Maternal childrearing anxiety reflects childrearing burden and quality of life.

BACKGROUND: The government of Japan has recently initiated public programs to allay maternal childrearing anxiety. The aim of the present study was to determine the prevalence of childrearing anxiety and describe its relationships with perceived childrearing burden and maternal quality of life (QOL). METHODS: A secondary analysis was done of survey data from 1229 mothers enrolled in the Seiiku Birth Cohort Study at the National Center for Child Health and Development between November 2003 and December 2006. Childrearing anxiety was determined by asking mothers, at infant age 3 months, 'Regarding childrearing, do you have any anxiety or worry?'. Childrearing burden was assessed in specific categories such as physical fatigue, household expenses, and personal time. The validated Japanese translation of the WHOQOL-BREF instrument was used to measure Maternal QOL. RESULTS: Sixty-four percent of mothers reported some and 9% much childrearing anxiety. In total, 73% percent of mothers reported any childrearing anxiety. As childrearing anxiety increased from 'none' to 'some' and 'much', the proportion of mothers who reported any childrearing burden increased from 75% to 99% (P < 0.001). QOL scores in each of four domains (physical, psychological, social relationships, and environment) decreased with increasing level of anxiety (P < 0.001). Primiparity, pregnant with more than a singleton and admission to the neonatal intensive care unit were associated with greater anxiety. CONCLUSIONS: The strong associations between childrearing anxiety and childrearing burden, and between childrearing anxiety and maternal QOL, suggest that childrearing anxiety is an empirically credible and measurable phenomenon.

Brainstem cranial-nerve lesions in an infant with hypoxic cerebral injury.

Recent studies have revealed that the brainstem is characteristically involved in hypoxic encephalopathy in infants. However, few reports have described clinical and cranial magnetic resonance findings in detail because most patients with brainstem lesions die during delivery or soon afterward. Reported here is a patient who manifested selective brainstem injury caused by perinatal hypoxic cerebral injury and exhibited palsy of the lower-brainstem cranial nerves. Magnetic resonance imaging was used to demonstrate lesions of brainstem cranial nerves, which were consistent with symptoms of brainstem dysfunction.

Brainstem lesions in children with perinatal brain injury.

Several distributive patterns of hypoxic-ischemic cerebral injury have been recognized in asphyxiated newborns. Lesions of the brainstem have been rarely noted on magnetic resonance images in previous reports because they are difficult to detect. In this study, we demonstrate subtle but definite uniform symmetric brainstem lesions in children with perinatal brain injury. The areas of abnormal intensity were judged to comprise the central tegmental tract. The clinical manifestations in our patients were less severe than those previously described in patients with brainstem lesions. Two patients had difficulty of eye movement, but otherwise had no significant symptoms of brainstem cranial nerve nuclei involvement. All patients had lesions of white matter or cortex. Therefore, the abnormality in the dorsal brainstem revealed by magnetic resonance images is possibly as a result of secondary degeneration of the neurons that send axons into that tract.

Mild trigonocephaly with clinical symptoms: analysis of surgical results in 65 patients.

INTRODUCTION: It has been believed that isolated, mild trigonocephaly rarely presents with clinical symptoms. PATIENTS AND METHODS: We diagnosed and operated on 65 patients with mild trigonocephaly and developmental delay up to July 2000. There were 47 boys and 18 girls in our series. All patients had symptoms such as delay in language development, hyperactivity, autistic tendencies, and motor dysfunctions. Their facial features were characterized by a metopic ridge, depressed temples, heel-shaped rather than keel-shaped forehead, and slight hypotelorism. The most important physical sign was the palpable metopic ridge. Most patients did not exhibit any symptoms until they were more than 1 year old. Fifteen patients showed regression in language acquisition and use. Three-dimensional computed tomography revealed the metopic ridge, depressed pterional regions, hypotelorism, and small anterior fossae. Magnetic resonance imaging was performed on all patients and demonstrated no abnormal findings in the brain. Single-photon emission computed tomography (SPECT) was performed on 83% of patients and revealed decreased cerebral blood flow (CBF) in the frontal lobes of 76% of those patients. Decompressive cranioplasty of the frontal bone involving the skull base was performed on all patients. RESULTS: In most (61 out of 65) patients a degree of postoperative improvement in clinical symptoms was noted, especially in behavioral problems. Postoperative SPECT demonstrated increased CBF in the frontal lobes in 95% of the patients. CONCLUSION: Based on these results, it can be postulated that mild trigonocephaly is frequently associated with developmental delays and that these symptoms can be improved to a certain degree by decompressive cranioplasty.