Current Status of Cooperation Between Obstetric Care Institutes and Psychiatrists in Japan.

In May 2024, we requested all obstetric institutes (n = 1970) that are members of the Japan Association of Obstetricians and Gynecologists (JAOG) to provide information concerning the collaboration between obstetric institutes and psychiatrists in Japan, such as (1) pregnancy and delivery management of all pregnant women with psychiatric complications, and (2) availability of smooth collaboration with associated psychiatry (or psychiatrists) regarding pregnant women with psychiatric complications. Of the 1970 obstetric institutes, 1483 (75.2%) responded with valid information (completion of data submitted). In Japan, only 21% (308/1483) of all obstetric institutes are able to see all pregnant women with psychiatric complications who attend their hospital, and 32% (480/1483) of the institutes responded that they have smooth cooperation with associated psychiatrists. The response to pregnant women with mental health problems in Japanese obstetric institutes is not adequately equipped yet.

Challenges for early diagnosis of neonatal herpes infection in Japan.

Background: This study aimed to analyze the recent prevalence of neonatal herpes simplex virus infection, maternal symptoms in the presence of neonate who has herpes simplex virus infection, and mode of delivery in Japan. Methods: We requested 2.078 obstetrical facilities that are members of the Japan Association of Obstetricians and Gynecologists (JAOG) to provide information on neonatal herpes simplex virus infection involving deliveries at or after 22 weeks of gestation between 2020 and 2022. Of these, 1.371 (66.0%) facilities responded with information that could undergo statistical analysis. Results: There were 10 cases of neonatal herpes simplex virus infection, and the incidence of neonatal herpes simplex virus infection in Japan was about 1 in 1.4 × 105 live births. There were no characteristic maternal findings common to cases of neonatal herpes simplex virus infection. Conclusion: The incidence of neonatal herpes simplex virus infection in Japan was low. We could not identify any characteristic maternal findings common to cases of neonatal herpes simplex virus infection.

Trends in Syphilis in Pregnant Women in Japan in 2016 and 2022.

Since 2012, the rate of syphilis infection has increased dramatically in high-income countries including Japan. In this study, we examined the rate of syphilis infection among pregnant women and perinatal outcomes in the syphilis-infected pregnancy in 2022 in Japan, and compared the results with those in 2016. We requested 2,005 obstetric institutes to provide information on syphilis infection in pregnant women who delivered in 2022. A total of 1,346 obstetrical facilities responded with valid information. We compared the results with those in our previous study. The prevalence of syphilis-infected pregnant women was 1/1,215. The incidence of preterm delivery, intrauterine fetal demise and congenital syphilis in surviving neonates in the syphilis-infected pregnancy were 9%, 2% and 7%, respectively. The prevalence of syphilis-infected pregnant women has increased significantly, while the incidence of congenital syphilis seems to have decreased clinically.

Expansion of Mental Health Care in Japanese Obstetric Institutes.

BACKGROUND: The Japan Association of Obstetricians and Gynecologists (JAOG) has raised awareness of the usefulness of identifying pregnant women with mental health problems and supporting them through multi-professional collaboration. We evaluated the results of questionnaire surveys on mental health care conducted in all obstetric institutes that are members of the JAOG annually. METHODS: Between 2017 and 2023, we requested all obstetric institutes (n = 2,073-2,427) that are members of the JAOG to provide information concerning mental health care for pregnant and postpartum women about the situation in December every year from 2017. Here, we evaluated the results of the questionnaire surveys. RESULTS: During the study periods, 56.9-74.8% of the 2,073-2,427 institutes responded with valid information. The percentage of obstetric institutes screening for mental health problems during pregnancy and the postpartum period increased from 54.3% and 53.7% to 87.1% and 83.8%, respectively (p < 0.01). However, the proportion of obstetric institutes able to manage pregnant women with mental disorders did not change significantly during the study period. CONCLUSION: There has been progress in the active identification of women with mental health problems during pregnancy and the postpartum period. However, the proportion of institutes managing mental disorders has not changed.

Antimicrobial Resistance for Chlamydia Trachomatis Genital Infection during Pregnancy in Japan.

The current study examined the antimicrobial resistance of Chlamydia trachomatis (CT) genital infection during pregnancy in Japan. We requested 2,146 obstetrical facilities that are members of Japan Association of Obstetricians and Gynecologists to provide information of CT screening tests and antimicrobial resistance in pregnant women between April 2020 and March 2021. The prevalence of CT genital infection in Japan was 2.1%. The antimicrobial resistance was recognized in 2.0 and 2.4% of the cases using azithromycin and clarithromycin, respectively. There were no significant differences in the antimicrobial resistance rate between the 2 analogues (P = 0.28). In Japan, azithromycin and clarithromycin have effectively treated genital CT infections during pregnancy.

Recent Prevalence of Human T-cell Leukemia Virus Type 1 Carrier Associated with Horizontal Transmission in Pregnant Japanese Women.

The current study was conducted to examine the number of human T-cell leukemia virus type 1 (HTLV-1) carriers and how horizontal transmission affected the prevalence of HTLV-1 carriers among pregnant Japanese women in 2019. We requested 2,214 obstetrical facilities to provide information on HTLV-1 tests for pregnant women who delivered in 2019. The estimated number of HTLV-1 carriers among pregnant Japanese women was 952. At least 10% or more of the carriers acquired HTLV-1 through horizontal transmission.

Current status of cervical cytology during pregnancy in Japan.

In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy.

Current status of Neisseria gonorrhoeae cervicitis in pregnant women in Japan.

We evaluated the current prevalence of gonococcal cervicitis among pregnant women in institutes that either do or do not routinely screen for gonococcal infection in Japan. We requested 2,330 obstetrical facilities to provide information on Neisseria gonorrhoeae cervicitis in pregnant women. A total of 1,876 (80.5%) of them responded. The universal screening test for gonococcal cervicitis, involving nucleic acid amplification for all pregnant women, was performed in 281 institutes (13.9% of institutes across Japan). The total rate of pregnant women with gonococcal cervicitis was 1.3% in the institutes performing the screening test during pregnancy, while it was only 0.2% (p < 0.01) in those not performing it. This suggests that 84% of infected women may have been missed in the institutes that do not routinely perform the screening test for gonococcal cervicitis. It may be time to examine the cost-effectiveness of providing gonococcal screening for all pregnant women in Japan.