2023年03月, 日本衛生学会, 奨励賞　　　　　　　　　　　　　　　

2019年12月, 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
前田 恵理

2018年11月, 秋田わか杉科学技術奨励賞　　　　　　　　　　　　　　　
前田 恵理

Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan.
Akira Tsujimura, Shinichiro Fukuhara, Koji Chiba, Tsuyoshi Yoshizawa, Hikaru Tomoe, Masato Shirai, Kazunori Kimura, Eiji Kikuchi, Eri Maeda, Yoshikazu Sato, Atsushi Nagai, Koichi Nagao, Haruaki Sasaki
The world journal of men's health, 2024年08月30日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice. MATERIALS AND METHODS: Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations. RESULTS: Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising. CONCLUSIONS: The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.

Psychometric properties of persian version of the cardiff fertility knowledge scale (CFKS–P)
Mojgan Mirghafourvand, Mohammad Asghari Jafarabadi, Maryam Gharacheh, Eri Maeda, Shima Haghani, Fahimeh Ranjbar
Heliyon, 10, 9, 2024年05月15日, ［査読有り］, ［国際共著］, ［国際誌］
研究論文（学術雑誌）, 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.

Feasibility and effectiveness of preconception check-ups at workplaces in Japan.
Akiko Fujishima, Eri Maeda, Koki Sato, Hidekazu Saito, Chihiro Ozeki, Yukihiro Terada
Journal of occupational health, 2024年04月29日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan.
Chihiro Ozeki, Eri Maeda, Osamu Hiraike, Kyoko Nomura, Yutaka Osuga
BMC women's health, 24, 1, 242, 242, 2024年04月15日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

不妊治療の保険適用－その影響と課題
前田恵理
社会保障研究, 8, 31, 464, 478, (株)毎日学術フォーラム, 2024年03月, ［招待有り］, ［筆頭著者］
日本語, 研究論文（学術雑誌）

Fertility education: recommendations for developing and implementing tools to improve fertility literacy†.
Mariana V Martins, Emily Koert, Randi Sylvest, Eri Maeda, Mariana Moura-Ramos, Karin Hammarberg, Joyce Harper
Human reproduction (Oxford, England), 2023年12月13日, ［査読有り］, ［国際共著］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

The first nationwide website survey of the availability and costs of medical and non-medical oocyte cryopreservation in Japan
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, Elsevier BV, 2023年08月, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Model-based estimation of the health care expenditure and out-of-pocket payment for assisted reproductive technology: A retrospective linkage study using the Japanese national ART registry.
Seung Chik Jwa, Rei Goto, Eri Maeda, Takeshi Kajihara, Osamu Ishihara
The journal of obstetrics and gynaecology research, 2023年05月16日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

High TLR6 Expression Status Predicts a More Favorable Prognosis after Esophagectomy for Locally Advanced Thoracic Esophageal Squamous Cell Carcinoma.
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年05月04日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

不妊治療の保険適用に関して 諸外国における不妊治療の公費負担状況
前田恵理
日本産科婦人科学会雑誌, 75, 3, 2023年, ［招待有り］

Fertility knowledge of Japanese undergraduates aspiring to become schoolteachers: a cross-sectional survey
Yuri Akizuki, Shoko Kusunoki, Eri Maeda
Sex Education, 2023年
研究論文（学術雑誌）, 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.

Out-of-pocket payment and patients' treatment choice for assisted reproductive technology by household income: a conjoint analysis using an online social research panel in Japan.
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年08月27日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Relationship between somatic symptoms with menstruation and intention to leave work among university hospital nurses in Japan: a cross-sectional study.
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年08月01日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Working conditions contribute to fertility-related quality of life: a cross-sectional study in Japan
Eri Maeda, Osamu Hiraike, Hiroki Sugimori, Asako Kinoshita, Maki Hirao, Kyoko Nomura, Yutaka Osuga
Reproductive BioMedicine Online, Elsevier {BV}, 2022年07月, ［筆頭著者］, ［国際誌］
研究論文（学術雑誌）

Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5066 Patients in the National Database of Hospital-Based Cancer Registries in Japan
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, LIPPINCOTT WILLIAMS & WILKINS, 2022年07月, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Longitudinal survey of depressive symptoms among university students during the COVID-19 pandemic in Japan.
Kyoko Nomura, Teiichiro Yamazaki, Eri Maeda, Junko Hirayama, Kyoichi Ono, Masahito Fushimi, Kazuo Mishima, Fumio Yamamoto
Frontiers in psychology, 13, 863300, 863300, FRONTIERS MEDIA SA, 2022年, ［国際誌］
英語, 研究論文（学術雑誌）, 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年01月, ［査読有り］

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年12月, ［査読有り］

Social capital and use of assisted reproductive technology in young couples: Ecological study using application information for government subsidies in Japan
Seung Chik Jwa, Osamu Ishihara, Akira Kuwahara, Kazuki Saito, Hidekazu Saito, Yukihiro Terada, Yasuki Kobayashi, Eri Maeda
SSM - Population Health, 16, 100995, 100995, Elsevier {BV}, 2021年12月, ［国際誌］
英語, 研究論文（学術雑誌）, 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年11月, ［査読有り］

Cumulative live birth rate according to the number of receiving governmental subsidies for assisted reproductive technology in Saitama Prefecture, Japan: A retrospective study using individual data for governmental subsidies.
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年10月, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

PET-Uptake Reduction into Lymph Nodes After Neoadjuvant Therapy is Highly Predictive of Prognosis for Patients Who have Thoracic Esophageal Squamous Cell Carcinoma Treated with Chemoradiotherapy Plus Esophagectomy.
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年08月05日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Household income and medical help-seeking for fertility problems among a representative population in Japan.
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年08月03日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Differences in treatment and survival between elderly patients with thoracic esophageal cancer in metropolitan areas and other areas.
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年07月19日, ［国際誌］
英語, 研究論文（学術雑誌）, 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, 70, 36, 36, 東北公衆衛生学会, 2021年07月
日本語

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, 70, 10, 10, 東北公衆衛生学会, 2021年07月
日本語

Cesarean delivery rates for overall and multiple pregnancies in Japan: A descriptive study using nationwide health insurance claims data
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, Wiley, 2021年06月28日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Effects of localisation of uterine adenomyosis on outcome of in vitro fertilisation/intracytoplasmic sperm injection fresh and frozen-thawed embryo transfer cycles: a multicentre retrospective cohort study.
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年06月04日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order.
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, JAPANESE SOC HYGIENE, 2021年03月05日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

IGF2BP3 Expression Correlates With Poor Prognosis in Esophageal Squamous Cell Carcinoma.
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年03月, ［国際誌］
英語, 研究論文（学術雑誌）, 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, 88, 3, 325, 329, (株)診断と治療社, 2021年03月, ［招待有り］
日本語, 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)

Associations between blood arsenic and urinary arsenic species concentrations as an exposure characterization tool.
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年01月01日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Live visualisation of electrolytes during mouse embryonic development using electrolyte indicators.
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年, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Promoting fertility awareness and preconception health using a chatbot: a randomized controlled trial.
Eri Maeda, Akane Miyata, Jacky Boivin, Kyoko Nomura, Yukiyo Kumazawa, Hiromitsu Shirasawa, Hidekazu Saito, Yukihiro Terada
Reproductive biomedicine online, 41, 6, 1133, 1143, Elsevier BV, 2020年12月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

【プレコンセプションケアってなに?】世界のプレコンセプションケアの動向
前田 恵理
産科と婦人科, 87, 8, 881, 886, (株)診断と治療社, 2020年08月, ［招待有り］
日本語, 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)

Preconception folic acid supplementation use and the occurrence of neural tube defects in Japan.
Yuto Maeda, Eri Maeda, Naoko Arata
Congenital anomalies, 60, 3, 100, 100, 2020年05月, ［査読有り］, ［国際誌］
英語

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
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, 75, Suppl., S153, S153, (一社)日本衛生学会, 2020年03月
日本語

Esophagectomy performed at institutes certified by the Japan Esophageal Society provide long-term survival advantages to esophageal cancer patients: second report analyzing 4897 cases with propensity score matching.
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年01月14日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Domestic work stress and self-rated psychological health among women: a cross-sectional study in Japan
Eri Maeda, Kyoko Nomura, Osamu Hiraike, Hiroki Sugimori, Asako Kinoshita, Yutaka Osuga
Environmental Health and Preventive Medicine, 24, 1, 75, 75, Springer Science and Business Media {LLC}, 2019年12月17日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

妊孕性・不妊に関する知識を高める授業プログラムの開発
楠木祥子, 秋月百合, 前田恵理
熊本大学教育学部紀要, 68, 68, 173, 179, 熊本大学, 2019年12月, ［査読有り］
日本語, 研究論文（大学，研究機関等紀要）, 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年10月, ［招待有り］
日本語

Usefulness of a suction ball coagulation probe for hemostasis in complete VATS lobectomy for patients with non-small cell lung cancer.
Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Kanno H, Maeda E, Saito H
Surgery today, 49, 7, 580, 586, 2019年07月, ［査読有り］

環境化学物質の妊孕性への影響 患者対照研究
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, 74, Suppl., S141, S141, (一社)日本衛生学会, 2019年02月
日本語

Associations of environmental exposures to methylmercury and selenium with female infertility: A case–control study
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, Elsevier {BV}, 2019年01月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Appropriateness of the institute certification system for esophageal surgeries by the Japan Esophageal Society: evaluation of survival outcomes using data from the National Database of Hospital-Based Cancer Registries in Japan.
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, 2018年10月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Two-year follow-up of a randomized controlled trial: knowledge and reproductive outcome after online fertility education.
Maeda E, Boivin J, Toyokawa S, Murata K, Saito H
Human reproduction (Oxford, England), 33, 11, 2035, 2042, 2018年09月, ［査読有り］

Assessment of Cardiac Autonomic Function in Relation to Methylmercury Neurotoxicity.
Karita K, Iwata T, Maeda E, Sakamoto M, Murata K
Toxics, 6, 3, 2018年07月, ［査読有り］

Cesarean section rates and local resources for perinatal care in Japan: A nationwide ecological study using the national database of health insurance claims
Eri Maeda, Osamu Ishihara, Jun Tomio, Aya Sato, Yukihiro Terada, Yasuki Kobayashi, Katsuyuki Murata
Journal of Obstetrics and Gynaecology Research, 44, 2, 208, 216, Blackwell Publishing, 2018年02月01日, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

環境保健研究のジレンマ
村田 勝敬, 岩田 豊人, 前田 恵理, 苅田 香苗
日本衛生学雑誌, 73, 2, 148, 155, 一般社団法人日本衛生学会, 2018年
日本語,

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.

The association between work-related stress and autonomic imbalance among call center employees in Japan
Mamiko Enoki, Eri Maeda, Toyoto Iwata, Katsuyuki Murata
Tohoku Journal of Experimental Medicine, 243, 4, 321, 328, Tohoku University Medical Press, 2017年12月01日, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Precarious Employment Is Not Associated with Increased Depressive Symptoms: A Cross-Sectional Study in Care Service Workers of Japan
Oa Tanaka, Eri Maeda, Masahito Fushimi, Toyoto Iwata, Tetsuo Shimizu, Seiji Saito, Katsuyuki Murata
TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE, 243, 1, 19, 26, TOHOKU UNIV MEDICAL PRESS, 2017年09月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Estimation of the number of children with cerebral palsy using nationwide health insurance claims data in Japan
Satoshi Toyokawa, Eri Maeda, Yasuki Kobayashi
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 59, 3, 317, 321, WILEY, 2017年03月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Characteristics of hand tremor and postural sway in patients with fetal-type Minamata disease
Toyoto Iwata, Shigeru Takaoka, Mineshi Sakamoto, Eri Maeda, Masaaki Nakamura, Xiao-Jie Liu, Katsuyuki Murata
JOURNAL OF TOXICOLOGICAL SCIENCES, 41, 6, 757, 763, JAPANESE SOC TOXICOLOGICAL SCIENCES, 2016年12月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan
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, BIOMED CENTRAL LTD, 2016年10月, ［査読有り］
英語, 研究論文（学術雑誌）, 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, 71, 3, 236, 251, (一社)日本衛生学会, 2016年09月
日本語

Effects of fertility education on knowledge, desires and anxiety among the reproductive-aged population: findings from a randomized controlled trial
E. Maeda, F. Nakamura, Y. Kobayashi, J. Boivin, H. Sugimori, K. Murata, H. Saito
HUMAN REPRODUCTION, 31, 9, 2051, 2060, OXFORD UNIV PRESS, 2016年09月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Fertility knowledge and the timing of first childbearing: a cross-sectional study in Japan
Eri Maeda, Fumiaki Nakamura, Jacky Boivin, Yasuki Kobayashi, Hiroki Sugimori, Hidekazu Saito
HUMAN FERTILITY, 19, 4, 275, 281, TAYLOR & FRANCIS LTD, 2016年, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

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, 佐藤 洋, 村田 勝敬, 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
日本衛生学雑誌, 71, 3, 236, 251, 一般社団法人日本衛生学会, 2016年
日本語,

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.

本邦女子大学生の「医学的理由でない卵子凍結・保存」に関する意識調査研究
瀬戸 さち恵, 梶原 健, 前田 恵理
産婦人科の実際, 64, 12, 1941, 1948, 金原出版, 2015年11月
日本語, 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。

Effects of work stress and home stress on autonomic nervous function in Japanese male workers
Eri Maeda, Toyoto Iwata, Katsuyuki Murata
INDUSTRIAL HEALTH, 53, 2, 132, 138, NATL INST OCCUPATIONAL SAFETY & HEALTH, JAPAN, 2015年03月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

A cross sectional study on fertility knowledge in Japan, measured with the Japanese version of Cardiff Fertility Knowledge Scale (CFKS-J)
Eri Maeda, Hiroki Sugimori, Fumiaki Nakamura, Yasuki Kobayashi, Joseph Green, Machi Suka, Masako Okamoto, Jacky Boivin, Hidekazu Saito
REPRODUCTIVE HEALTH, 12, 10, BIOMED CENTRAL LTD, 2015年01月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Age-specific cost and public funding of a live birth following assisted reproductive treatment in Japan
Eri Maeda, Osamu Ishihara, Hidekazu Saito, Akira Kuwahara, Satoshi Toyokawa, Yasuki Kobayashi
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 40, 5, 1338, 1344, WILEY-BLACKWELL, 2014年05月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

秋田県カドミウム土壌汚染地域住民健康調査により見出された尿細管機能障害症例の検討
堀口兵剛, 小熊悦子, 大森由紀, 小林桃子, 熊澤由美子, 徳本真紀, 姫野誠一郎, 内田正美, 前田恵理, 小松田敦, 日本衛生学雑誌(Web), 79, Supplement, 2024年

すべての若者に届けたいプレコンセプションケア
前田恵理, 熊本県母性衛生学会雑誌, 27, 2024年

不妊症の有病率に関する疫学研究
前田恵理, Journal of Mammalian Ova Research, 41, 1, 2024年

被虐待経験と成人期の性交未経験との関連
松原玄馬, 前田恵理, 黒鳥偉作, 木村尚史, 玉腰暁子, 日本疫学会学術総会講演集(Web), 34th, Suppl., 156, 156, 2024年
(一社)日本疫学会, 日本語

秋田県内へのプレコンセプションケア周知に向けた活動
藤嶋 明子, 前田 恵理, 菊地 麻里, 水田 圭, 菅原 香織, 大木 春菜, 佐藤 高輝, 寺田 幸弘, 産科と婦人科, 90, 7, 799, 806, 2023年07月, ［査読有り］
＜文献概要＞晩産化時代の今,妊娠を願う人々の希望を実現し,安全な妊娠・出産を増やすには,「妊娠前からのヘルスケア(プレコンセプションケア)」を地域で展開する必要がある.プレコンセプションケアの対象は前思春期から生殖可能年齢の男女と幅広く,周知を進めるためには多様なアプローチが必要である.2021年より美術大学やNPO法人らとともに秋田県内へのプレコンセプションケア普及啓発活動を開始した.1年間の活動内容について報告する., (株)診断と治療社, 日本語

【生殖医療の保険適用の実際I】各国の生殖医療への保険適用状況について
石原 理, 前田 恵理, 産婦人科の実際, 72, 5, 469, 473, 2023年05月
＜文献概要＞医療費負担を軽減する医療保険のしくみは,国により大きく異なり,公的医療保険だけでなく,民間医療保険も大きな役割を果している。その背景には,「不妊症」を「疾病」として認知すること,また治療の有効性・有用性の確保と負担の公平性を担保するための様々な制度整備が基本構造として存在している。, 金原出版(株), 日本語

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, 日本衛生学雑誌, 78, Suppl., S86, S87, 2023年03月
(一社)日本衛生学会, 日本語

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, 日本衛生学雑誌, 78, Suppl., S86, S87, 2023年03月
(一社)日本衛生学会, 日本語

コロナ禍における大学生のこころの健康 全国緊急事態宣言後1年の縦断的評価
野村 恭子, 山崎 貞一郎, 前田 恵理, 平山 純子, 大貫 佑佳, 尾野 恭一, 伏見 雅人, 三島 和夫, 山本 文雄, 日本衛生学雑誌, 78, Suppl., S177, S177, 2023年03月
(一社)日本衛生学会, 日本語

生殖補助医療の保険適用が医療費および患者自己負担額に及ぼす影響の検討　　　　　　　　　　　　　　　
左 勝則, 後藤 励, 前田 恵理, 梶原 健, 石原 理, Journal of Epidemiology, 33, Suppl.1, 91, 91, 2023年02月
(一社)日本疫学会, 日本語

生殖補助医療の保険適用が医療費および患者自己負担額に及ぼす影響の検討
左 勝則, 後藤 励, 前田 恵理, 梶原 健, 石原 理, Journal of Epidemiology, 33, Suppl.1, 91, 91, 2023年02月
(一社)日本疫学会, 日本語

42歳未満の女性フルタイムワーカーにおける月経前症候群に関する健康尺度の開発
清水紀翔, 竹之下千尋, 前田恵理, 野村恭子, 日本公衆衛生学会総会抄録集(CD-ROM), 82nd, 2023年

生殖看護に期待したいプレコンセプションケア
前田恵理, 日本生殖看護学会学術集会プログラム・講演集, 21st, 2023年

月経前症候群のセルフチェックシートによる啓発と受診行動および症状の変化
大関千潤, 前田恵理, 平池修, 野村恭子, 大須賀穣, 秋田県公衆衛生学雑誌, 18, 1, 2023年

ART実施施設における治療情報・成績の開示に対する実態調査
左勝則, 前田恵理, 石原理, 辻村晃, 寺田幸弘, 大須賀穣, 日本生殖医学会雑誌, 68, 4, 2023年

秋田県南部のカドミウム土壌汚染地域における農業従事者のカドミウム曝露とその健康影響
堀口兵剛, 小熊悦子, 大森由紀, 小林桃子, 熊澤由美子, 徳本真紀, 佐藤雅彦, 姫野誠一郎, 姫野誠一郎, 前田恵理, 前田恵理, Fundamental Toxicological Sciences (Web), 10, Supplement, 2023年

周産期の栄養Q2 ヘルスリテラシーって何ですか？
前田恵理, 齊藤英和, 周産期医学, 52, 増刊, 5, 6, 2022年11月, ［招待有り］, ［筆頭著者］
＜ポイント＞・ヘルスリテラシーとは,健康や医療に関する情報を入手し,理解し,評価し,活用する能力である。・ヘルスリテラシーは本人の能力だけでなく,置かれた状況に大きく影響を受ける。・自分が測定したいヘルスリテラシーとは何かを明確にして,適切な尺度を用いて評価する必要がある。(著者抄録), (株)東京医学社, 日本語

The validity of claim‐based cesarean deliveries in Japan
Eri Maeda, Hiroshi Miura, Yukihiro Terada, Journal of Obstetrics and Gynaecology Research, 48, 7, 2021, 2022, 2022年07月
Wiley

【魚と健康-その健康影響と有益性を知る-】妊婦および乳幼児の魚摂取 健康リスク軽減のための食行動
村田 勝敬, 前田 恵理, 保健の科学, 63, 5, 313, 317, 2021年05月
(株)杏林書院, 日本語

COVID-19感染拡大に伴う自粛中の大学生における抑うつ症状,自殺関連念慮に関連する因子の検討
野村恭子, 南園佐知子, 前田恵理, KIM Roseline, 岩田豊人, 平山純子, 尾野恭一, 伏見雅人, 後藤猛, 三島和夫, 山本文雄, 日本心身医学会総会ならびに学術講演会抄録集, 62nd (CD-ROM), 2021年

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　　　　　　　　　　　　　　　
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, 日本生殖医学会雑誌, 65, 4, 349, 349, 2020年11月
(一社)日本生殖医学会, 日本語

韓国・台湾の生殖補助医療公費負担制度　　　　　　　　　　　　　　　
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, 日本生殖医学会雑誌, 65, 4, 352, 352, 2020年11月
(一社)日本生殖医学会, 日本語

これから求められるSRHRとは（特集：ライフサイクルを見通したリプロダクティブ・ヘルス／ライツ）　　　　　　　　　　　　　　　
前田恵理, 家族と健康, 800, 2020年11月, ［招待有り］
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）

リプロダクティブ・ヘルス プレコンセプションケア 公衆衛生学的視点からみたプレコンセプションケア　　　　　　　　　　　　　　　
前田 恵理, 日本女性医学学会雑誌, 28, 1, 75, 75, 2020年10月
(一社)日本女性医学学会, 日本語

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　　　　　　　　　　　　　　　
前田 恵理, 左 勝則, 小林 廉毅, 日本公衆衛生学会総会抄録集, 79回, 283, 283, 2020年10月
日本公衆衛生学会, 日本語

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　　　　　　　　　　　　　　　
左 勝則, 小林 廉毅, 前田 恵理, 日本公衆衛生学会総会抄録集, 79回, 283, 283, 2020年10月
日本公衆衛生学会, 日本語

pre-conception care 諸外国の取組から考えるプレコンセプションケア
前田 恵理, 母性衛生, 61, 3, 71, 71, 2020年09月
(公社)日本母性衛生学会, 日本語

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
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, 75, Suppl., S153, S153, 2020年03月
(一社)日本衛生学会, 日本語

本邦女子医学生の妊娠・出産に関する意識及び知識調査
金正 めぐみ, 前田 恵理, 村田 勝敬, 秋田県公衆衛生学雑誌, 14, 1, 29, 34, 2018年05月
秋田 : 秋田県公衆衛生学会, 日本語

コールセンター従業員における職業性ストレスと睡眠時間の関係
榎 真美子, 前田 恵理, 岩田 豊人, 村田 勝敬, 秋田県公衆衛生学雑誌, 14, 1, 15, 21, 2018年05月
秋田県公衆衛生学会, 日本語

職場のリスク評価につなげる健康管理とは
村田 勝敬, 前田 恵理, 岩田 豊人, 産業医学ジャーナル, 40, 3, 67, 71, 2017年05月
産業医学振興財団, 日本語

産業医に役立つ最新の研究報告 職場の健康管理 : 生活習慣を再考する
村田 勝敬, 岩田 豊人, 前田 恵理, 産業医学ジャーナル, 39, 3, 69, 73, 2016年05月
産業医学振興財団, 日本語

DOES FERTILITY KNOWLEDGE AFFECT LIFE PLANNING AND CHILDBEARING?
E. Maeda, F. Nakamura, J. Boivin, H. Sugimori, H. Saito, FERTILITY AND STERILITY, 102, 3, E247, E247, 2014年10月
ELSEVIER SCIENCE INC, 英語, 研究発表ペーパー・要旨（国際会議）

Fertility knowledge among adults in Japan, measured with the Japanese version of Cardiff Fertility Knowledge Scale (CFKS-J)
E. Maeda, H. Sugimori, F. Nakamura, Y. Kobayashi, J. Green, M. Suka, M. Okamoto, J. Boivin, H. Saito, HUMAN REPRODUCTION, 29, 274, 274, 2014年07月
OXFORD UNIV PRESS, 英語, 研究発表ペーパー・要旨（国際会議）

突発性難聴の治療成績-重症度・糖尿病合併の有無による比較-
中原 はるか, 前田 恵理, 坂田 阿希, 松崎 真樹, 室伏 利久, 耳鼻と臨床, 55, 5, 175, 182, 2009年
2004 年 4 月から2006 年 12 月までの 2 年 9 カ月の間に、発症後 1 カ月以内に受診し、クリニカルパスに沿って一定の入院加療を行った突発性難聴に対する治療経過を報告した。症例は、50 名(51 耳)、男性 25 名(26 耳)、女性 25 名(25 耳)であった。患側は、左 25 耳、右 26耳、年齢は、15 歳から 81 歳で平均 52 歳であった。突発性難聴での重症度基準 5) によるgrade 1 では、治療開始 2 週間後で聴力改善はほぼ飽和したが、grade が上がるにつれて、聴力が改善する期間もより長期にわたるようになり、grade 4 では 2 カ月に及んだ。いずれの重症度でも高音部の改善は得られにくかった。また糖尿病合併症例では、高音部の聴力低下が著しく、また高音部の低下は治療による改善も得られにくい傾向を認めた。, 耳鼻と臨床会, 日本語

原著 耳下腺唾石症に対して体外衝撃波結石破砕術が奏効した1症例
前田 恵理, 中原 はるか, 坂田 阿希, 能勢 頼人, 竹島 雄太, 田島 惇, 室伏 利久, 耳鼻咽喉科・頭頸部外科, 80, 11, 797, 800, 2008年10月20日
株式会社医学書院

原著 第VIII脳神経症状を初発とした原発性肺癌内耳道内転移の1症例
高浪 太郎, 中西 わか子, 山田 智佳子, 井上 里可, 前田 恵理, 鈴木 光也, 耳鼻咽喉科・頭頸部外科, 80, 6, 367, 371, 2008年05月20日
株式会社医学書院

経皮的気管切開術後に生じた気管切開チューブ誤挿入の１例
前田 恵理, 木村 美和子, 二藤 隆春, 高野 真吾, 田山 二朗, 日本気管食道科学会会報, 58, 5, 502, 506, 2007年
経皮的気管切開術（percutaneous dilational tracheostomy，以下PDT）はその簡便さから，近年，本邦でも広く普及しつつある。今回われわれはPDT後の気管切開チューブ誤挿入の1症例を経験したので報告する。
症例は65歳男性。肺炎により人工呼吸器管理中，救急部でPDTが施行された。術後，内科で気管切開チューブの交換が行われたが，挿入時に抵抗があり難渋した。呼吸困難の訴えもあったが，自然に軽快したため経過観察されていた。肺炎の治療効果判定のため胸部CTを施行したところ，気管前壁外の縦隔に気管切開チューブを認め，当科受診となった。気管切開チューブを抜去すると，気管外前方に気管内腔と交通のない死腔を認めた。気管内腔に問題はなかったため，消毒と圧迫処置で，死腔は徐々に縮小し皮膚切開創は閉鎖した。現在，気管狭窄などの異常は認めていない。
PDTで作製された気管孔は，外科的に作製されたものに比べて小さく，深くなる傾向があるため，より慎重な気管孔管理が必要である。, 特定非営利活動法人 日本気管食道科学会, 日本語

プレコンセプションケア　　　　　　　　　　　　　　　
荒田 尚子, 三戸 麻子, 岡﨑 有香, ライフコースアプローチ
メジカルビュー社, 2024年04月, 9784758321402, ［共著］

少子化社会対策に関する意識調査報告書(妊娠・出産に関する意識調査)　　　　　　　　　　　　　　　
内閣府
2019年06月, ［その他］

厚生労働科学研究補助金 平成３０年度研究報告書 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　　　　　　　　　　　　　　　
前田 恵理
2019年05月, ［その他］

男性も女性も知っておきたい 妊娠・出産のリテラシー
齊藤英和, 杉森裕樹, 齊藤英和, 杉森裕樹, 第５章 適切な意思決定をする上で必要な、正しい知識獲得の重要性
大修館書店, 2018年11月, 4469268534, 221, ［共著］

ヘルスリテラシー :健康教育の新しいキーワード
中山 和弘, 福田 洋, 江口 泰正
大修館書店, 2016年06月, 4469267953, 168, ［共著］

FDAリスク&ベネフィット・コミュニケーション : エビデンスに基づく健康・医療に関する指針
Fischhoff Baruch, Brewer Noel T, Downs Julie S, 中山 健夫, 杉森 裕樹
丸善出版, 2015年, 9784621089545, 日本語, ［共訳］

プレコンセプションケアとは？　　　　　　　　　　　　　　　
前田恵理
第83回日本公衆衛生学会総会×第138回サイエンス・カフェ札幌, 2024年10月29日, シンポジウム・ワークショップパネル（指名）
［招待講演］

食生活と妊孕性（シンポジウム２: DOHaD分野横断的融合研究が切り拓く食品安全性評価の新潮流）　　　　　　　　　　　　　　　
前田恵理
第12回日本DOHaD学会, 2024年10月14日, シンポジウム・ワークショップパネル（指名）
［招待講演］

不妊症の有病率に関する疫学研究　　　　　　　　　　　　　　　
前田 恵理
日本卵子学会 倫理講習会, 2024年05月19日, 公開講演，セミナー，チュートリアル，講習，講義等
2024年05月18日 - 2024年05月19日, ［招待講演］

Fertility education: is it effective?　　　　　　　　　　　　　　　
Maeda E
ESHRE Campus workshop: Fertility education and reproductive decision-making: why, who, when and how?, 2023年10月27日, シンポジウム・ワークショップパネル（指名）
2023年10月26日 - 2023年10月27日, ［招待講演］

生殖看護に期待したいプレコンセプションケア　　　　　　　　　　　　　　　
第21回日本生殖看護学会学術集会前日セミナー, 2023年09月02日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

Attitudes and experiences regarding fertility education among health and physical education teachers and Yogo teachers in upper secondary schools in Japan　　　　　　　　　　　　　　　
Y. Akizuki, E. Maeda, T. Ohba, Y. Takagishi
ESHRE 39th Annual Meeting, ポスター発表
2023年06月25日 - 2023年06月28日

Frequency of sexual intercourse and fecundability among women trying to conceive in Japan　　　　　　　　　　　　　　　
Maeda E, Akizuki Y, Fujishima A, Nomura K, Arata N
ESHRE 39th Annual Meeting, Copenhagen, ポスター発表
2023年06月25日 - 2023年06月28日

すべての若者に届けたいプレコンセプションケア　　　　　　　　　　　　　　　
第27回熊本県母性衛生学会学術集会, 2023年05月28日, 口頭発表（招待・特別）
［招待講演］

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年03月03日

少子化対策における企業の役割　　　　　　　　　　　　　　　
前田恵理
愛媛県人口減少問題セミナー, 2022年08月29日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

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　　　　　　　　　　　　　　　
第５９回全国大学保健管理研究集会東北地方研究集会, 2022年07月15日, 口頭発表（招待・特別）
［招待講演］

女性活躍を阻害する要因とは　　　　　　　　　　　　　　　
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年07月09日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

生涯を通じた切れ目ないケアへ：プレコンセプションケアを考える. 日本版プレコンセプションケアの現状と課題
前田恵理
第80回日本公衆衛生学会, 2021年12月21日, シンポジウム・ワークショップパネル（公募）
2021年12月21日 - 2021年12月23日, 30208482

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　　　　　　　　　　　　　　　
前田恵理
第66回日本生殖医学会学術講演会・総会, 2021年11月12日, シンポジウム・ワークショップパネル（指名）
2021年11月11日 - 2021年11月12日, ［招待講演］

Probability of receiving assisted reproductive technology treatment through out-of-pocket payment and household income: A discrete choice experiment in Japan　　　　　　　　　　　　　　　
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年06月26日, ポスター発表
2021年06月26日 - 2021年07月01日

諸外国のプレコンセプションケアの動向：FertiSTATを中心に　　　　　　　　　　　　　　　
前田 恵理
看護薬理カンファレンス2020 in 東京, 2020年12月20日, 口頭発表（招待・特別）
［招待講演］

日本におけるプレコンセプションケア　　　　　　　　　　　　　　　
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年12月12日, シンポジウム・ワークショップパネル（指名）
［招待講演］

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　　　　　　　　　　　　　　　
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年12月03日

韓国・台湾の生殖補助医療公費負担制度　　　　　　　　　　　　　　　
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年12月03日

公衆衛生学的視点からみたプレコンセプションケア　　　　　　　　　　　　　　　
前田恵理
第35回日本女性医学学会学術集会, 2020年11月22日, シンポジウム・ワークショップパネル（指名）
［招待講演］

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　　　　　　　　　　　　　　　
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年10月20日, 口頭発表（一般）

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　　　　　　　　　　　　　　　
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年10月20日, 口頭発表（一般）

諸外国の取組から考えるプレコンセプションケア　　　　　　　　　　　　　　　
前田恵理
第61回日本母性衛生学会総会, 2020年10月10日, シンポジウム・ワークショップパネル（指名）
2020年10月09日 - 2020年10月10日, ［招待講演］

Promoting fertility awareness and preconception health using a chatbot: A randomized controlled trial　　　　　　　　　　　　　　　
Maeda E, Miyata A, Boivin J, Nomura K, Kumazawa Y, Shirasawa H, Saito H, Terada Y
36th Annual Meeting of ESHRE, 2020年07月05日, ポスター発表
2020年07月05日 - 2020年07月08日

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　　　　　　　　　　　　　　　
前田恵理
第90回日本衛生学会学術総会, 2020年03月27日, 口頭発表（一般）
2020年03月26日 - 2020年03月28日

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　　　　　　　　　　　　　　　
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年02月20日, ポスター発表

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　　　　　　　　　　　　　　　
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年11月29日, 日本語, ポスター発表
［国内会議］

プレコンセプション・ヘルス・ケアとは　　　　　　　　　　　　　　　
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年10月26日, 日本語, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］, ［国内会議］

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～　　　　　　　　　　　　　　　
前田 恵理
プレコンセプションケアを考える会, 2019年10月07日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］, ［国内会議］

プレコンセプションケアと魚介類摂取　　　　　　　　　　　　　　　
前田 恵理
第43回日本女性栄養・代謝学会学術講演会, 2019年09月06日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］, ［国内会議］

プレコンセプション・ヘルス・ケアとは　　　　　　　　　　　　　　　
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年08月03日, その他
［招待講演］

International Symposium “How can we support infertile couples without health insurance? Perspective from public health（Japan)"　　　　　　　　　　　　　　　
Eri Maeda
日本受精着床学会総会・学術講演会 International Symposium, 2019年08月02日, 英語, シンポジウム・ワークショップパネル（指名）
［招待講演］, ［国内会議］

Working conditions and fertility quality of life (FertiQoL): a cross-sectional study in Japan.　　　　　　　　　　　　　　　
Maeda, E, Hiraike, O, Murata, K, Sugimori, H, Osuga, Y
35th Annual Meeting of ESHRE, 2019年06月25日, 英語, ポスター発表
［国際会議］

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　　　　　　　　　　　　　　　
前田 恵理
令和元年度第１回産学官交流プラザ, 2019年06月04日, 日本語, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］, ［国内会議］

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　　　　　　　　　　　　　　　
前田 恵理
第71回日本産科婦人科学会学術講演会, 2019年04月14日, 日本語, シンポジウム・ワークショップパネル（指名）
［招待講演］, ［国内会議］

Two-year follow-up of a randomised control trial: knowledge and reproductive outcome after online fertility education　　　　　　　　　　　　　　　
Maeda E, Boivin J, Toyokawa S, Murata K, Saito H
34th Annual Meeting of ESHRE - Barcelona 2018, 2018年07月02日, 英語, 口頭発表（一般）
［国際会議］

Various Japanese attempts to raise fertility awareness and stop declining fertility rates.　　　　　　　　　　　　　　　
Maeda E, Saito H
Precongress Course n° 6 - 34th Annual Meeting of ESHRE - Barcelona 2018, 2018年07月01日, 英語
［招待講演］, ［国際会議］

新しい時代のリプロダクティブヘルスを考える　　　　　　　　　　　　　　　
前田 恵理
秋田県臨床細胞学会総会, 2018年06月09日, 日本語, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］, ［国内会議］

妊娠・出産に関するリテラシー ―啓発の現状と効果―　　　　　　　　　　　　　　　
第58回日本卵子学会学術集会
［招待講演］, ［国内会議］

レセプトNDB分析による全国の不妊治療実施状況の評価
科学研究費助成事業
2024年04月01日 - 2027年03月31日
前田 恵理
日本学術振興会, 基盤研究(C), 北海道大学, 24K13521

未婚男性への教育介入は精液所見と将来の出生力を改善するか
戦略的な研究開発の推進 創発的研究支援事業
2021年04月 - 2027年
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。
科学技術振興機構, 秋田大学, 研究代表者

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　　　　　　　　　　　　　　　
厚生労働科学研究補助金
2022年11月 - 2024年03月
厚生労働省, 成育疾患克服等次世代育成基盤研究事業, 研究代表者, 22DA1003

就労女性の月経随伴症状と労働生産性に関する研究
科学研究費助成事業
2021年04月 - 2024年03月
野村 恭子, 岩田 豊人, 前田 恵理
日本学術振興会, 基盤研究(B), 秋田大学, 21H03192

本邦における不妊症有病率の推定と未受診要因の解明
科学研究費助成事業
2021年04月 - 2024年03月
前田 恵理, 野村 恭子, 左 勝則, 小林 廉毅
日本学術振興会, 基盤研究(B), 秋田大学, 21H03193

低濃度マンガン曝露の無症候性神経機能に及ぼす影響の解析
科学研究費助成事業 基盤研究(C)
2018年04月01日 - 2022年03月31日
岩田 豊人, 前田 恵理, 村田 勝敬
マンガンは必須金属でありながら、作業環境や一般環境で過剰な曝露を受けるとパーキンソン病に似た運動障害を発症することが知られている。マンガンによる健康障害がどの程度の曝露レベルから生じるかを検討するために、マンガン鋼鋳物製造作業者や溶接作業者をはじめとする幅広い曝露レベルが想定される健常成人男性を対象として、血中マンガン濃度と手のふるえや重心動揺との量－影響関係を精査し、影響の現れはじめる曝露レベルを推定しようとする計画である。特に手のふるえはマンガンの作用点として知られている大脳基底核に関係している事と、加速度センサーを用いて客観的に数値化して評価できることから影響指標として適していると考えられる。
初年度は、協力の得られた事業所で「マンガン作業者」として特殊健康診断を受ける者を含む53名について、手のふるえと重心動揺を測定することができた。当日の血液中マンガン濃度は6.5～27.8 ng/gであった。マンガンの体内動態に影響しうるとされる血清鉄は0.34～2.03 mg/Lであった。血中金属濃度のパターンからは、別に鉛の曝露を受けた対象者も含まれていたようであった。また、これらの作業者は交替制により夜間勤務をおこなう者も含まれているため、解析にあたっては年齢、喫煙・飲酒習慣の他にこれらの要因による影響も考慮する必要がある。
今後はマンガン作業者と曝露を受けない対照者について、特に夜間勤務の有無に注目して観察対象者を増やしていく予定である。
日本学術振興会, 基盤研究(C), 秋田大学, 18K10100

多胎妊娠のレセプトNDB分析を通じた地域別周産期医療の質の評価
科学研究費助成事業 若手研究
2018年04月01日 - 2022年03月31日
前田 恵理
わが国では正常妊娠・分娩が保険外診療の枠組みで取り扱われており、妊娠・出産に関する全国規模のデータは極めて限られている。例えば、出生数や死産数は人口動態統計に基づいて住所地で登録されているため、出生や死産の場所（医療機関所在地）に関する情報は、辛うじて文字データで存在するだけで、これまでに集計が行われたことはない。そのため、里帰り分娩の頻度について正式な統計は存在しないし、どの地域のどのレベルの施設（規模・機能等）がどのような患者（母体年齢などリスクの有無）の診療にあたっているかについて全体像を把握することは極めて困難である。日本産科婦人科学会が運営する周産期登録データベースへの参加施設数も、年々増加傾向にはあるものの、全体から見ると一部に留まっている。このような状況下で、「多胎妊娠」に関するレセプト情報の解析はわが国の周産期医療の全体像を知る手がかりになり得る。「多胎妊娠」は、通常初診時から保険診療となることが多く症例のほとんどが最終的に帝王切開術（保険診療）で出産する。本研究では、わが国の多胎妊娠の妊娠・分娩管理について記述的に明らかにすることを目的に、レセプトNDB特別抽出情報（個票）を利用して多胎妊娠症例の受診頻度、転院・搬送、入院期間、医療機関の種類（NICU有無、病床数等）、産科合併症の発生率について記述的に明らかにする。
日本学術振興会, 若手研究, 秋田大学, 18K17372

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　　　　　　　　　　　　　　　
女性の健康の包括的支援政策研究事業
2019年04月 - 2022年03月
大須賀穣
厚生労働省, 競争的資金

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　　　　　　　　　　　　　　　
女性の健康の包括的支援政策研究事業
2019年04月 - 2021年03月
荒田尚子
厚生労働省, 競争的資金

「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　　　　　　　　　　　　　　　
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)
2018年04月 - 2021年03月
前田 恵理
厚生労働省, 研究代表者, 競争的資金

生涯を通じた健康の実現に向けた「人生最初の1000日」のための、妊娠前から 出産後の女性に対する栄養・健康に関する知識の普及と行動変容のための研究
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)
2020年04月
荒田尚子
厚生労働省, 研究分担者

副腎ホルモン産生異常に関する調査研究　　　　　　　　　　　　　　　
難治疾患政策研究事業
2017年04月 - 2020年03月
長谷川奉延
厚生労働省, 競争的資金

メチル水銀の生殖機能に及ぼす影響に関する研究
科学研究費助成事業 基盤研究(C)
2016年04月01日 - 2019年03月31日
村田 勝敬, 前田 恵理, 坂本 峰至, 寺田 幸弘, 岩田 豊人
【背景】メチル水銀の生殖への影響については、先行研究が極めて少ない上、欧米の対象者の水銀値は日本人より著しく低く、他の金属類との相互作用も考慮されていなかった。今回、魚介摂取の多いわが国で初めて、メチル水銀をはじめとする金属類曝露と妊孕性の関連を調べる疫学調査を実施した。
【方法】秋田県内の産婦人科にて不妊と診断された女性患者９８名と県内の健康保険組合加入の３０代女性労働者４３名から提供された血液検体および生活習慣や食生活に関する質問紙調査の回答を用いて患者対照研究を行った。２群間で血中総水銀、鉛、カドミウム、砒素、マンガン、亜鉛、セレンを比較した。また、抗ミューラー管ホルモン（AMH）値と各血中金属類濃度との相関分析を行った。
【結果】患者・対照群間の血中総水銀濃度に有意差はなかったが、血中セレン濃度(189±25 μg/L対200±25 μg/L)および血中セレン/水銀モル比（94.6±44.3対118.4±70.5）は患者群で有意に低かった。年齢ほかを調整した総水銀濃度は患者群で有意に高く、調整セレン濃度は患者群で有意に低かった。多重ロジスティック回帰分析による調整後も、血中総水銀濃度が高いことと血中セレン濃度が低いことは不妊と有意な関連があった。AMH値と血中金属類濃度に有意な相関は認めなかった。
【考察・結論】妊孕性に対してメチル水銀が悪影響を及ぼす一方、セレンには保護作用がある可能性があることを世界で初めて示唆した研究である。妊娠を希望する女性は、メチル水銀は少なく、セレンや多価不飽和脂肪酸の含有量の多い魚介類の摂取を心がける必要性が示唆される。
日本学術振興会, 基盤研究(C), 秋田大学, 16K09124

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　　　　　　　　　　　　　　　
2017年12月 - 2018年11月
前田 恵理
ファイザーヘルスリサーチ振興財団, 研究代表者, 競争的資金

帝王切開率の地域差に影響する因子の検討
科学研究費助成事業 研究活動スタート支援
2016年08月26日 - 2018年03月31日
前田 恵理
全国のレセプト情報を解析することで、今回初めて、わが国の年間を通した帝王切開術実施状況を明らかにした。わが国の年間を通した帝王切開率（2013 年）は 18.5%で、都道府県別では 14.0%から 25.6%まで差があり、周産期医療に関わるマンパワーや施設が少ない地域、分娩取扱機能が分散している地域では予定帝王切開術が多く行われる傾向にあった。多くの先進諸国で社会的理由による帝王切開率が増加している中、わが国の帝王切開率は世界保健機関の推奨する値に比較的近く保たれ、周産期医療水準の高さが改めて確認された一方で、予定帝王切開率の地域差の背景に周産期医療体制の違いのある可能性が示唆された。
日本学術振興会, 研究活動スタート支援, 秋田大学, 16H06647

効果的な医療費助成のあり方に関する医療政策的研究
科学研究費助成事業 特別研究員奨励費
2014年04月25日 - 2016年03月31日
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）。
日本学術振興会, 特別研究員奨励費, 東京大学, 14J01591