Studies have shown that approximately half of young Japanese women experience consistent, remarkable coldness in their extremities. The authors previously demonstrated an association of unusual coldness with lower daily energy intake and reduced thermoregulatory sympathetic nervous system (SNS) activity in young women. This led to the hypothesis that the unusual coldness observed among these young women derives from a widening difference between core and peripheral temperatures because of lowered thermogenesis. This study aims to examine this hypothesis. Twenty women aged 18-21 years participated in this study ; ten women consistently suffer severe coldness even at thermoneutral temperature (C-group), and another ten who do not experience such coldness (N-group). Body composition, resting energy expenditure (REE), thermoregulatory SNS evaluated by heart rate variability analysis, body temperature, and cold discomfort scores using visual-analogue scales were measured in a temperature-controlled room (26℃) at 8:30 a.m. after an overnight fast on two different days. As indices of core and peripheral temperatures, eardrum, finger, and toe temperatures were measured using high-sensitivity thermo-sensors for 60 min. C-group showed a significantly lower thermoregulatory SNS and tended to have lower REE per lean body mass as compared to N-group. Eardrum temperature did not differ between the groups. Only C-group showed a significantly increased difference between core and peripheral temperatures (eardrum-finger or eardrum-toe, 0-60 min). A positive correlation was observed between eardrum-toe temperatures and cold discomfort scores at the toe. Our results suggest that women who consistently experience such coldness characteristically have 1) lowered REE. 2) increased difference in core-peripheral temperatures during 60 min, 26℃-environmental exposure despite similar core temperature, and 3) increased coldness due to wider core-peripheral temperatures, thus supporting our hypothesis.

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Objective : The purpose of this study is to compare pregnant women with mental illness to healthy pregnant women from the perspective of perinatal management. Subjects and methods : This study is a retrospective comparative controlled trial. Twenty-two pregnant women with mental illness were included in subjective group abbreviated as A, and 108 healthy pregnant women were included in controlled group abbreviated B. The 14 items shown below were compared among the two groups with statistical analysis. (1)The percentage of multipara (2)Maternal age (year) (3)Body mass index (BMI) immediately before pregnancy (4)Alcohol consumers before pregnancy (%) (5)Smokers before pregnancy (%) (6)Interval between obstetrical examinations (weeks) (7)Weight gain during pregnancy/Gestational age at delivery (kg/week) (8) Alcohol consumers during pregnancy (%) (9)Smokers during pregnancy (%) (10)Patients with pregnancy induced hypertension (PIH) (11)Patients with preterm delivery (%) (12) Gestational age at delivery (weeks) (13)Caesarean section (%) (14)Birth weight (g) (15)Apgar score 5 minutes after birth (16)Breast feeding (%) Results : The significance was not recognized on the percentage of multipara, maternal age, BMI, interval between obstetrical exams. Weight gain per week was higher in A (p<0.01). The percentage of alcohol consumers before and during pregnancy was changed from 13.6% to 9.1% in A, from 46.2% to 7.4% in B. The percentage of smokers before and during pregnancy was changed from 31.8% to 31.8% in A, from 17.5% to 8.3% in B. The significance was not recognized on the incidence of PIH and preterm delivery. Gestational age at delivery was earlier and Birth weight was lower in A (p<0.01). The percentage of Caesarean section was 50% in A and 13.8% in B (p<0.01). The percentage of breast feeding was 27.2% in A and 100% in B (p<0.01). Conclusion : Pregnant women with mental illness may not have adequate awareness of self-management because of the higher rate of weight gain and smoking during pregnancy. On the other hand, for weight gain, it is necessary to consider the effects of antipsychotics. Aggressive intervention in labor is required in the case that psychiatric symptoms get worse. This results in an earlier gestational week at delivery, a lower birth weight of infants, and a higher rate of Caesarean section deliveries. The rate of breast feeding is lower because of the medication.

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This study aimed to find out why some mothers choose to have fewer children than they would really like. The significance of this study was to offer suggestions for maternity service so that mothers would be encouraged to have more children. 1,800 questionnaires were distributed to mothers in A Prefecture. Out of 499 respondents. 14.6% of mothers answered that they did not want to have more children. The biggest influence was economic circumstances. The desire to have no more children was also correlated to the fact that the last pregnancy childbirth was unwanted. From a maternity service point of view, the following are suggested to encourage mothers to have more children. 1. Mothers with an unwanted pregnancy should be encouraged to feel the joy of having a child. 2. For mothers who feel that earlier experiences of pregnancy and childbirth were traumatic, early detection and prevention of abnormalities, and client satisfaction are important. 3. Mothers who feel that child rearing is stressful should be encouraged to have more confidence. 4. Since economic circumstances are an important factor, the situation of the client should be considered when care and service are provided. The results of this study suggest that for the mothers with a reasonable income, support for a satisfying delivery is most likely to encourage them to have more children. For the mothers on a low income, economic support for child-rearing expenses would be the most helpful factor.

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