清水 三紀子

This study aimed to clarify the temporal changes in transcutaneous hemoglobin levels up to 1 month postpartum and the influencing factors in postpartum women using a noninvasive transcutaneous hemoglobin measuring device. The study participants were pregnant women recruited at an outpatient clinic. We collected information on their dietary history using a concise self-administered questionnaire and an agreement document when they were hospitalized for delivery. Transcutaneous hemoglobin levels of the mothers were measured using Pronto (Masimo) at 1 day, 4 days, 2 weeks, and 1 month postpartum. We included 135 mothers (mean age, 31.7 years) who delivered at full term. The mean transcutaneous hemoglobin levels decreased slightly from day 1 (11.9 ± 1.6 g/dL) to day 4 postpartum (11.8 ± 1.7 g/dL), followed by a significant increase from day 4 to 2 weeks postpartum (13.8 ± 1.0 g/dL; p < 0.01), and no change from 2 weeks to 1 month postpartum (13.8 ± 0.9 g/dL). Iron intake in the third trimester of pregnancy affected transcutaneous hemoglobin levels from day 4 postpartum to recovery by 2 weeks postpartum. The rapid increase in hemoglobin levels from day 4 to 2 weeks postpartum was a novel finding. Evaluation of hemoglobin levels in women at 2 weeks postpartum is important for postpartum recovery. Furthermore, health guidance regarding iron intake in the third trimester of pregnancy has been suggested to be effective in restoring postpartum hemoglobin levels.

OBJECTIVE: This review will identify the effectiveness of non-pharmacological interventions in preventing iron deficiency anemia in pregnant women with a normal course of pregnancy. INTRODUCTION: The global prevalence of anemia among pregnant women is 36.5%, posing risks to women and fetuses. This underscores the need for effective prevention; however, the effectiveness of non-pharmacological approaches in preventing pregnancy anemia remains unclear. INCLUSION CRITERIA: This review will encompass experimental and quasi-experimental studies on the following approaches to prevent anemia during pregnancy: recommendations for dietary supplements, oral iron supplements (over the counter), provision of supplements to promote iron absorption, participation in anemia prevention education, and provision of information. There will be no restrictions on the duration or frequency of intervention, and longitudinal intervention studies will be included. In studies with a control group, the comparator may be usual care or pharmacological interventions; in studies without, it may involve no intervention, temporal comparisons, or baseline periods without non-pharmacological interventions. Evaluation of hemoglobin, hematocrit, and ferritin will be included as primary outcomes. Low birth weight, preterm birth, amount of blood loss at delivery, small for gestational age, and Apgar scores will be included as secondary outcomes. METHODS: A search will be conducted in MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), Scopus, Australian New Zealand Clinical Trials Registry, Cochrane Central Register of Controlled Trials, and ICHUSHI-Web. Researchers will screen studies, extract data, assess the quality of studies, and analyze the data in accordance with the JBI guidance for systematic reviews of effectiveness. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to assess the certainty of the findings. REVIEW REGISTRATION: PROSPERO CRD42022344155.

目的：成人女性を対象として足浴による生体反応を生理・心理学的な評価指標を用いて足浴の最適な「水深」を明らかにした．<br>方法：成人女性19名（21～37歳）を対象に，座位にて41°Cの湯温の足浴を15分間実施した．足浴の水深は三陰交を含まない8 cm，三陰交を含み腓腹筋を含まない15 cm，腓腹筋を含む20 cmを設定し，1日おきに3種類の足浴を実施した．心拍変動から低周波成分（LF）と高周波成分（HF）を算出し，副交感神経活動をHF，交感神経活動をLF/HFとした自律神経活動，表面温，深部温，血圧を生理的指標とし，日本語版POMS-短縮版と新版STAIを心理的指標とした．<br>結果：POMSにおいては水深15 cmでは6項目すべてのT得点において足浴前より足浴後の方が有意に低くなり，8 cm・20 cmに比較してよりリラックス効果が得られた．また，交感神経活動，副交感神経活動，心拍数，表面温，血圧においては水深の相違による有意差はみられなかった．深部温においては水深15 cmが8 cm・20 cmに比較して有意に安定していた．<br>結論：成人女性を対象とした足浴の水深は生理・心理学的に8 cm・20 cmより15 cmの方が最適であることが示唆された．

本研究の目的は,非侵襲的ヘモグロビン測定器Pronto-7を用いたヘモグロビン値測定による妊娠貧血検査の可能性について検討することである。妊婦健康診査で産婦人科外来を受診した妊婦35名を対象に,非侵襲的にSpHbを測定し,血液検査によるHbと比較した。その結果SpHbの平均値は12.0±1.2 (SD) g/dl (最小9.2g/dl,最大14.8g/dl), Hbの平均値は11.2±1.0g/dl (最小8.7g/dl,最大13.7g/dl)であった。ピアソンの相関係数は0.47であり弱い正の相関がみられた(p<0.001)。しかし,妊娠時期別では,妊娠初期の相関係数は0.54 (p<0.01),妊娠中期の相関係数は0.62と正の相関となったが(p<0.001),妊娠末期では相関はみられなかった。本研究結果から妊娠貧血検査の可能性について判断はできなかった。よって今後はさらに対象数を増やし,条件を整えたうえで検証を進めていき,その上で妊婦健康診査時にどのような使用が可能となるか検討していく必要がある。