研究者詳細 - 牧　尉太

論文 - 牧　尉太

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Author Correction: Partner relationships, hopelessness, and health status strongly predict maternal well-being: an approach using light gradient boosting machine. 査読国際誌

Hikaru Ooba, Jota Maki, Takahiro Tabuchi, Hisashi Masuyama

Scientific reports 15 ( 1 ) 8693 - 8693 2025年3月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

No recent study has explicitly focused on predicting the well-being of pregnant women. This study used data from an extensive online survey in Japan to examine the predictors of the subjective well-being of pregnant women. We developed and validated a light Gradient Boosting Machine (lightGBM) model using data from 400 pregnant women in 2020 to identify three factors that predict subjective well-being. The results confirmed that the model could predict subjective well-being in pregnant women with 84% accuracy. New variables that contributed significantly to this prediction were "partner help", "hopelessness," and "health status". A new lightGBM model was built with these three factors, trained and validated using data from 400 pregnant women in 2020, and predicted using data from 1791 pregnant women in 2021, with an accuracy of 88%. These factors were also significant risk factors for subjective well-being in the regression analysis adjusted for maternal age, region, parity, education level, and the presence of mental illness. Mediation analysis, with "hopelessness" as the mediator, showed that both "partner help" and "health status" directly and indirectly affected the outcome.

DOI： 10.1038/s41598-025-93454-y

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Determinants of residual myometrial thickness after cesarean delivery: Comparative analysis of barbed versus conventional sutures-A sub-analysis from the SPIRAL trial. 査読国際誌

Jota Maki, Hikaru Ooba, Tomohiro Mitoma, Hikari Nakato, Ayano Suemori, Chiaki Kuriyama, Shujiro Sakata, Sakurako Mishima, Akiko Ohira, Eriko Eto, Hisashi Masuyama

International Journal of Gynecology & Obstetrics 00 1 - 8 2025年6月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: This sub-analysis aimed to determine whether conventional suture-associated risk factors for cesarean scar defect show similar outcomes with barbed continuous suturing, and to identify factors influencing residual myometrial thickness when using barbed continuous sutures. METHODS: This sub-analysis of a multicenter, parallel-group, randomized controlled trial across four Japanese obstetrics and gynecology departments included 1211 women who had their first cesarean delivery between May 2020 and March 2023. Among them, 298 women underwent a C-section, with 253 follow-up through July 2023. Singleton pregnancies were randomly assigned to receive either barbed or conventional double-layered continuous sutures in a 1:1 ratio; they were monitored from consent through their 6- to 7-month check-up. The effects of cervical ripening, facility characteristics, and surgeon experience were investigated using a two-way ANOVA. RESULTS: Of the remaining 253 patients, 33 were lost to follow-up and 220 completed follow-up (110 per group). One institution enrolled the largest proportion of participants (45.9%), whereas two other institutions had more experienced surgeons. Two-way ANOVA revealed that surgeon experience (P = 0.020) and institutional factors (P < 0.001) significantly influenced the residual myometrial thickness at 6-7 months after surgery, whereas cervical dilation during active labor did not (P = 0.215). Additionally, a significant interaction was observed between institutional factors and suture type (barbed vs. conventional) on residual myometrial thickness (Pinteraction <0.001). CONCLUSION: Institutional factors and surgeon experience represent significant determinants of residual myometrial thickness when using barbed sutures for cesarean closure, highlighting the importance of standardized surgical protocols and training across facilities.

DOI： 10.1002/ijgo.70273

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Role of galectin-9 in the development of gestational diabetes mellitus. 査読国際誌

Haya Hamed Hassan Albuayjan, Mayu Watanabe, Ryosuke Sugawara, Eri Katsuyama, Koki Mise, Yukiko Oi, Ayaka Kanno, BoXuan Yang, Toshihisa Tahara, Ichiro Nojima, Atsuko Nakatsuka, Jun Eguchi, Jota Maki, Eriko Eto, Kei Hayata, Hisashi Masuyama, Jun Wada

Scientific reports 15 ( 1 ) 18981 - 18981 2025年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Galectin-9 (Gal-9) is highly expressed in trophoblasts in placenta. Interaction between Gal-9 and T-cell immunoglobulin and mucin-domain containing-3 (Tim-3) is important for the differentiation of tissue resident natural killer (trNK) cells in placenta and maintenance of normal pregnancy. Furthermore, the enhanced maternal systemic inflammation associated with increased proinflammatory cytokines in preeclampsia is mediated by enhanced interaction between Gal-9 and Tim-3. However, the role of Gal-9 in gestational diabetes (GDM) remains unexplored. Plasma Gal-9 levels were elevated at 3rd trimester in pregnant women with GDM and positively correlated with placenta and newborn weight. Lgals9 knockout pregnant mice fed with high fat diet (HFD KO) demonstrated maternal glucose intolerance and fetus macrosomia compared with controls (HFD WT). In HFD KO, increased proliferating cells, reduced apoptosis, and autophagy impairment were observed in junctional zones. The number of trNK cells and percentage of Tim-3 + trNK increased, while early apoptosis percentage in Tim-3 + trNK was reduced in placenta of HFD KO. The elevation of plasma Gal-9 may be a biomarker for prediction of maternal glucose intolerance and fetal macrosomia in pregnant women with GDM and Gal-9 functions as a compensation factor for GDM by inducing apoptosis in Tim-3 + trNK cells.

DOI： 10.1038/s41598-025-03879-8

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Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire. 査読国際誌

Hikaru Ooba, Jota Maki, Takahiro Tabuchi, Hisashi Masuyama

Journal of epidemiology and global health 15 ( 1 ) 30 - 30 2025年2月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Placental abruption (PA) is a critical obstetric complication, with maternal smoking recognized as a key risk factor. Despite the increased use of heated tobacco products (HTPs), the impact of HTPs remains unclear. This study investigated whether pregnant women using HTPs are at a higher risk of PA than non-users. METHODS: We analyzed data from "the Japan COVID-19 and Society Internet Survey," a prospective, self-reported online survey cohort. Questionnaires were randomly distributed between July 28, 2021, and August 30, 2021. Pregnant respondents in 2021 were invited to complete an additional survey from February 14, 2022, to February 28, 2022. We set the outcome as the absolute risk difference (aRD) and relative risk ratio (rRR) of PA incidence due to smoking HTPs in the first trimester of pregnancy. The sample size included 12 836 participants. We calculated outcomes using a generalized linear model (GLM) and inverse probability of treatment weighting (IPTW). We also performed a Bayesian approach and multiple-bias analysis for sensitivity analysis. RESULTS: We found the robust aRD of 0.07 (95% confidence interval (CI): 0.06, 0.09) and the rRR of 11.3 (95% CI: 7.5, 17.0). Multiple bias analyses showed that unmeasurable confounders would need to have at least an rRR = 14 relationship with both exposure and outcome to disprove the observed association. There has not been post hoc analysis or secondary use of data. CONCLUSION: Early pregnancy use of HTPs is associated with an increased risk of PA.

DOI： 10.1007/s44197-025-00373-2

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Voice analysis and deep learning for detecting mental disorders in pregnant women: a cross-sectional study. 査読国際誌

Hikaru Ooba, Jota Maki, Hisashi Masuyama

Discover mental health 5 ( 1 ) 12 - 12 2025年2月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Perinatal mental disorders are prevalent, affecting 10-20% of pregnant women, and can negatively impact both maternal and neonatal outcomes. Traditional screening tools, such as the Edinburgh Postnatal Depression Scale (EPDS), present limitations due to subjectivity and time constraints in clinical settings. Recent advances in voice analysis and machine learning have shown potential for providing more objective screening methods. This study aimed to develop a deep learning model that analyzes the voices of pregnant women to screen for mental disorders, thereby offering an alternative to the traditional tools. METHODS: A cross-sectional study was conducted among 204 pregnant women, from whom voice samples were collected during their one-month postpartum checkup. The audio data were preprocessed into 5000 ms intervals, converted into mel-spectrograms, and augmented using TrivialAugment and context-rich minority oversampling. The EfficientFormer V2-L model, pretrained on ImageNet, was employed with transfer learning for classification. The hyperparameters were optimized using Optuna, and an ensemble learning approach was used for the final predictions. The model's performance was compared to that of the EPDS in terms of sensitivity, specificity, and other diagnostic metrics. RESULTS: Of the 172 participants analyzed (149 without mental disorders and 23 with mental disorders), the voice-based model demonstrated a sensitivity of 1.00 and a recall of 0.82, outperforming the EPDS in these areas. However, the EPDS exhibited higher specificity (0.97) and precision (0.84). No significant difference was observed in the area under the receiver operating characteristic curve between the two methods (p = 0.759). DISCUSSION: The voice-based model showed higher sensitivity and recall, suggesting that it may be more effective in identifying at-risk individuals than the EPDS. Machine learning and voice analysis are promising objective screening methods for mental disorders during pregnancy, potentially improving early detection. CONCLUSION: We developed a lightweight machine learning model to analyze pregnant women's voices for screening various mental disorders, achieving high sensitivity and demonstrating the potential of voice analysis as an effective and objective tool in perinatal mental health care.

DOI： 10.1007/s44192-025-00138-0

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分娩管理のABC 入院から産褥まで肩甲難産への対応招待査読

牧尉太

臨床婦人科産科 79 ( 2 ) 2025年

岡山県周産期搬送連携体制の構築システム”iPicss”

大井伸子, 兼子加寿子, 藤本千賀子, 牧尉太

助産師 79 ( 2 ) 2025年

これだけは押さえたい最重要疾患の病態・診断・治療法産科編胎児・母体管理糖代謝異常合併妊娠招待査読

牧尉太

臨床婦人科産科 79 ( 4 ) 2025年

Effectiveness of Exercise Therapy on Chemotherapy-induced Peripheral Neuropathy in Patients with Ovarian Cancer: A Scoping Review 査読

Masanori Konuma, Tomohiro Ikeda, Tomohiro Mitoma, Shinsuke Shirakawa, Jota Maki, Yoshimi Katayama, Masanori Hamada, Shoji Nagao, Toshifumi Ozaki

Gynecologic Oncology 192 155 - 162 2024年12月

自然妊娠後に発症した正所異所同時妊娠の1例査読

高谷優, 大平安希子, 栗山千晶, 坂田周治郎, 大石恵一, 末森彩乃, 中藤光里, 大羽輝, 三苫智裕, 加藤正和, 三島桜子, 桐野智江, 牧尉太, 衛藤英理子, 増山寿

現代産婦人科 73 ( 1 ) 97 - 101 2024年12月

胎児超音波検査にて臍帯ヘルニアと両大血管右室起始を認め,出生後にheteropagus twinsと診断した一例査読

杉原百芳, 谷和祐, 大羽輝, 三苫智裕, 三島桜子, 大平安希子, 桐野智江, 牧尉太, 衛藤英理子, 早田桂, 増山寿

現代産婦人科 73 ( 1 ) 91 - 95 2024年12月

ADAR1 could be a potential diagnostic target for intrauterine infection patients. 査読国際誌

Keiichiro Nakamura, Kunitoshi Shigeyasu, Thuy Ha Vu, Jota Maki, Kazuhiro Okamoto, Hisashi Masuyama

Scientific reports 14 ( 1 ) 29419 - 29419 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Intrauterine infection (IUI) is mainly an ascending infection in which vaginal and cervical pathogens ascend to the uterus and can affect the fetus. Until now, there is still no effective diagnostic biomarker for IUI, such as chorioamnionitis (CAM) and funisitis (FUN). Deoxyribonucleic acid (DNA)/Ribonucleic acid (RNA) editing molecules such as apolipoprotein-B mRNA-editing complex (APOBEC) 3 families and Adenosine deaminase family acting on RNA (ADAR)1 were examined in chorioamniotic membranes and umbilical cord of 83 patient samples. Furthermore, Ureaplasma parvum induced ADAR1 was investigated in human HTR-8/SVneo EVT cell line. ADAR1 had a significantly higher area under the curve (AUC) (0.721 and 0.745) than other APOBEC3s or cytokines in CAM and FUN patients. In vitro, ureaplasma parvum was demonstrated to activate ADAR1 (p = 0.025) and reduce RIG-I, IRF3, IFN-[Formula: see text], and IFN-β expression in EVT cell line (p = 0.005, p = 0.010, p < 0.001, and p = 0.018, respectively). High expression of ADAR1 was strongly associated with CAM and FUN patients (multivariate analyses; p = 0.035 and p = 0.002). ADAR1 could be a potential diagnostic target for IUI, such as CAM and FUN patients.

DOI： 10.1038/s41598-024-81097-4

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地域産婦人科医療における統合的医療DXの推進招待査読

牧尉太

Rad Fan(ラドファン) 22 ( 13 ) 68 - 72 2024年11月

健康・医療情報のデータ共有基盤構築/デジタル田園健康特区での取組みデジタル田園健康特区での健康医療系サービス実装に関する現状と課題査読

牧尉太, 那須保友, 櫻井淳, 前田嘉信

医療情報学連合大会論文集 44回 337 - 340 2024年11月

Decline in and recovery of fertility rates after COVID-19-related state of emergency in Japan. 査読国際誌

Tomohiro Mitoma, Jota Maki, Hikaru Ooba, Hisashi Masuyama

BMJ open 14 ( 10 ) e087657 2024年10月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: The COVID-19 pandemic led to a decline in fertility rates worldwide. Although many regions have experienced a temporary drop in fertility rates with the spread of the infection, subsequent recovery has varied across countries. This study aimed to evaluate the impact of COVID-19 infection rates and regional sociodemographic factors on the recovery of fertility rates in Japan following the state of emergency. METHODS: This study examined prefectural fertility data from before the COVID-19 pandemic to forecast fertility rates up to 2022 using a seasonal autoregressive integrated moving average model. A regression analysis was conducted on fertility rates during the first state of emergency and the subsequent recovery rate with respect to the number of new COVID-19 cases and sociodemographic factors specific to each prefecture. RESULTS: During the first state of emergency, the monthly fertility rate decreased by an average of -13.8% (SD: 6.26, min: -28.78, max: 0.15) compared with the previous year. Over the following 22 months, the average fertility recovery rate was +2.31% (SD: 3.57; min: -8.55, max: 19.54). Multivariate analysis of the impact of the pandemic on fertility changes during the first emergency indicated a negative correlation between new COVID-19 cases per capita and the proportion of nuclear households. No significant correlation was found between fertility recovery rate and new COVID-19 cases or emergency duration. When classifying fertility rate fluctuation patterns before and after the emergency into four clusters, variations were noted in the proportion of the elderly population, marriage divorce rate and the number of internet searches related to pregnancy intentions across the clusters. CONCLUSIONS: No association was found between pregnancy intentions related to the spread of infection, such as the number of new cases and the fertility recovery rate following the first state of emergency. Differences in the patterns of decline and recovery during the pandemic were observed based on population composition and internet searches for infection and pregnancy across different prefectures.

DOI： 10.1136/bmjopen-2024-087657

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Evaluating the impact of a trial of labor after cesarean section on labor duration: a retrospective cohort study. 査読国際誌

Hikaru Ooba, Jota Maki, Hisashi Masuyama

BMC pregnancy and childbirth 24 ( 1 ) 542 - 542 2024年8月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Cesarean section (C-section) rates are increasing globally, and repeated C-sections are associated with increased maternal morbidity. Trial of labor after C-section (TOLAC) is an approach to reduce the recurrence of C-sections. However, limited research exists on the impact of cesarean scars on labor duration in TOLAC, considering the termination of labor through C-section and selection bias. This study aimed to investigate the impact of cesarean scars on labor duration in TOLAC participants, accounting for potential confounding factors and biases. METHODS: This retrospective cohort study included 2,964 women who attempted vaginal birth at a single center in Japan from 2012 to 2021. The study categorized participants into TOLAC (n = 187) and non-TOLAC (n = 2,777) groups. Propensity scores were calculated based on 14 factors that could influence labor duration, and inverse probability of treatment weighting (IPTW) was applied. Cox proportional hazards regression analysis estimated hazard ratios (HRs) for labor duration, with and without IPTW adjustment. Sensitivity analyses used propensity score matching, bootstrapping, and interval censoring to address potential biases, including recall bias in the reported onset of labor. RESULTS: The unadjusted HR for labor duration in the TOLAC group compared to the non-TOLAC group was 0.83 (95% CI: 0.70-0.98, P = 0.027), indicating a longer labor duration in the TOLAC group. After adjusting for confounding factors using IPTW, the HR was 0.98 (95% CI: 0.74-1.30, P = 0.91), suggesting no significant difference in labor duration between the groups. Sensitivity analyses using propensity score matching, bootstrapping, and interval censoring yielded consistent results. These findings suggested that the apparent association between TOLAC and longer labor duration was because of confounding factors rather than TOLAC itself. CONCLUSIONS: After adjusting for confounding factors and addressing potential biases, cesarean scars had a limited impact on labor duration in TOLAC participants. Maternal and fetal characteristics may have a more substantial influence on labor duration.

DOI： 10.1186/s12884-024-06744-0

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The adenosine deaminase family acting on RNA 1 can be a useful diagnostic biomarker in chorioamnionitis. 査読国際誌

Keiichiro Nakamura, Kunitoshi Shigeyasu, Jota Maki, Eriko Eto, Hisashi Masuyama

Placenta 153 53 - 58 2024年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Chorioamnionitis (CAM) involves infection and inflammation of the chorion and amniotic membrane, but there are still no effective diagnostic biomarkers for CAM. METHODS: We investigated the correlation between RNA editing enzyme Adenosine deaminase family acting on RNA 1 (ADAR1) and CAM in chorion and amniotic membrane specimens derived from premature rupture of the membrane (PROM), CAM (pathologically diagnosed), and clinical CAM (clinically diagnosed) patients using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: ADAR1 was upregulated in the chorion and amniotic membrane specimens of CAM and clinical CAM patients (p < 0.001 and p = 0.005). ADAR1 had a significantly higher area under the curve (AUC) (0.735 and 0.828) than markers of inflammation characteristics in diagnosing CAM and clinical CAM patients. ADAR1 also had significantly higher AUC (0.701 and 0.837) than clinical characteristics for CAM and clinical CAM patients. DISCUSSION: ADAR1 can be a useful diagnostic biomarker in CAM patients.

DOI： 10.1016/j.placenta.2024.05.133

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【周産期(産科)の手術の工夫-筆者はこうしている】帝王切開術筋層縫合法新しい縫合糸による筋層縫合招待査読

牧尉太, 増山寿

周産期医学 54 ( 8 ) 1084 - 1088 2024年8月

Multicenter Remote-Access Simulation of Vaginal Delivery for High-Flexibility Medical Education during the Coronavirus Pandemic. 査読

Eriko Eto, Jota Maki, Noriyuki Yamashita, Toru Hasegawa, Ayano Suemori, Hikari Nakato, Hikaru Oba, Tomohiro Mitoma, Sakurako Mishima, Satoe Kirino, Akiko Ohira, Hisashi Masuyama

Acta medica Okayama 78 ( 4 ) 313 - 322 2024年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

During the coronavirus pandemic, face-to-face simulation education became impossible. Therefore, we aimed to develop remote-access simulation education with a sense of realism through Information and Communication Technology (ICT) using a perinatal whole-body management and delivery simulator. In September 2021, we administered a multi-center simultaneous remote simulation based on our developed model. Ten universities in the Chugoku-Shikoku region were connected via a web-conferencing system to a live broadcast of a virtual vaginal birth in which a fictional hospitalized pregnant woman experienced accelerated labor and gave birth through vacuum delivery for fetal distress. A Video on Demand (VOD) was made beforehand using a new simulator that allowed for a visual understanding of the process of the inter-vaginal examination. We provided a participatory program that enhanced the sense of realism by combining VOD and real-time lectures on each scenario, with two-way communication between participants and trainee doctors using a chat function. Most participants answered "satisfied" or "very satisfied" with the content, level of difficulty, and level of understanding. From November 2021, we have used the videos of all processes in face-to-face classes. Our construction of a high-flexibility education system using remote simulation in the field of obstetrics and gynecology, especially in the vaginal delivery module, is unique, creative, and sustainable.

DOI： 10.18926/AMO/67547

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Barbed versus conventional sutures for cesarean uterine scar defects: A randomized clinical trial. 査読国際誌

Jota Maki, Tomohiro Mitoma, Hikaru Ooba, Hikari Nakato, Sakurako Mishima, Kazumasa Tani, Eriko Eto, Dan Yamamoto, Risa Yamamoto, Kenji Kai, Takashi Tamada, Kazuyo Akamatsu, Kunihiro Kawanishi, Hisashi Masuyama

American journal of obstetrics & gynecology MFM 6 ( 9 ) 101431 - 101431 2024年7月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The role of barbed sutures in preventing myometrial defects and enhancing postpartum outcomes after cesarean section is uncertain. OBJECTIVE: This study compared clinical and ultrasonographic outcomes of uterine scar defects after C-section with barbed and conventional smooth thread sutures. STUDY DESIGN: This was a multicenter, parallel-group, randomized, controlled clinical trial. Four obstetrics and gynecology departments across three Japanese healthcare regions were included. The participants were women requiring their first cesarean delivery between May 2020 and March 2023. Of the 1211 participants enrolled, 298 underwent cesarean section and 253 were followed-up until July 2023. Participants with singleton pregnancies were randomly assigned (1:1 ratio) to receive either conventional or spiral thread sutures with a double-layer continuous suture. The study period comprised the time of consent to the 6- to 7-month examination. The primary endpoint was the rate of scar niches >2 mm evaluated using transvaginal ultrasonography at 6 to 7 months after surgery. Additional metrics included the total operative time, suture application time, operative blood loss, number of additional sutures required for hemostasis, maternal surgical complications, postoperative infections, surgeon's years of experience, and individual subscale scores. RESULTS: All data of the 220 participants (barbed suture group: 110; conventional suture group: 110) were available, thus enabling a full analysis set. A comparison of the barbed and conventional suture groups, respectively, revealed the following: niche length, 2.45±1.65 mm (range: 1.0-6.7) versus 3.79±1.84 mm (range: 1.0-11.0) (P<0.001); niche depth, 1.78±1.07 mm (range: 1.0-5.7) versus 2.70±1.34 mm (range: 1.0-7.3) (P<0.001); residual myometrial thickness, 8.46±1.74 mm (range: 4.8-13.0) versus 7.07±2.186 mm (range: 2.2-16.2) (P<0.001); and niche width, 1.58±2.73 mm (range: 0.0-14.0) versus 2.88±2.36 mm (range: 0.0-11.0) (P<0.001), respectively. The barbed suture group exhibited no defects and a residual myometrial thickness <3 mm. Furthermore, the barbed suture group had a lower rate of uterine niches (29.1%; n=32/110) than the conventional suture group (68.2%; n=75/110). Secondary outcomes showed no significant differences in operative times, maternal surgical complications, or postoperative complications. CONCLUSIONS: Double-layer barbed sutures during cesarean delivery may prevent cesarean section scar defects and postoperative complications.

DOI： 10.1016/j.ajogmf.2024.101431

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