This is the first study to develop scales for pregnancy-related discomforts in Japanese women in order to evaluate psychosomatic states during each trimester of pregnancy. Because the number of scale items had decreased by more than half as compared to previous scales, this new, more feasible scale may be useful in clinical settings.

The present study aimed to clarify the changes in the incidence and frequency of pregnancy-related discomforts in the period from the third-trimester pregnancy to 1 year postpartum, and factors associated with the symptoms. MethodsThe participants were pregnant women who visited the obstetrics and gynecology outpatient departments of four hospitals for medical examinations or maternity classes in Hiroshima, Japan. A questionnaire survey was administered five times longitudinally: during the pregnancy period, at discharge, and at 1 month, 4 months, and 1 year after childbirth. The contents of the survey consisted of the existence and the frequency of 29 frequently experienced discomforts of pregnancy, type of delivery, feeding condition, childcare burden scale, Japanese version of maternal attachment inventory (MAI-J), and Japanese version of Edinburgh postnatal depression scale (EPDS). We performed one-way analysis of variance for analyzing the changes in the number of symptoms from pregnancy to postpartum and chi-square tests for analyzing the prevalence of each symptom. The Pearson product factor correlation coefficient and unpaired t-tests were used for analyzing the relation between the number of symptoms and the factors affecting postpartum health. ResultsQuestionnaires were distributed to 1566 women in the pregnancy period, and we collected third-trimester data of 681 women and used data of 422 women. Questionnaires were also distributed to the women during the following postpartum periods: time of discharge, 126; 1 month after childbirth, 88; 4 months after childbirth, 79; and 1 year after childbirth, 70. The number of pregnancy-related symptoms were decreased as time passed by (F=130.93, p<0.01). The prevalence of 22 symptoms significantly decreased after childbirth, while the prevalence of three symptoms increased and that of four symptoms remained unaltered. The number of symptoms at the time of discharge and 1 month after childbirth were significant correlated with the EPDS score (r=0.39-0.58, p<0.01) and the childcare burden scale (r=0.30-0.44, p<0.05) from 1 month to 1 year after childbirth. ConclusionThe findings of this study confirm that some pregnancy-related discomforts continue to postpartum and that the number of symptoms in postpartum is associated with postpartum depression and the stress of postnatal care. We thus showed the importance of maternal care during pregnancy as it affects childcare later on. Childcare starts from pregnancy. Thus, a smooth transition to childcare is possible only if pregnancy-related discomforts such as "minor troubles" are not taken lightly, as women require all the physical, mental, and emotional care right from the beginning of pregnancy to be strong and healthy in all aspects of the postnatal phase.

This study was to clarify the characteristics and changes of the sleep-wake rhythm in mothers from late pregnancy to four months postpartum. Methods Participants were 57 women in late pregnancy to four months postpartum. The subjects were 57 mothers after 35 weeks of pregnancy who gave informed consent to participate. Of these, forty-seven mothers 1 month postpartum and thirty-four at 4 months postpartum, were surveyed longitudinally at. Participant recorded 24 hours sleep-and-wakefulness using a day-by-day plot method on Sleep Log at intervals of 30 minutes for one week. We calculated sleep parameters: total sleep time (TST), nocturnal sleep time (NST), diurnal sleep time (DST), longest sustained sleep period (LSP), LSP onset and offset times, numbers of total sleep hours and diurnal sleep hours, time of waking after sleep onset (WASO), number of WASO and sleep-wake cycle. Results TST were 7.79 hours in late pregnancy, 6.73 hours 1 month postpartum and 6.91 hours in 4 month after delivery (F=18.21, p<0.001). NST were 6.75 hours, 5.85 hours and 6.36 hours (F=12.27, p<0.001) respectively. LSP were 6.39 hours, 3.46 hours and 4.13 hours (F=87.61, p<0.001). TST, NST and LSP in postpartum were shorter than those late pregnancy. WASO were 0.42 hours, 1.70 hours and 1.14 hours (F=45.42, p<0.001). Number of WASO were 0.3 times, 1.7 times and 1.5 times (F=78.60, p<0.001). WASO in postpartum was longer than those late pregnancy, and number of WASO in postpartum was larger than those late pregnancy. It was found that LSP showed significant negative correlation with LSP onset in late pregnancy (r=-0.481, p<0.001), and 4 months postpartum (r=-0.396, p<0.05). In addition, LSP were predominantly between 0:22 and 6:50, while cycle of sleep-and-wakefulness rhythm was approximately 24 hours, which showed a range of 24.04 hours to 24.08 in the mothers in this study. Conclusion The sleep-wakefulness rhythm in mothers is disturbed from late pregnancy to postpartum, although TSP, NSP, LSP decrease and WASO increases. The mothers who go to bed early are able to sleep longer during nighttime hours and sleep-and-wakefulness was approximately 24 hours cycle in all mothers.

PurposeBecause sleep is essential for normal pregnancy-associated physiological changes and healthy fetal development it is important to provide advice to first trimester expectant mothers in order to enhance self-care. Therefore, the aims of the present study are to clarify first trimester sleep quality and sleepiness characteristics, and to elucidate the affects of stress on sleep and sleepiness characteristics. MethodsSelf-administered questionnaires were distributed to 46 first trimester expectant mothers who were recruited from outpatient departments of two hospitals in Hiroshima, Japan between April 2007 and January 2008. The questionnaire was composed of the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), a sleep log, and the Perceived Stress Scale (PSS). ResultsThe average global score of the PSQI (PSQIG) was 6.67 (±3.20), and 65.2% of participants exceeded the cutoff score. Participants with higher perceived stress had significantly higher PSQIG scores (r=0.38, n=46, p<0.01). There was a positive correlation with PSQIG (r=0.40, n=46, p<0.01) and regularity of bedtime, indicating that participants with well-regulated daily habits have lower PSQIG scores. The average ESS score was 10.1 (±4.3), with 50.0% of participants scoring 11 points or higher. Moreover, primipara had higher scores than multipara (un-paired t (44)=2.52, p <0.05), and those participants with more children had lower scores (r=-0.32, n=46, p<0.05). Sleepiness duration and nap duration were not significantly different for parity. For employment (employed or not-employed), nap duration was significantly different (un-paired t (27)=2.27, p<0.05), however, there was no significant difference in sleepiness duration. ConclusionThis study has shown that first trimester expectant mothers have markedly poor sleep quality and higher levels of sleepiness when compared to women of the same age in the general population. In addition, this study suggests that sleep quality is improved by controlling stress and by having well regulated sleep habits.

Supportand care for partners of high-risk pregnancies Abstract PurposeThe purpose of this research is to shed light on how nursing practices support the role of partners of high-risk pregnancies (HRP). Partners of HRP are often ambivalent about their roles and responsibilities. They not only have an important role in the economic support of their partners, but they are also expected to be the key-person in her psychological support system.