Maternal folic acid supplement use/dietary folate intake from preconception to early pregnancy and neurodevelopment in 2-year-old offspring: the Japan Environment and Children's Study.

We evaluated the association between maternal prenatal folic acid supplementation/dietary folate intake and motor and cognitive development in 2-year-old offspring using data from the Japan Environment and Children's Study database. Neurodevelopment of 2-year-old offspring were evaluated using the Kyoto Scale of Psychological Development 2001. In total, data of 3839 offspring were analysed. For folic acid supplementation, a multiple regression analysis showed that offspring of mothers who started using folic acid supplements before conception had a significantly lower developmental quotient (DQ) in the postural-motor DQ area than offspring of mothers who did not use them at any time throughout their pregnancy (partial regression coefficient (B) -2·596, 95 % CI -4·738, -0·455). Regarding daily dietary folate intake from preconception to early pregnancy, a multiple regression analysis showed that the group with ≥ 200 µg had a significantly higher DQ in the language-social area than the group with <200 µg. The DQ was higher in the ≥ 400 µg group (B 2·532, 95 % CI 0·201, 4·863) than the 200 to <400 µg group (B 1·437, 95 % CI 0·215, 2·660). In conclusion, our study showed that maternal adequate dietary folate intake from preconception to early pregnancy has a beneficial association with verbal cognition development in 2-year-old offspring. On the other hand, mothers who started using folic acid supplements before conception had an inverse association with motor development in 2-year-old offspring. There were no details on the amount of folic acid in the supplements used and frequency of use. Therefore, further studies are required.

Kangaroo mother care alters chromogranin A and perfusion index in preterm babies.

BACKGROUND: While providing various benefits, concerns about the potential risks of kangaroo mother care, or skin-to-skin contact (SSC), between mother and her preterm infant hinder its widespread implementation in some resource- rich countries. In neonates, salivary chromogranin A (s-CgA) is elevated upon exposure to stress, whereas the perfusion index (PI) is associated with hemodynamics and peripheral perfusion. Here, we investigated the effects of SSC on s-CgA and the PI in preterm infants. METHODS: Twelve infants were enrolled in the study. Factors associated with baseline s-CgA were analyzed. Baseline s-CgA and the level after SSC were compared. Secreted IgA in the saliva was compared as the control. The PI before, throughout, and after SSC were compared. RESULTS: Baseline s-CgA was significantly lower in infants who were supplemented with baby formula milk in addition to breast milk before SSC (n = 2) compared with those fed with their mother's breast milk alone (n = 10, P = 0.03). SSC significantly decreased s-CgA in babies who were fed breast milk only before SSC (n = 10, P = 0.01) but not in those supplemented with formula milk before SSC (n = 2). Secreted IgA in saliva was not affected by SSC. The PI was significantly elevated during SSC (P = .01). CONCLUSION: Our data indicate that SSC can reduce s-CgA levels when combined with mother's breast milk and increase the PI in preterm infants, thereby providing additional evidence of the benefit of SSC.

A Long-term Study of the Association between the Relative Poverty Rate and Suicide Rate in Japan.

The annual number of suicides in Japan totaled around 23,000 in 1997 and abruptly increased to around 31,000 in 1998. This figure has remained high since then. This abrupt increase in the number of suicides was primarily due to an increase in suicides occasioned by economic concerns. The association between various economic factors and suicide must be studied in detail and over the long term in order to ascertain the association between economic concerns and suicide. This study examined the relative poverty rate and the suicide rate in Japan over 30 years and discussed the association between those two rates. The results suggest that the relative poverty rate may be associated with the suicide rate for both sexes. This association is true for men in particular. The organizations and professionals involved in implementing suicide prevention measures should be cognizant of the current findings and consider formulating additional specific measures.

Spontaneous awakening from nocturnal sleep and cardiac autonomic function in preschool children.

A cross-sectional study was carried out to clarify the physiological features of spontaneous awakening from nocturnal sleep (i.e., whether a child can spontaneously wake up on weekday mornings). The study population comprised 116 children at ages 5 and 6 years. Heart rate variability reflecting cardiac sympathetic and parasympathetic activities was measured. Children's typical bedtimes and wake times for weekdays and the presence/absence of spontaneous awakening from nocturnal sleep were reported by parents, and information about obligatory naptimes was provided by preschool teachers. The mean total sleep duration in the children was 625+/-56 (standard deviation) min. Total and nocturnal sleep durations were significantly shorter in 52 children without spontaneous awakening than in 64 children with it. Similarly, the parasympathetic activity was significantly lower in the children without spontaneous awakening, even in using analysis of covariance. Heart rate was significantly increased in the children without spontaneous awakening, but neither total nor nocturnal sleep durations were significant covariates in the analysis of covariance. In conclusion, the absence of spontaneous awakening from nocturnal sleep in preschool children is suggested to be characterized by short sleep duration, parasympathetic hypoactivity, and elevated heart rate.

Impact of total sleep duration on blood pressure in preschool children.

The onset of some adult diseases, e.g., cardiovascular disease, is known to be associated with lifestyles in childhood. The objective of this study was to clarify the relationship between total sleep duration (TSD) and systolic and diastolic blood pressure (SBP and DBP) among 117 children at ages 5-6 years. Parents reported their children's typical bedtimes and wake times for weekdays, and questions about mandatory nap times were answered by the preschool teachers. In the children, the mean TSD, SBP, and DBP were 624 +/- 57 (standard deviation) min, 99 +/- 10 mmHg, and 62 +/- 9 mmHg, respectively. When the children were divided into quartile groups based on TSD, the SBP was significantly higher in the highest group (TSD > 660 min) than in the lowest group (TSD < or = 585 min). The TSD was significantly correlated with SBP (r = 0.265) but not with DBP (r = 0.105), these relationships were similar when TSD and possible confounders such as age and body mass index were set as independent variables of multiple regression analysis. These findings suggest that sleep duration in preschool children is associated with SBP, and extremely short or long sleep may invite subclinical health problems.

Cardiac autonomic hypofunction in preschool children with short nocturnal sleep.

Preschool children with sleep deficit may suffer from autonomic symptoms or hypotension. Heart rate variability, reflecting cardiac parasympathetic and sympathetic activities, and blood pressure were assessed to clarify the effects of nocturnal sleep duration on cardiac autonomic function in 134 preschool children aged 5 and 6 years. Parents reported their children's typical bedtimes and wake times for weekdays. In the children, the mean nocturnal sleep duration (+/- standard deviation) was 575 +/- 42 min. The parasympathetic and sympathetic activities and systolic blood pressure (SBP) were significantly lower in the 80 children with short sleep (nocturnal sleep duration < 10 hrs) than in the 54 children with long sleep (> or = 10 hrs). Only the SBP was positively correlated with nocturnal sleep duration in the children (p < 0.001); also, short nocturnal sleep duration was significantly related to hypotension (SBP < 100 mmHg), as judged by multiple logistic regression analysis. Among the children, inverse correlations were seen between the parasympathetic activity and SBP and between the sympathetic activity and diastolic blood pressure (p < 0.05). These findings indicate that shortening of nocturnal sleep is associated with cardiac autonomic hypofunction and low SBP in preschool children. We suggest that sleep duration is an important predictor for autonomic development in childhood.