucial problem is child developmental neurotoxicity resulting from prenatal exposure to methylmercury, but its precise assessment seems to be difficult because most of such effects are neither severe nor specific. (3) Several problems raised in birth cohort studies (e.g., whether IQ deficits due to prenatal methylmercury exposure remain when the children become adults, or whether the postnatal exposure at low levels also causes such adverse effects in children) remain unsolved. (4) Concurrent exposure models of methylmercury, lead, polychlorinated biphenyls, aresenic, and organochlorine pesticides, as well as possible antagonists such as polyunsaturated fatty acids and selenium, should be considered in the study design because the exposure levels of methylmercury are extremely low in developed countries. (5) Further animal experiments and molecular biological studies, in addition to human studies, are required to clarify the mechanism of methylmercury toxicity.

  • 瀬戸 さち恵, 梶原 健, 前田 恵理, 石原 理
    産婦人科の実際 金原出版 64 (12) 1941 - 1948 0558-4728 2015/11 [Not refereed][Not invited]
     
    看護学、保健栄養学、文学、経済学、商学系学部に所属する女子大学生353名を対象に、「医学的理由ではない卵子凍結・保存」に対する意識について無記名アンケート調査を行い、263名から回答を得(回答率74.5%)、うち解析対象は244名(平均年齢19.3歳)であった。卵子凍結が現在可能なことを「知っていた」41.4%、自分の卵子を自分が使用するための凍結保存を「したいと思う・どちらかと言えばしたいと思う」34.9%であり、卵子凍結に慎重な者ほど卵子凍結に対する知識が有意に高かった。あなたの凍結卵子を知り合いに「提供してもよい」7.1%、第三者に「提供してもよい」17.6%、自分のための卵子凍結の条件は「子供への安全性」73.4%、「不妊」54.5%、「将来の妊娠能力に影響しない」47.5%、他者の卵子凍結を認める条件は「ガン」76.2%、「不妊」84.4%などであった。
  • Eri Maeda, Toyoto Iwata, Katsuyuki Murata
    INDUSTRIAL HEALTH 53 (2) 132 - 138 0019-8366 2015/03 [Refereed][Not invited]
     
    Autonomic imbalance is one of the important pathways through which psychological stress contributes to cardiovascular diseases/sudden death. Although previous studies have focused mainly on stress at work (work stress), the association between autonomic function and stress at home (home stress) is still poorly understood. The purpose was to clarify the effect of work/home stress on autonomic function in 1,809 Japanese male workers. We measured corrected QT (QTc) interval and QT index on the electrocardiogram along with blood pressure and heart rate. Participants provided self-reported information about the presence/absence of work/home stress and the possible confounders affecting QT indicators. Home stress was related positively to QT index (p=0.040) after adjusting for the possible confounders, though work stress did not show a significant relation to QTc interval or QT index. The odds ratio of home stress to elevated QT index (2105) was 2.677 (95% CI, 1.050 to 6.822). Work/home stress showed no significant relation to blood pressure or heart rate. These findings suggest that autonomic imbalance, readily assessed by QT indicators, can be induced by home stress in Japanese workers. Additional research is needed to identify different types of home stress that are strongly associated with autonomic imbalance.
  • Eri Maeda, Hiroki Sugimori, Fumiaki Nakamura, Yasuki Kobayashi, Joseph Green, Machi Suka, Masako Okamoto, Jacky Boivin, Hidekazu Saito
    REPRODUCTIVE HEALTH 12 10  1742-4755 2015/01 [Refereed][Not invited]
     
    Background: A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods: We studied people aged 18-59 years old, n = 4,328 (the "General" group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the "Triers" group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results: The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact "at school", and around 65% first learned it "through mass media" or "via the Internet". More than 30% of the respondents first learned it "less than 5 years before" the survey. Conclusions: Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information.
  • Eri Maeda, Osamu Ishihara, Hidekazu Saito, Akira Kuwahara, Satoshi Toyokawa, Yasuki Kobayashi
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 40 (5) 1338 - 1344 1341-8076 2014/05 [Refereed][Not invited]
     
    AimThe aim of this study was to calculate and assess the cost of assisted reproductive technology (ART) treatment cycles and live-birth events in Japan in 2010. Material and MethodsWe performed a retrospective analysis of 238185 ART cycles, registered with the national registry of assisted reproductive treatment during 2010. Costs were calculated, using a decision analysis model. ResultsThe average cost per live birth was yen1974000. This varied from yen1155000 in women aged<30 years to yen50189000 in women aged45, which was 29.6 times higher than that of women aged 35-39 years. This rose sharply in the early 40s and upwards. Public funding per live birth was yen442000. This was yen6118000 in women aged45, 15.4 times higher than that of the 35-39-year-old age group. ConclusionsThe costs and public funding of a live birth after ART treatment rises with age due to the lower success rates in older women. It may provide economic background to improve the current subsidy system for ART and to provide practical knowledge about fertility for the general population.

MISC

Books etc

Presentations

  • 不妊症の有病率に関する疫学研究  [Invited]
    前田 恵理
    日本卵子学会 倫理講習会  2024/05
  • Fertility education: is it effective?  [Invited]
    Maeda E
    ESHRE Campus workshop: Fertility education and reproductive decision-making: why, who, when and how?  2023/10
  • 生殖看護に期待したいプレコンセプションケア  [Invited]
    第21回日本生殖看護学会学術集会前日セミナー  2023/09
  • Attitudes and experiences regarding fertility education among health and physical education teachers and Yogo teachers in upper secondary schools in Japan  [Not invited]
    Y. Akizuki, E. Maeda, T. Ohba, Y. Takagishi
    ESHRE 39th Annual Meeting
  • Frequency of sexual intercourse and fecundability among women trying to conceive in Japan  [Not invited]
    Maeda E, Akizuki Y, Fujishima A, Nomura K, Arata N
    ESHRE 39th Annual Meeting, Copenhagen
  • すべての若者に届けたいプレコンセプションケア  [Invited]
    第27回熊本県母性衛生学会学術集会  2023/05
  • 不妊症に関する社会医学的研究:予防から治療支援まで
    前田恵理
    第93回日本衛生学会学術総会 奨励賞受賞講演  2023/03
  • 少子化対策における企業の役割  [Invited]
    前田恵理
    愛媛県人口減少問題セミナー  2022/08
  • 全ての若者に知ってほしい、 プレコンセプションケア（妊娠前からの健康管理）とは  [Invited]
    第５９回全国大学保健管理研究集会東北地方研究集会  2022/07
  • 女性活躍を阻害する要因とは  [Invited]
    前田恵理
    日本家族計画協会 指導者のための避妊と性感染症予防セミナー  2022/07
  • 前田恵理
    第80回日本公衆衛生学会  2021/12
  • 不妊治療の保険適用は少子化対策となるか 韓国・台湾における不妊治療への経済的支援の拡大  [Invited]
    前田恵理
    第66回日本生殖医学会学術講演会・総会  2021/11
  • Probability of receiving assisted reproductive technology treatment through out-of-pocket payment and household income: A discrete choice experiment in Japan  [Not invited]
    Eri Maeda, Seung Chik Jwa, Yukiyo Kumazawa, Kazuki Saito, Arisa Iba, Ayako Yanagisawa‐Sugita, Akira Kuwahara, Hidekazu Saito, Yukihiro Terada, Takashi Fukuda, Osamu Ishihara, Yasuki Kobayashi
    37th Virtual Annual Meeting of the European Society of Human Reproduction and Embryology  2021/06
  • 諸外国のプレコンセプションケアの動向：FertiSTATを中心に  [Invited]
    前田 恵理
    看護薬理カンファレンス2020 in 東京  2020/12
  • 日本におけるプレコンセプションケア  [Invited]
    前田恵理
    第６回プレコンセプションケア・オープンセミナー（プレコンセプションケア日米合同カンファレンス）  2020/12
  • 生殖補助医療を利用する患者の所得と特定不妊治療支援事業利用状況および治療内容との関連  [Not invited]
    左勝則, 石原理, 桑原 章, 齊藤和毅, 齊藤英和, 寺田幸弘, 前田恵理
    第65回日本生殖医学会学術講演会・総会  2020/12
  • 韓国・台湾の生殖補助医療公費負担制度  [Not invited]
    前田恵理, 石原理, 桑原章, 左勝則, 齊藤和毅, 齊藤英和, 寺田幸弘
    第65回日本生殖医学会学術講演会・総会  2020/12
  • 公衆衛生学的視点からみたプレコンセプションケア  [Invited]
    前田恵理
    第35回日本女性医学学会学術集会  2020/11
  • 生殖補助医療を利用する患者の所得と特定不妊治療支援事業利用状況の関連  [Not invited]
    左勝則, 小林廉毅, 前田恵理
    第79回日本公衆衛生学会総会  2020/10
  • 都道府県等における特定不妊治療実施医療機関の認定審査状況  [Not invited]
    前田恵理, 左勝則, 小林廉毅
    第79回日本公衆衛生学会総会  2020/10
  • 諸外国の取組から考えるプレコンセプションケア  [Invited]
    前田恵理
    第61回日本母性衛生学会総会  2020/10
  • Promoting fertility awareness and preconception health using a chatbot: A randomized controlled trial  [Not invited]
    Maeda E, Miyata A, Boivin J, Nomura K, Kumazawa Y, Shirasawa H, Saito H, Terada Y
    36th Annual Meeting of ESHRE  2020/07
  • 不妊治療中の女性労働者における労働環境と労働生産性  [Not invited]
    前田恵理
    第90回日本衛生学会学術総会  2020/03
  • 35歳未満女性におけるART助成金利用率に影響を及ぼす要因の探索  [Not invited]
    左勝則, 石原理, 桑原章, 齊藤英和, 齊藤和毅, 寺田幸弘, 小林廉毅, 前田恵理
    第30回日本疫学会学術総会  2020/02
  • 副腎ホルモン産生異常症に関する保険未収載臨床検査の全国調査  [Not invited]
    髙橋克敏, 曽根正勝, 武田仁勇, 岩崎泰正, 石井智弘, 前田恵理, 長谷川奉延, 厚生労働省, 副腎ホルモン産生異常に関する調査研究班, 日本小児内分泌学会, 性分化, 副腎疾患委員会
    日本内分泌学会第29回臨床内分泌代謝Update in Kochi  2019/11
  • プレコンセプション・ヘルス・ケアとは  [Invited]
    前田 恵理
    指導者のための避妊と性感染症予防セミナー  2019/10
  • 日本のプレコンセプションケアを考える～公衆衛生の立場から～  [Invited]
    前田 恵理
    プレコンセプションケアを考える会  2019/10
  • プレコンセプションケアと魚介類摂取  [Invited]
    前田 恵理
    第43回日本女性栄養・代謝学会学術講演会  2019/09
  • プレコンセプション・ヘルス・ケアとは  [Invited]
    前田 恵理
    指導者のための避妊と性感染症予防セミナー  2019/08
  • International Symposium “How can we support infertile couples without health insurance? Perspective from public health（Japan)"  [Invited]
    Eri Maeda
    日本受精着床学会総会・学術講演会 International Symposium  2019/08
  • Working conditions and fertility quality of life (FertiQoL): a cross-sectional study in Japan.  [Not invited]
    Maeda, E, Hiraike, O, Murata, K, Sugimori, H, Osuga, Y
    35th Annual Meeting of ESHRE  2019/06
  • 晩産化に関わる母子健康課題の解決を目指して 妊娠・出産に関する医療政策的研究と予防医学的アプローチ  [Invited]
    前田 恵理
    令和元年度第１回産学官交流プラザ  2019/06
  • 倫理委員会企画： JSOG周産期・腫瘍・生殖データベースの新展開：生殖分野  [Invited]
    前田 恵理
    第71回日本産科婦人科学会学術講演会  2019/04
  • Two-year follow-up of a randomised control trial: knowledge and reproductive outcome after online fertility education  [Not invited]
    Maeda E, Boivin J, Toyokawa S, Murata K, Saito H
    34th Annual Meeting of ESHRE - Barcelona 2018  2018/07
  • Various Japanese attempts to raise fertility awareness and stop declining fertility rates.  [Invited]
    Maeda E, Saito H
    Precongress Course n° 6 - 34th Annual Meeting of ESHRE - Barcelona 2018  2018/07
  • 新しい時代のリプロダクティブヘルスを考える  [Invited]
    前田 恵理
    秋田県臨床細胞学会総会  2018/06
  • 妊娠・出産に関するリテラシー ―啓発の現状と効果―  [Invited]
    第58回日本卵子学会学術集会

Association Memberships

  • THE JAPANESE SOCIETY FOR HYGIENE   JAPAN SOCIETY OF OBSTETRICS AND GYNECOLOGY   JAPAN SOCIETY FOR REPRODUCTIVE MEDICINE   JAPANESE SOCIETY OF PUBLIC HEALTH   

Research Projects

  • 日本学術振興会：科学研究費助成事業
    Date (from‐to) : 2024/04 -2027/03 
    Author : 前田 恵理
  • 科学技術振興機構：戦略的な研究開発の推進 創発的研究支援事業
    Date (from‐to) : 2021/04 -2027 
    Author : 前田 恵理
     
    先進諸国の男性の精液所見は近年悪化していることが知られていますが、一般男性を対象に生活環境要因と将来の妊娠出産との関係を長期的に評価した研究は極めて少ない状況です。本研究では男性を対象に、生活習慣や環境化学物質曝露等、修正可能なリスク因子を測定し、精液所見や将来の出生力との関連を明らかにします。さらに、将来の健康と家族形成を見据えた保健教育を実施し、男性への教育により不妊予防が可能か検討します。
  • 不妊治療における情報提供の方策等の確立に向けた研究
    厚生労働省：厚生労働科学研究補助金
    Date (from‐to) : 2022/11 -2024/03
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)
    Date (from‐to) : 2021/04 -2024/03 
    Author : 野村 恭子, 岩田 豊人, 前田 恵理
  • 日本学術振興会：科学研究費助成事業
    Date (from‐to) : 2021/04 -2024/03 
    Author : 前田 恵理, 野村 恭子, 左 勝則, 小林 廉毅
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)
    Date (from‐to) : 2018/04 -2022/03 
    Author : Iwata Toyoto
     
    Effects of toxic metals to standing postural sways and postural hand tremors were examined among workers of ferromanganese casting factories in a cross-sectional study. Spino-cerebellar disturbance type sway increase was found to be related to the increase in blood mercury (or arsenic). Decrease in several parameters including sway area when eyes closed were related to the increase in blood cadmium. Increase in blood manganese was related to the increase in 7 Hz tremor of dominant hand, and that in blood lead to the decrease in 10 Hz or larger frequency tremor of both hands.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Early-Career Scientists
    Date (from‐to) : 2018/04 -2022/03 
    Author : Maeda Eri
     
    Due to the lack of national perinatal registries, population-wide descriptive statistics on cesarean deliveries in Japan are unknown. We aim to describe cesarean deliveries for overall and multiple pregnancies using the Japan National Database of health insurance claims. We calculated the national and prefectural cesarean delivery rates for overall and multiple pregnancies in 2014. We described maternal morbidities (e.g., blood transfusion) and the place and type of the institutions providing prenatal and perinatal care. The national cesarean delivery rates were 18.6% overall and 82.7% for women with multiple pregnancies. Prefectural cesarean delivery rates for overall and multiple pregnancies varied from 12.5% to 24.2% and from 49.2% to 100%, respectively, showing a moderate positive correlation (r = 0.59, p < 0.001). The overall cesarean delivery rate in Japan was optimal, but the rate was high for multiple pregnancies, with large regional differences.
  • 女性特有の疾病に対する健診等による介入効果の評価研究
    厚生労働省：女性の健康の包括的支援政策研究事業
    Date (from‐to) : 2019/04 -2022/03 
    Author : 大須賀穣
  • 保健・医療・教育機関・産業等における女性の健康支援のための研究
    厚生労働省：女性の健康の包括的支援政策研究事業
    Date (from‐to) : 2019/04 -2021/03 
    Author : 荒田尚子
  • 「不妊に悩む方への特定治療支援事業」のあり方に関する医療政策的研究
    厚生労働省：成育疾患克服等次世代育成基盤研究事業(健やか次世代育成総合研究事業)
    Date (from‐to) : 2018/04 -2021/03 
    Author : 前田 恵理
  • 厚生労働省：成育疾患克服等次世代育成基盤研究事業(健やか次世代育成総合研究事業)
    Date (from‐to) : 2020/04 
    Author : 荒田尚子
  • 副腎ホルモン産生異常に関する調査研究
    厚生労働省：難治疾患政策研究事業
    Date (from‐to) : 2017/04 -2020/03 
    Author : 長谷川奉延
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)
    Date (from‐to) : 2016/04 -2019/03 
    Author : Murata Katsuyuki
     
    To investigate the association between environmental exposures to metals and female fertility, we conducted a case-control study, including 98 infertile women (infertile group) and 43 female workers in their thirties (control group) who provided blood samples and returned a questionnaire on lifestyles and dietary characteristics. Blood levels of mercury, lead, cadmium, arsenic, manganese, zinc, and selenium were compared between the groups. The mean selenium level in blood and the selenium/mercury molar ratio were significantly lower in the infertile group than in the control group. By contrast, blood mercury levels after adjusting for blood selenium and age were significantly higher in the infertile group than in the control group. Multiple logistic regression analyses confirmed significant associations of infertility with elevated mercury and reduced selenium levels. Methylmercury and selenium exposures appear to have adverse and protective effects on female fertility, respectively.
  • プレコンセプションケア啓発プログラムの開発および実践と評価
    ファイザーヘルスリサーチ振興財団：
    Date (from‐to) : 2017/12 -2018/11 
    Author : 前田 恵理
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Research Activity Start-up
    Date (from‐to) : 2016/08 -2018/03 
    Author : Maeda Eri
     
    We examined nationwide CS statistics and evaluated the association with local resources for perinatal care. We used accumulated data for CS registered in the Japan National Database of health insurance claims in 2013 and calculated crude and age-standardized CS rates at national and prefectural levels. We analyzed the ecological associations with supply of obstetricians and institution and scale of obstetric facilities using multiple regression models. There were 190 361 cesarean deliveries in 2013, giving an overall CS rate of 18.5%, which varied by prefecture from 14.0% to 25.6%. In multiple regression analyses, the areal number of obstetricians (β = －0.58), the proportion of births at small-scale institutions (β = 0.36) and the number of beds at neonatal intensive care units per birth (β = －0.20) were significantly associated with the age-standardized elective CS rate . Higher elective CS rates might be associated with limited or unconsolidated medical resources.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for JSPS Fellows
    Date (from‐to) : 2014/04 -2016/03 
    Author : 前田 恵理
     
    【経済的支援が成長ホルモン分泌不全性低身長症の治療に与える影響】 財団法人成長科学協会の症例データベースを用いて、経済的支援の有無が小児慢性疾患医療費助成の終了基準到達後の治療に与える影響について検討した。2001年1月～2013年5月に助成終了基準身長に到達するまで小児慢性疾患医療費助成基準を満たした696名について、助成終了基準身長に到達後も治療を継続した者の割合は、何らかの公的経済的支援（市町村小児医療費助成等）のある患者で高かった。臨床的・その他の要因について多重ロジスティック回帰分析を用いて調整しても結果は同様であった。peer review誌に投稿中である。 【妊孕性知識の啓発を通じた、特定不妊治療費助成制度の効果的運用】 2014年4月、特定不妊治療費助成制度では早期治療のインセンティブとなるような年齢要件を伴った制度改正が行われたが、我が国の人々の妊孕性知識は、先進諸国に比べて低いとの報告がある。助成制度の効果的運用には、妊孕性知識を啓発し、計画的なライフプランや早期受診を促すことが重要である。(1) 35歳から44歳までの子供のいる男女690名について、初産年齢と10年以上前からの妊孕性知識について重回帰分析で検討したところ、10年以上前から知識があった女性では初産年齢は2.3歳若かった。妊孕性知識により、自身の家族形成についてインフォームドチョイスを実践できる可能性が示唆された。（Hum Fertil誌に採択済）(2）妊孕性に関する情報とその他の情報（葉酸摂取や社会保障に関する情報）で受け手の心理的負荷に差があるか明らかにする目的で、20歳から39歳までの将来子供が欲しい男女1455名を対象に、ランダム化比較試験を実施した。妊孕性に関する情報介入群では、男女とも妊孕性知識が有意に増加した一方、不安も有意に増加していた（peer review誌に投稿中）。

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