Suchergebnisse

AbstractThe new West Japan Twins and Higher Order Multiple Births Registry was established by recruiting young twins and multiple births and by referrals from public health centers in the 1990s. The participants included in the survey comprised over 7800 twins and 4241 higher order multiples, and their families. Specifically, the present registry contains one of the largest triplet samples in the world. For these twins and multiples, data on year of delivery, mode of delivery, gestational age, intrapartum complications, longitudinal physical measures, motor milestones, cerebral palsy and feeding methods were obtained from records in the Maternal and Child Health Handbooks and schools. Participating mothers were asked to indicate family structure, parental educational history, maternal sleeping time, maternal health condition, maternal and paternal age at multiple delivery, complications during pregnancy, handedness of multiples and age at menarche of multiples. However, the zygosity differed among the various collaborating public health centers according to factors such as the time of investigation. Follow-up questionnaires have been mailed out every 3–4 years for longitudinal studies. This article describes the goals of this registry, recruitment of multiples and the focus of the study. The goals of this registry are not only to conduct research on human genetics and maternal and child health, but also to contribute to providing appropriate information for families with multiples.

The West Japan Twins and Higher Order Multiple Births Registry was established in the 1990s by recruiting young twins and multiples and through referrals from public health centers. To date, over 7,000 twins and 4,300 higher order multiple births and their families have been registered in the survey, and it includes one of the largest triplet samples in the world. Follow-up questionnaires are also mailed every 2 to 3 years as part of longitudinal survey studies. This article describes the goals of the registry, the recruitment of multiples, and the overall focus of the study. The goals of the registry are not only to provide data for research on human genetics and maternal and child health, but also to provide appropriate information for families with multiples.

AbstractThe purpose of this study was to clarify the characteristic child-rearing problems for mothers of multiple children who conceived after infertility treatment as compared to mothers of multiple children who conceived spontaneously. The subjects were 990 mothers of multiple children: 359 who conceived after infertility treatment and 631 who conceived spontaneously. Mothers who conceived after infertility treatment were more delighted when informed of a multiple pregnancy than those who conceived spontaneously. In addition, with respect to anxiety during twin pregnancies, mothers of twins who conceived after infertility treatment showed lower rates of anxiety about nursing the infants and economic concerns than those of twins who conceived spontaneously. However, after delivery, mothers who conceived after infertility treatment showed a higher rate of depressive symptoms than those who conceived spontaneously. After adjusting for each associated factor using logistic regression, the risk of depressive symptoms in mothers who conceived after infertility treatment was significantly associated with disabled multiple children and the methods for alleviating stress. The odds ratio indicated that mothers with at least one disabled child were twice as likely to have depressive symptoms as mothers with no disabled children. Furthermore, the odds ratio indicated that mothers who used no methods for alleviating stress were twice as likely to have depressive symptoms than those who did.

We aimed to analyze the characteristics of development of relative weight in Japanese triplets from birth until 12 years of age. Data were collected through a mailed questionnaire sent to mothers of triplets asking for information recorded in medical records. Altogether we had information on 1,061 triplet children of 354 mothers born between 1978 and 2006. For these births, data on triplets' height and weight growth, gestational age, sex, parity, and maternal age at delivery were obtained from records in the maternal and child health handbooks and records from the schools where children receive health check-ups. In addition, information on maternal height and weight was obtained. Triplets have a lower ponderal index at birth and lower body mass index (BMI) compared with the general population until 12 years of age, except for the period during 1 and 3 years of age. Moreover, birth weight had the strongest contribution to BMI of triplets until 6 years of age. After 9 years of age, maternal BMI was a significant factor affecting BMI of triplets.

We analyzed the characteristics associated with the growth in weight of Japanese triplets from birth to 12 years of age. The study included 376 mothers and their 1,128 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' weight growth, gestational age, sex, parity, maternal age at delivery, maternal height, and maternal body mass index were obtained from records in the Maternal and Child Health Handbooks and records in the school where children receive health check-ups. The weight deficit of the triplets compared to the general population of Japan remained between 10% and 17% until 12 years of age. Moreover, at 12 years of age, the differences of weight between the general population and triplets were approximately –4.75 kg for boys and –6.00 kg for girls. Very low birth weight had the strongest contribution to body weight until 8 years of age. After 8 years of age, maternal body mass index was a significant factor affecting the weight of triplets until 12 years of age.

AbstractWe analyzed the characteristics of weight growth and present the weight growth charts from birth to 6 years of age in Japanese triplets. The study included 366 mothers and their 1098 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' weight growth, gestational age, sex, parity, and maternal age at delivery were obtained from records in the Maternal and Child Health Handbooks, which is provided by the authorities after a report of pregnancy. Birthweight proved to be the strongest contribution on weight of triplets from 1 to 6 years of age. In addition, gestational age was also a significant contributing factor to weight from birth to 6 years of age. Moreover, males had a higher weight from birth to 6 years of age than females. Compared to the 50th percentile of the growth standard for the general population of Japan, the weight deficit of the triplets was more than 40% at birth (male, –1.28 kg; female, –1.28 kg), decreased within the first 1 year of age, and fluctuated between 4% and 9% until 6 years of age (male, –1.82 kg; female, –1.78 kg). In conclusion, triplets have lower birth weight than singletons and in spite of the rapid catch-up growth during first year of life they are behind singletons even in mid-childhood. This study provides growth curves for use in triplets.

Background:The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk.Methods:Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis.Results:After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment.Conclusion:Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

Length and weight in infancy are associated with neurodevelopment, but less is known about growth in other anthropometric measures. In this study we analyzed how the development in length, weight, head circumference, and chest circumference over infancy is associated with motor development in early childhood, using a twin study design. Information on physical development over infancy and the age at achievement of eight developmental milestones over early childhood was collected for 370 Japanese twin pairs. Linear mixed models were used to analyze how physical development is associated with motor development between individual twins, as well as within twin pairs, adjusting the results for shared maternal and postnatal environmental factors. Delayed motor development was associated with smaller body size over infancy, and we also found some suggestive evidence that it was associated with catch-up growth as well. When studying the associations within twin pairs discordant for motor development, similar associations were found. However, chest circumference showed the most robust association within discordant twin pairs. Smaller body size and rapid catch-up growth are associated with delayed motor development. When studying these associations within twin pairs and thus adjusting the results for gestational age as well as many other maternal and postnatal environmental factors, chest circumference showed the most robust association. Chest circumference, rarely used in developed countries, can offer additional information on prenatal conditions relevant for further motor development not achieved by more traditional anthropometric measures.

We analyzed the characteristics associated with the growth in height of Japanese triplets from birth to 12 years of age. The study included 376 mothers and their 1,128 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' length and height growth, gestational age, sex, parity, maternal age at delivery, and maternal height were obtained from records in the Maternal and Child Health Handbooks and records in the school which children receive health check-ups. The height deficit of the triplets compared to the general population of Japan remained between 2% and 5% until 12 years of age. Moreover, at 12 years of age, the differences of height between the general population and triplets were approximately -3.6 cm for male and -4.4 cm for female. Maternal height showed the strongest contribution to height of triplets from 6 to 12 years of age. In conclusion, triplets remain shorter than singletons until 12 years of age.

AbstractWe analyzed the characteristics associated with the growth in length and height of Japanese triplets from birth to 6 years of age and present the growth charts for them. The study included 354 mothers and their 1,061 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' length and height growth, gestational age, sex, parity, and maternal age at delivery were obtained from records in the Maternal and Child Health Handbooks, which is provided by the authorities after a report of pregnancy. Birth length showed the strongest contribution to height of triplets from 1 to 6 years of age. In addition, birthweight was also a significant contributing factor to height from 1 to 3 years of age. Compared to the 50th percentile of the growth standard for the general population of Japan, the length and height deficit of the triplets was approximately 15% at birth (male, –7.0 cm; female, –7.0 cm), decreased within the first year of age, and fluctuated between 2 and 5% until 6 years of age (male, –3.7 cm; female, –3.3 cm). In conclusion, triplets have lower birth length and subsequent height than singletons. In spite of the catch-up growth during the first year of life, they are behind singletons even in mid-childhood. This study provides height growth curves for triplets.

AbstractThis study was performed using population-based data to analyze whether motor development in early life is different between singletons and twins in Japan. For better comparison and investigation, we divided the 2 groups into a group with a birthweight of 2.5 kg or greater (subgroup A) and a group with a birthweight of less than 2.5 kg (subgroup B), respectively. We analyzed the database of medical check-ups for children aged 3 years between April 2001 and July 2004. They received medical checkups at 4 months, 1.5, and 3 years of age. Children who were suspected of having neurological abnormality or disability were referred to specialists and excluded from the database. The data of 14,132 children were analyzed. Among these, 13,040 (92.3%) children were singletons in subgroup A, 75 (0.5%) were twins in subgroup A, 866 (6.1%) were singletons in subgroup B and 151 (1.1%) were twins in subgroup B. The mean age at achieving milestones was slower in twins of subgroup A for each developmental outcome than singletons of subgroup A, and the difference between twins and singletons was significant after adjustment for rolling over. On the contrary, after adjusting for a confounding factor (gestational age), singletons of subgroup B attained motor development facilitating walking independently slower than twins of subgroup B. There were different tendencies in the results regarding the motor development of subjects of subgroup A and that of subjects of subgroup B.