Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: While women's parity status and education level have independent associations with cardiovascular and other diseases, no studies have evaluated the additive interaction of these two factors. Therefore, we examined the additive interaction between parity and education level on mortality from stroke, coronary heart disease, total cardiovascular disease, cancer, non-cardiovascular disease, and non-cancer causes, and all causes in Japanese women. METHODS: This study followed 41,242 women aged 40-79 years without a history of cardiovascular disease or cancer from 1988 to 1990 until 2009. Baseline parity and education level were classified into four categories, with highly educated parous women as the reference group. Cox proportional hazards regression analyses were performed to calculate the risk of mortality. We also assessed the additive interactions between parity and education level on mortality from cardiovascular disease and other causes using the relative excess risk due to interaction obtained using Cox models. RESULTS: During the median follow-up period of 19.1 years, we identified 6299 deaths. In a multivariable model adjusted for cardiovascular disease and other disease risk factors, nulliparous women with low education levels had increased multivariable-adjusted hazard ratios of 1.67 (95% confidence interval [CI] 1.13, 2.47) for stroke, 1.98 (95% CI 1.15, 3.39) for coronary heart disease, 1.71 (95% CI 1.34,2.18) for total cardiovascular disease, 1.69 (95% CI 1.33, 2.14) for non-cardiovascular and non-cancer, and 1.51 (95% CI 1.30, 1.75) for all-cause mortality when compared with highly educated parous women. Moreover, we observed significant additive interactions between parity and education level on total cardiovascular disease mortality (P = 0.04), non-cardiovascular disease and non-cancer mortality (P = 0.01), and all-cause mortality (P = 0.005). CONCLUSIONS: Nulliparity and low education levels are super-additively associated with total cardiovascular disease, non-cardiovascular and non-cancer, and all-cause mortality risks, suggesting that nulliparous women with low education levels need specific support for preventing mortality related to cardiovascular and other diseases.

File： Yasukawa_et_al-2022-BMC_Women's_Health.pdf

DOI： 10.1186/s12905-022-01805-y

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Circulation Society  

Background: Nulliparity is associated with an excess risk of cardiovascular disease (CVD). “Ikigai”, subjective wellbeing in Japan, is associated with reduced risk of CVD. The impact of ikigai on the association between parity and the risk of CVD, however, has not been reported. Methods and Results: A total of 39,870 Japanese women aged 40–79 years without a history of CVD, cancer or insufficient information at baseline in 1988–1990, were enrolled and followed until the end of 2009. They were categorized into 7 groups according to parity number 0–≥6. Using Cox regression hazard modeling, the associations between parity and mortality from stroke, coronary artery disease, and total CVD were investigated. During the follow-up period, 2,121 total CVD deaths were documented. No association was observed between parity and stroke and CVD mortality in women with ikigai, but there was an association in those without ikigai. The multivariable hazard ratios of stroke and total CVD mortality for nulliparous women without ikigai vs. those with 1 child were 1.87 (95% CI: 1.15–3.05) and 1.46 (95% CI: 1.07–2.01), respectively, and that for stroke mortality in high parity women without ikigai was 1.56 (95% CI: 1.00–2.45). Conclusions: Nulliparous or high parity women without ikigai had higher mortality from stroke and/or total CVD, suggesting that ikigai attenuated the association between parity and CVD mortality in Japanese women.

DOI： 10.1253/circj.CJ-17-1201

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Authorship：Lead author   Language：Japanese   Publisher：THE OBSTETRICAL GYNECOLOGICAL SOCIETY OF KINKI DISTRICT JAPAN  

In recent years, women who complain of climacteric symptoms increase, particularly psychological in nature. We suppose that such symptoms influence the everyday life of climacteric women. In this study, we compared health-related quality of life (HRQOL) in climacteric patients and healthy women using Short Form-36 Health Survey (SF-36) and assessed the effects of hormone replacement therapy (HRT) on HRQOL in patients with climacteric disturbance. The subjects included in this study were: 22 patients with climacteric disturbance, aged 47-63 years with a mean age of 54.5 years, who visited the outpatient clinic of the Department of Gynecology of Kobe University Hospital and 22 healthy women, aged 45∼62 years with a mean age of 54.3 years, who had regular uterine cancer screening. We classified the climacteric patients into three groups according to main symptoms: physical (somatic) symptoms group (N=10), psychological symptoms group (N=5) and mixed physical and psychological symptoms group(N=7). Assessment of HRQOL in all patients, before HRT use, using the SF-36 health survey was done and scores in each group were compared. Then, we evaluated the scale scores of the SF-36 questionnaire before and after HRT in climacteric patients. Furthermore, we compared the outcome of HRQOL according to the SF-36 and symptoms level based on Kupperman index (vasomotor, paresthesia, psychological, arthralgia, symptoms index and total index). For all scales except physical functioning, climacteric patients had significantly lower SF-36 scores. This tendency was evident especially in the mixed physical and psychological symptoms group. No significant difference was apparent in scale score of the SF-36 after HRT in the physical symptoms group, but scales of mental QOL in the psychological symptoms group and scales of both physical and mental QOL improved significantly. In addition, patients had significantly improved vasomotor symptoms and total index of Kupperman index after HRT, except for the psychological symptoms group and the mixed physical and psychological symptoms group. In summary, the results of this study imply that climacteric patient's QOL were noticeably impaired, when compared with healthy women and that psychological symptoms affect patient's QOL strongly. Further, it suggested that both physical and mental QOL improved after HRT, and the SF-36 health survey was one of the useful scales for objectively evaluating the severity and treatment outcome in patients with climacteric disturbance. [Adv Obstet Gynecol, 55(1) : 1-10, 2003 (H.15.2)]<br>

DOI： 10.11437/sanpunosinpo.55.1

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Authorship：Lead author   Language：Japanese  

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Authorship：Lead author   Language：Japanese  

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Authorship：Lead author   Language：Japanese  

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Event date： 2023.2.1 - 2023.2.3

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2020.10.20 - 2020.10.22

Language：Japanese   Presentation type：Oral presentation (general)  

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Type：Other

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