Details of a Researcher

Fetal heart rate patterns complicated by chorioamnionitis and subsequent cerebral palsy in Japan Reviewed

Yamaguchi-Goto T., Ohashi M., Kodama Y., Sameshima H.

Journal of Obstetrics and Gynaecology Research 49 ( 2 ) 625 - 634 2023.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research

Aim: This retrospective study was performed to investigate whether certain fetal heart rate patterns were associated with subsequent cerebral palsy (CP) in infants with chorioamnionitis at or near term. Methods: We used cases registered by the Japan Obstetric Compensation System for CP, which is a nationwide population-based database. Among them, 133 infants with chorioamnionitis who were born at ≥34 weeks of gestation were enrolled. All infants underwent magnetic resonance imaging (MRI), and all fetal heart rate charts had been interpreted according to the National Institute of Child Health and Human Development criteria, focusing on antepartum and immediately before delivery. Results: The incidence of CP after chorioamnionitis at ≥34 weeks of gestation was 0.3 per 10 000 in Japan. Between the clinical (24%) and subclinical groups (76%), the incidence of abnormal fetal heart rate patterns did not differ. According to the MRI classification, 88% of the infants with CP showed hypoxic–ischemic encephalopathy. Half of the infants with CP experienced terminal bradycardia, leading to severe acidosis and exclusively to hypoxic–ischemic encephalopathy. In another half, who did not experience bradycardia, 80% had moderate acidosis (pH 7.00–7.20) resulting in hypoxic–ischemic encephalopathy, and the remaining 20% showed non-acidosis resulting in brain damage other than hypoxic–ischemic encephalopathy. The fetal heart rate patterns before the terminal bradycardia showed that the incidence rates of late deceleration or decreased variability were high (>60%). Conclusion: Fifty percent of pregnant women with chorioamnionitis-related CP had terminal bradycardia that exclusively resulted in hypoxic–ischemic encephalopathy.

DOI： 10.1111/jog.15508

Antepartum Antibiotic Therapy under 34 Weeks of Gestation and Its Impact on Early-Onset Neonatal Infection and Maternal Vaginal Microbiota Reviewed

Muraoka J., Kaneko M., Doi K., Kodama Y., Sameshima H.

Microbiology Research 13 ( 3 ) 598 - 608 2022.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Microbiology Research

The use of prenatal antibiotics should be carefully considered, owing to their potential adverse effects on neonatal outcomes. This study aimed to identify the contributing factors to early-onset neonatal infection and to determine the influence of antepartum antibiotics on women and neonates. This study included 127 pregnant women without obvious intra-amniotic infection on admission, who delivered under 34 weeks of gestation. Information on maternal and neonatal characteristics was obtained from their medical charts. Vaginal swabs were taken from all women on admission. In total, 29 (22.8%) neonates developed early-onset infection. Multivariate analysis revealed that antepartum antibiotics were the most strongly associated factor for early-onset neonatal infection (odds ratio, 11.2; 95% confidence interval, 4.08–31.02). The frequency of early-onset neonatal infection was significantly higher in women who received antibiotic therapy than in those who did not; no significant difference in prolonging their gestation or neonatal morbidities was observed. The prevalence of women who hosted vaginal microorganisms on admission was similar to that in women whose infants subsequently developed early-onset neonatal infection compared with that of women whose infants did not. Among infants of the 40 women who received antepartum antibiotic therapy, 21 developed early-onset infection. Of the women who delivered these 21 infants, 62% (13/21) showed reduced lactobacilli and 43% (9/21) had resistant bacterial strains in their vaginal microbiota at the time of delivery. The use of antepartum antibiotics is the most strongly associated factor in early-onset neonatal infection; it does not prolong gestation and would change the vaginal environment.

DOI： 10.3390/microbiolres13030042

Novel SKIC3 variants in tricho-hepato-enteric syndrome with hemochromatosis. Reviewed

Ochiai K, Aoki Y, Yamada N, Aman M, Yamashita A, Yamaguchi M, Nakato D, Takenouchi T, Kosaki K, Kodama Y, Moritake H

Human genome variation 12 ( 1 ) 14 2025.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Human Genome Variation

Tricho-hepato-enteric syndrome (THES), a rare autosomal recessive disorder caused by variants in the SKIC3 or SKIC2 gene, is characterized by intractable diarrhea, woolly hair, growth restriction and liver disease. Here we report a neonatal case of THES with neonatal hemochromatosis, in which the novel compound heterozygous SKIC3 variants NM_014639.4:c.815_816del p.(Gly272AlafsTer9) and NM_014639.4:c.2284G>A p.(Gly762Arg) were identified. Further research is needed to elucidate the mechanisms underlying iron metabolism dysregulation in THES.

DOI： 10.1038/s41439-025-00318-y

Trends in the causes of stillbirths over 20 years in Southern Japan Reviewed

Kino Emi, Maki Yohei, Yamada Naoshi, Kodama Yuki, Katsuragi Shinji, Sameshima Hiroshi, Ikenoue Tsuyomu

BMC Pregnancy and Childbirth 25 654 2025.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Background
This study aimed to determine the temporal trend in the causes of stillbirths over a period of two decades using a regional perinatal database in order to facilitate the development of perinatal strategies to prevent stillbirths in Japan.

Methods
This was a population-based retrospective study. Cases of perinatal death and neurological damage were reported by perinatal centers and primary birth clinics, followed by their peer review and audit, and final registration in the database. Data for stillbirths, defined as fetal death at ≥ 22 weeks of gestation between January 1, 2001, and December 31, 2020, were extracted from the database. Causes of stillbirths were reclassified according to the ReCoDe system. Temporal trends in the causes of stillbirths per 1,000 births and proportion of the causes were evaluated using the Cochran-Armitage test.

Results
Over the 20 years, in the study region, a total of 205,025 were delivered at ≥ 22 weeks of gestation, and 569 were stillborn (2.8 per 1,000 births). The most common cause of stillbirth was “no relevant condition identified” in 39.5% cases, followed by “abruption” in 12.3%, “lethal congenital anomaly” in 9.5%, and “umbilical cord, other” in 5.8%. The trends in stillbirths caused by “fetal growth restriction,” “abruption,” “asphyxia,” and “no relevant condition identified” significantly decreased. However, no change in trend due to “lethal congenital anomaly” was seen. The stillbirth trend caused by “cord, other” significantly increased. The proportion of stillbirths related to unidentified causes remained unchanged.

Conclusions
Over the 20-year period, the rate of stillbirths caused by abruption, fetal growth restriction, and asphyxia, which can be reduced by early detection and intervention, decreased. The incidence of stillbirths caused by cord constriction increased. Investigations to prevent cord-accident stillbirths would be required to further reduce stillbirths in the study region. Establishment of algorithms that allow the identification of the causes of stillbirths would be crucial to reduce instances of stillbirths due to unidentified causes.

Effects of Songs Recorded by Parents on the Vital Signs of Preterm Infants: A Randomized Controlled Trial Reviewed

宮崎県における子宮内胎児死亡と糖代謝異常合併妊娠に関する後方視的研究 Reviewed

山田直史，児玉由紀，鮫島浩，桂木真司

糖尿病と妊娠 25 ( 1 ) 8 - 13 2025.2

Language：Japanese Publishing type：Research paper (scientific journal)

Aoki Y., Kota Y., Shimada M., Taniguchi T., Yamauchi S., Matsusaka M., Hamasuna K., Watanabe Y., Kodama Y., Moritake H.

Children 12 ( 2 ) 2025.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Children

Background: Preterm infants often have unstable vital signs and prolonged hospital stays that can hinder parent–infant bonding, especially under COVID-19 restrictions. This study aimed to evaluate whether listening to songs recorded by parents was effective in stabilizing the condition of premature infants. Methods: This randomized controlled study was conducted at the University of Miyazaki Hospital from October 2022 to March 2024 during the COVID-19 pandemic period. The participants were preterm infants born at less than 33 weeks gestation and their parents, all of whom recorded songs. The recorded songs were played daily to the infants in the intervention group, while the control group received usual care. Primary outcomes included vital signs (respiratory rate, pulse oximetry saturation, heart rate) and activity level. Results: Data for 33 preterm infants (intervention, n = 17 [total 749 sessions]; control, n = 16 [total 721 sessions]) were analyzed for changes in vital signs and activity levels. The intervention reduced infants’ respiratory rates (4.1 [95% CI: 2.5–5.6], p < 0.001) and slightly but statistically significantly increased pulse oximetry saturation (0.6 [95% CI: 0.02–1.2], p < 0.044). Conclusions: Recorded parental songs were found to safely stabilize the respiratory status of preterm infants and may serve as an accessible intervention to support parent–infant attachment, particularly in settings with restricted parental visitation.

DOI： 10.3390/children12020146

Safety and efficacy of ripasudil eye drops in preterm infants with retinopathy of prematurity: phase 1/2, open label, single-arm trial Reviewed

Arima M., Inoue H., Misumi A., Tsukamoto S., Matsushita I., Araki S., Ohta M., Takahashi K., Imazato M., Goto T., Aoki Y., Tagawa K., Hirose M., Fujita Y., Yoshida N., Nakao S., Kondo H., Kusuhara K., Kimura K., Hasegawa S., Ikeda Y., Kodama Y., Moritake H., Ochiai M., Ohga S., Kishimoto J., Todaka K., Ieiri I., Sonoda K.H.

Japanese Journal of Ophthalmology 68 ( 5 ) 490 - 499 2024.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Journal of Ophthalmology

Purpose: To assess the safety and efficacy of ripasudil for retinopathy of prematurity (ROP). Study design: Phase 1/2, multicenter, open-label, single-arm, 12-week clinical trial. Methods: Infants born with gestational age (GA) of ≤ 32 weeks or weight of ≤ 1500 g with zone I or II, ≥ stage 1, ROP in both eyes were enrolled. Ripasudil eye drops were administered to patients in both eyes. Phase 1 was a dose-escalation study (once daily for 1 week, then twice daily for 2 weeks); an additional dosing up to 9 weeks was allowed if no safety issues occurred. In phase 2, ripasudil was administered twice daily for up to 12 weeks. Adverse events were assessed. The proportion of patients with type 1 ROP progression, number of days for type 1 ROP progression, and progression to the most advanced ROP stage were estimated. Results: Twenty-four infants were enrolled (phase 1, n = 3; phase 2, n = 21). Nineteen and four patients experienced systemic and ocular adverse events, respectively. Efficacy endpoints were not different between the ripasudil and historical control groups. However, in the GA ≤ 27 weeks subgroup, fewer patients progressed to type 1 ROP in the ripasudil than in the historical control group (P = 0.09). In the GA ≤ 27 weeks subgroups, the 25th percentile for the number of days for type 1 ROP progression was 22 days in the historical control group and 44 days in the ripasudil group. Conclusion: Ripasudil was safe and inhibited/delayed type 1 ROP progression, especially in infants with short GA.

DOI： 10.1007/s10384-024-01100-3

Cell-mediated and humoral immune responses to human cytomegalovirus in pregnant women with vertically transmitted infection following primary infection: A case report. Reviewed

妊婦の新型コロナウイルス感染症～中等度Ⅰ母体に発症した胎児機能不全の一例～ Reviewed

児玉由紀

宮崎県医師会医学会誌 48 ( 1 ) 71 - 76 2024.3

Publishing type：Case report

生後9ヶ月まで生存したThanatophoric dysplasiaの一例 Reviewed

児玉由紀

宮崎県医師会医学会誌 47 ( 2 ) 186 - 190 2023.9

Publishing type：Case report

Cell-medated and humoral immune responses to human cytomegalovirus in pregnant women with vertically transmitted infection following primary infection: A case report. Reviewed

Yuki Kodama

Journal of Infection and Chemotherapy 29 1071 - 1074 2023.9

Publishing type：Case report

Yamada N, Kaneko M, Yang L, Matsuzawa S, Minematsu T, Kodama Y

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2023.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Infection and Chemotherapy

Human cytomegalovirus (HCMV) is the major cause of neurological sequelae in infants. Immune control of primary HCMV infection appears to depend on the interaction between humoral and cell-mediated immune responses. We report the case of an HCMV-transmitter mother observed with dissociation between humoral and cell-mediated immune responses. The patient had immunoglobulin (Ig) G and M positivity at 11 weeks of gestation and showed fetal hyperechoic bowel and minimal ascites at 21 weeks of gestation. At 25 weeks of gestation, the polymerase chain reaction result for HCMV using amniotic fluid was positive. The numbers of spots in the enzyme-linked immunosorbent spot (ELISPOT) assay at 25, 36, and 39 weeks of gestation were three, five, and six spots/2 × 105 peripheral blood mononuclear cells, respectively. Furthermore, IgG avidity indexes (AIs) at 21, 25, 36, and 39 weeks of gestation were 37.6, 49.7, 72.5, and 74.3, respectively. At 40+1 weeks of gestation, the patient delivered a symptomatic infected newborn with a weight of 2,384 g (−2.6 SD) and a head circumference of 30 cm (−2.6 SD). The neonate had a petechial rash and bilateral hearing loss although did not show liver dysfunction or thrombocytopenia. Cranial magnetic resonance imaging revealed mild ventriculomegaly, left lateral/parietal polymicrogyria, and a punctate white matter lesion. This case showed that IgG AI increased with increasing gestational age, whereas the numbers of spots in the ELISPOT assay had no change. The dissociation between humoral and cell-mediated immune responses may be characteristic of the immune response of a transmitter mother.

DOI： 10.1016/j.jiac.2023.07.004

Pulmonary lymphangiectasia in an extremely preterm infant complicated with Ureaplasma pneumonitis Reviewed

Sakakibara Kouhei, Yamada Naoshi, Kodama Yuki, Obata Shizuka, Tsuzuki Yasue, Muraoka Junsuke, Aoki Yoshinori, Yamashita Rie, Nakame Kazuhiko, Kaneko Masatoki, Katsuragi Shinji, Tsuzuki Ryo, Sato Yuichiro

Journal of Japan Society of Perinatal and Neonatal Medicine 59 ( 1 ) 116 - 121 2023

Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society of Perinatal and Neonatal Medicine

Here we report a case of pulmonary lymphangiectasia that caused exacerbation of respiratory status after an infection. A preterm infant born at 23 weeks of gestation without obvious clinical intrauterine infection showed worsening respiratory status and increased c-reactive protein on day 15 of life. Chest X-ray showed consolidation in right upper lobe and whole left lung. Several broad-spectrum antibiotics were administered unsuccessfully. Finally, Ureaplasma urealyticum was detected in sputum culture, and azithromycin was administered. Although the inﬂammation improved, tension pneumothorax and pulmonary hypertension developed and he died on day 44 of life. At autopsy, there were few ﬁndings of lung inﬂammation, and congenital lymphangiectasia was diagnosed. It seems that exacerbation was triggered by the infection, although there was no remarkable evidence to support causality. There have been few case reports of pulmonary lymphangiectasia in extremely low birth weight infants. This case was considered to be classiﬁed as primary, although the respiratory condition at birth was relatively good. There are no clear diagnostic criteria for this disease and no eﬀective treatments. Clinically, neonatologists should keep in mind pulmonary lymphangiectasia if respiratory failure in newborns does not respond to common treatment approach.

DOI： 10.34456/jjspnm.59.1_116

Low-dose aspirin therapy improves decidual arteriopathy in pregnant women with a history of preeclampsia. Reviewed

Antepartum antibiotic therapy under 34 weeks of gestation and its impact on early-onset neonatal infection and maternal vaginal microbiota Reviewed

Yuki Kodama

Microbiological Reserch 13 598 - 608 2022.8

Publishing type：Research paper (scientific journal)

Tomimori-Gi K, Katsuragi S, Kodama Y, Yamada N, Sameshima H, Maekawa K, Yamashita A, Gi T, Sato Y

Virchows Archiv : an international journal of pathology 481 ( 5 ) 713 - 720 2022.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Virchows Archiv

Preeclampsia, a multisystem pregnancy-specific hypertensive disorder, results in significant maternal and perinatal morbidity and mortality. This condition is associated with placental histopathological abnormalities and particularly affects the decidual spiral arteries. Reportedly, aspirin prevents preeclampsia, specifically early-onset preeclampsia, although findings in decidual arteries in women treated with aspirin therapy remain unclear. We compared the clinical and histopathological placental findings between women with a history of preeclampsia, who did and did not receive low-dose aspirin therapy (LDA and non-LDA groups, respectively). We identified 26 women with a history of preeclampsia; 9 women received LDA (aspirin ≤ 100 mg/day, initiated at < 16 weeks, LDA group), and 17 women did not receive LDA (non-LDA group). The mean gestational age was higher (36.7 weeks vs. 32.3 weeks, P = 0.0221) and the incidence of preeclampsia was lower (11% vs. 59%, P = 0.0362) in the LDA than in the non-LDA group. Histopathologically, the incidence of decidual arteriopathy, particularly that of fibrinoid necrosis and thrombosis, was lower in the LDA than in the non-LDA group (44% vs. 88%, P = 0.0283). Immunohistologically, endothelial marker (CD31 and CD39) expression was stronger in the LDA than in the non-LDA group. Notably, we observed no significant intergroup differences in inflammatory changes (chronic perivasculitis, protease-activated receptor 1 expression, and CD3-positive cells). This study highlights that LDA inhibits hypertension-induced endothelial injury and thrombosis, and thereby protects maternal placental perfusion and prevents preeclampsia.

DOI： 10.1007/s00428-022-03388-3

Association between Chorioamnionitis Severity and Procalcitonin Levels in Umbilical Venous Blood Reviewed

Kaneko M., Muraoka J., Yamada N., Kodama Y.

Clinical and Experimental Obstetrics and Gynecology 49 ( 7 ) 2022.7

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Clinical and Experimental Obstetrics and Gynecology

Background: Procalcitonin can effectively differentiate between bacterial sepsis and a systemic inflammatory response syndrome of noninfectious origins in the adult. However, the usefulness of procalcitonin in perinatal field is not determined. Thus, the purpose of this study was to determine whether procalcitonin levels in the umbilical blood reflect the severity of chorioamnionitis and to assess their correlation with perinatal outcomes. Methods: A retrospective study was conducted in 145 pregnant women with singleton pregnancies and their neonates at a tertiary center between September 2010 and March 2013. Procalcitonin levels in the umbilical blood were measured by an immunoluminometric assay. The severity of chorioamnionitis was classified by the histological stage and grade for maternal and fetal inflammatory responses. Procalcitonin levels were evaluated according to the severity of chorioamnionitis; and the association with neonatal sepsis, intraventricular hemorrhage (IVH), neonatal death within 28 days of life, and periventricular leukomalacia was investigated. Results: In total, 28 women (19%) had chorioamnionitis, of which 21 (75%) delivered at less than 34 weeks of gestation. Fetal response in those with chorioamnionitis was correlated with maternal response. Procalcitonin levels in the group with fetal stage 2 and 3 or grade 2 responses were significantly higher than those infants with any other stage or grade. The frequency of neonatal sepsis, IVH stage III or IV, and neonatal death significantly increased (p < 0.01), when a Procalcitonin level of ≥2 ng/mL was obtained. Conclusions: Procalcitonin levels in the umbilical blood reflect the severity of chorioamnionitis and are associated with neonatal outcomes such as neonatal sepsis, neonatal death, and severe IVH. When PCT level in umbilical venous blood show the high value of ≥2 ng/mL, it might be required that antibiotics therapy is initiated immediately after birth.

DOI： 10.31083/j.ceog4907160

Myeloid cell thrombus and fetal vascular malperfusion in placentas with transient abnormal myelopoiesis Reviewed

Association between chorioamnionitis severity and procalcitonin levels in umbilical venous blood Reviewed

Yuki Kodama

Clinical and Experimental Obstetrics & Gynecology 49 ( 7 ) 16 2022.7

Publishing type：Research paper (scientific journal)

Low-dose aspirin therapy improves decidual arteriopathy in pregnant women with a history of preeclampsia Reviewed

Yuki Kodama

Virchows Archiv 481 713 - 720 2022.7

Publishing type：Research paper (scientific journal)

Tomimori K., Kodama Y., Tanaka H., Yamashita A., Gi T., Asada Y., Doi K., Katsuragi S., Sato Y.

Virchows Archiv 480 ( 6 ) 1181 - 1187 2022.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Virchows Archiv

Transient abnormal myelopoiesis (TAM), also known as transient myeloproliferative disorder or transient leukemia, is a self-regressing neoplasia that afflicts infants with trisomy 21. A recent review article documented “myeloid cell thrombus (MCT)” and “fetal vascular malperfusion (FVM)” in placentas with TAM, although the characteristic TAM placental findings have not been clarified. Here, we compared the clinical and pathological placental findings between trisomy 21 patients with or without TAM. In 13 cases of trisomy 21, we identified six placentas with TAM and seven placentas without TAM. The six placentas with TAM included two stillborn cases. Microscopically, MCT was noted in all the cases, and a high incidence of FVM (50%) was observed in TAM cases. Immunohistochemically, MCT was found to be a platelet-rich thrombus. The placentas were grouped according to the presence or absence of TAM and subsequently compared. Clinically, the incidences of abnormal fetal heart rate pattern and fetal or neonatal death were significantly higher in TAM cases. Pathologically, placenta in TAM cases weighted more than those in cases without TAM, and the incidence of MCT was significantly higher in placentas with TAM. Moreover, the incidence of FVM was higher in placentas with TAM, but this difference was not statistically significant. We propose that MCT is a diagnostic feature of placentas with TAM and may be associated with poor fetal outcomes.

DOI： 10.1007/s00428-022-03289-5

C4d deposition and CD39 downregulation in the placental infection by SARS-CoV-2 Reviewed

Yuki Kodama

Pathology International 72 267 - 269 2022.4

Publishing type：Research paper (scientific journal)

C4d deposition and CD39 downregulation in the placental infection by SARS-CoV-2. Reviewed

Shimao Y, Yamauchi A, Ohtsuka T, Terao K, Kodama Y, Yamada N, Asada Y, Sato Y

Pathology international 2022.2

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1111/pin.13214

Association between fetal vascular malperfusion and gestational diabetes Reviewed

Goto T., Sato Y., Kodama Y., Tomimori K., Sameshima H., Aman M., Maekawa K., Yamashita A., Asada Y.

Journal of Obstetrics and Gynaecology Research 48 ( 1 ) 80 - 86 2022.1

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research

Aim: Diabetes mellitus (DM) is a major complication in pregnancy. Placental lesions with DM remain unclear and controversial. Recently, the terms of placental pathological findings, such as maternal and fetal vascular malperfusions (MVM and FVM, respectively) were introduced by the Amsterdam Placental Workshop Group Consensus Statement (APWGCS). FVM cases were classified as the partial obstruction type (global FVM) and the complete obstruction type (segmental FVM). The aim of this study was to clarify the pathological characteristics of the placenta with pregestational DM/gestational DM; GDM according to APWGCS. Methods: We studied the placentas of 182 DM women (27 pregestational DM and 155 GDM) and control placentas of 460 women without DM during 2011–2018. We excluded cases of intrauterine fetal death or multiple pregnancies. We reviewed microscopical findings including, MVM, FVM, chorioamnionitis with the slides according to the APWGCS. Results: Microscopically, the incidence of FVM was significantly higher in GDM patients than control (17% vs. 10%, p = 0.0138), but not significant in pregestational DM (11%, p = 0.7410). Segmental FVM (complete obstruction) was significantly more observed in GDM than control group (5% vs. 0.4%, p = 0.0013). Segmental FVM in GDM showed high incidence of light-for-dates infant (three of seven cases, 43%, p = 0.0288). In addition, several segmental FVM findings (villous stromal-vascular karyorrhexis and stem vessel occlusion) were frequently noted in 2 or 3 points positive of 75 g oral glucose tolerance test than 1 point positive GDM. Conclusion: Our placental findings suggest disorder of carbohydrate metabolism might affect the fetal vascular damage, especially complete fetal vascular obstruction.

DOI： 10.1111/jog.15046

特集周産期医学必修知識(第9版) 分娩時アスフィキシアと脳性麻痺の因果関係の判定基準

後藤智子, 児玉由紀, 鮫島浩

周産期医学 51 ( 13 ) 453 - 456 2021.12

Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

DOI： 10.24479/j00621.2022108803

Congenital tracheo-esophageal transition: A previously undescribed tracheo-esophageal malformation that showed direct transition of the trachea to the esophagus. Reviewed

Kiwaki T, Nagayasu MA, Yamada N, Kodama Y, Umekita Y, Fukushima T, Kataoka H, Tanaka H

Pathology international 2021.12

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1111/pin.13189

特集在胎22～23週の超早産をめぐる課題と展望母体の背景と管理法　切迫早産の管理 Invited International coauthorship

松澤聡史, 児玉由紀

周産期医学 51 ( 8 ) 1109 - 1112 2021.8

Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

DOI： 10.24479/j00621.2021323159

A case of facial cellulitis caused by group B streptococcus in an extremely low birthweight infant. Reviewed

Muraoka J, Kodama Y, Higashi M, Yamada N, Yamashita R, Nakame K, Kaneko M, Sameshima H

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 47 ( 3 ) 1110 - 1117 2021.5

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1016/j.jiac.2021.04.021

Intrapartum fetal heart rate patterns and perinatal outcome in chorioamnionitis at or beyond 34 weeks of gestation Reviewed

Muraoka J., Kodama Y., Ohashi M., Goto T., Sameshima H.

Journal of Obstetrics and Gynaecology Research 47 ( 3 ) 1110 - 1117 2021.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research

Aim: To investigate intrapartum fetal heart rate (FHR) patterns in women with chorioamnionitis at or beyond 34 weeks of gestation in relation to neonatal outcome and to compare clinical and subclinical chorioamnionitis. Methods: A retrospective questionnaire survey on deliveries during 2015 was conducted by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology from 2016 to 2018. A total of 498 singleton births complicated by chorioamnionitis delivered at ≥34 weeks of gestation without major congenital malformations were included. The subjects were divided into clinical and subclinical chorioamnionitis groups based on Lencki's criteria. Poor perinatal outcome was defined as death or brain damage. We analyzed clinical features, FHR patterns in the last 2 h before delivery, gestational age, birthweight, Apgar score, umbilical arterial blood gas analysis, and infant's outcome. Results: Incidence of chorioamnionitis at ≥34 weeks of gestation was 0.59% (522/87827). Clinical and subclinical chorioamnionitis comprised 240 and 258 cases, respectively. Abnormal FHR patterns (late deceleration or decreased baseline variability) were significantly associated with poor perinatal outcome. Combined late deceleration and decreased variability showed low positive predictive value (12.8%) and high negative predictive value (99.5%), and was significantly associated with long-term poor outcome in clinical chorioamnionitis only (odds ratio: 29.4, p < 0.01). Poor perinatal outcome showed no significant difference between the clinical and subclinical chorioamnionitis groups. Conclusions: Combined late deceleration and decreased variability could predict poor perinatal outcome in clinical chorioamnionitis. Poor perinatal outcome occurred in infants born to mothers with clinical and subclinical chorioamnionitis.

DOI： 10.1111/jog.14641

村岡純輔, 児玉由紀

周産期医学 50 ( 12 ) 2042 - 2044 2020.12

Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

DOI： 10.24479/j00621.2021085660

Synergic interaction between ritodrine and magnesium sulfate on the occurrence of critical neonatal hyperkalemia: A Japanese nationwide retrospective cohort study Reviewed

Yada Y., Ohkuchi A., Otsuki K., Goishi K., Takahashi M., Yonemoto N., Saito S., Kusuda S., Ota H., Kosugiyama K., Okuyama K., Mizushima M., Negishi H., Koshida S., Kasai M., Okabe M., Sato A., Adachi H., Banzai M., Akaba K., Suzuki R., Ishibashi N., Watanabe T., Kasuga Y., Kameda T., Fujiu T., Takagi T., Maruyama K., Higashino M., Naito T., Kamei Y., Kunikata T., Iitsuka Y., Otsuka H., Yamamoto Y., Yamada M., Daigo M., Hyodo H., Sato A., Kataoka N., Yamanaka S., Okahashi A., Kojima Y., Kabashima S., Nakamura Y., Okuno R., Hirose S., Sugahara K., Okamoto S., Hara S., Shima W., Suzuki T., Kagawa H., Fujioka K., Kurasaki A., Miura A., Hokuto I., Arase T., Taguchi N., Sekiguchi K., Matsuo T., Ohnuma E., Fujiwara K., Ogawa M., Uozumi A., Yokomichi N., Hirose A., Okuda M., Fukuyama A., Ishimoto H., Mitsuzuka K., Kondo S., Kitazawa M., Kikuchi N., Miyashita Y., Tsutsumi C., Terada S., Ohki S., Kawamura T., Yasuda M., Soeno Y., Kurabayashi T., Nagayama Y., Yoneda S., Shiga T., Hayashi S., Tsuda H., Oshiro M., Ushida T., Mizutani T., Asada H., Miura R., Tanaka R., Kato N., Sasaki Y., Yokoyama T., Hirooka T., Yamada T., Maruwaka K., Nagara S.

Scientific Reports 10 ( 1 ) 2020.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Scientific Reports

Our aim was to evaluate the association between ritodrine and magnesium sulfate (MgSO4) and the occurrence of neonatal hyperkalemia or hypoglycemia among late preterm infants in a retrospective cohort study. We used a nationwide obstetrical database from 2014. A total of 4,622 live preterm infants born at 32–36 gestational weeks participated. Fourteen risk factors based on both clinical relevance and univariate analysis were adjusted in multivariable logistic regression analyses. Neonatal hyperkalemia and hypoglycemia occurred in 7.6% (284/3,732) and 32.4% (1,458/4,501), respectively. Occurrence of hyperkalemia was associated with concomitant usage of ritodrine and MgSO4 compared with no usage (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.09–2.15). Occurrence of hypoglycemia was associated with ritodrine alone (aOR 2.58 [CI 2.21–3.01]) and with concomitant usage of ritodrine and MgSO4 (aOR 2.59 [CI 2.13–3.15]), compared with no usage, and was associated with long-term usage (≥ 48 hours) of ritodrine and cessation directly before delivery. In conclusion, in late preterm infants, usage of ritodrine together with MgSO4 was associated with occurrence of critical neonatal hyperkalemia, and long-term usage of ritodrine and cessation directly before delivery were associated with neonatal hypoglycemia.

DOI： 10.1038/s41598-020-64687-w

特集 HTLV-1母子感染をもっと知ろうキャリアマザーから出生した児の産科施設退院までの留意点 Invited

吉本望, 児玉由紀

周産期医学 50 ( 10 ) 1741 - 1743 2020.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

DOI： 10.24479/j00621.2021005607

特集 [必携]専攻医と指導医のための産科診療到達目標病態･疾患編【妊娠中】胎児発育不全 Invited

土井宏太郎, 児玉由紀

周産期医学 50 ( 8 ) 1346 - 1351 2020.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社

DOI： 10.24479/j00621.2020377214

特集経腟分娩vs帝王切開-分娩様式の選択と対応- 9.胎児異常症例 Invited

山口智子, 児玉由紀

産婦人科の実際 69 ( 6 ) 603 - 608 2020.6

Publishing type：Research paper (scientific journal) Publisher：金原出版

DOI： 10.18888/sp.0000001301

Pathologically diagnosed superficial form of placenta accreta: a comparative analysis with invasive form and asymptomatic muscular adhesion. Reviewed

Sato Y, Aman M, Maekawa K, Yamashita A, Kodama Y, Doi K, Sameshima H, Asada Y

Virchows Archiv : an international journal of pathology 2020.1

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1007/s00428-019-02723-5

Two cases of very low birth weight infants with congenital syphilis Reviewed

Tokuda Atsuko, Kodama Yuki, Kanno Chika, Goto Tomoko, Yamada Naoshi, Yamashita Rie, Doi Koutarou, Kaneko Masatoki, Sameshima Hiroshi

Journal of Japan Society of Perinatal and Neonatal Medicine 56 ( 3 ) 538 - 543 2020

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society of Perinatal and Neonatal Medicine

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Congenital syphilis occurs as a result of vertical transmission from a mother to the fetus. The number of congenital syphilis cases has recently been rising in both the United States and Japan. Vertical transmission of syphilis can be prevented by early detection during pregnancy and adequate treatment of the mother. Here we report two cases of very low birth weight infants with congenital syphilis, who had different clinical courses. One survived and developed normally following successful antibiotic treatment, while the other died at 14 hours of age with Treponema pallidum infection in the placenta and multiple organs.

DOI： 10.34456/jjspnm.56.3_538

Characteristics and influence of Mycoplasma / Ureaplasma cultures in amniotic fluid on perinatal outcomes Reviewed

Sho Takakura, Yuki Kodama, Rie Yamashita, Emi Kino, Noriko Kawano, Kayo Tominori, Yohei Maki, Koutaro Doi, Masatoki Kaneko, Hiroshi Sameshima

Journal of Obstetrics and Gynaecology Resarch 46 ( 3 ) 389 - 395 2019.12

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

DOI： 10.1111/jog.14183

過去20年の総合周産期母子医療センターにおける産科症例の変遷 Reviewed

川越靖之、大西淳仁、古川誠志、児玉由紀、金子政時、鮫島浩、池ノ上克

宮崎県医師会医学会誌 43 ( 2 ) 139 - 144 2019.11

Language：Japanese Publishing type：Research paper (scientific journal)

Intrapartum fetal asphyxia influence on blood levels of procalcitonin in neonate immediately after birth Reviewed

Journal of Japan Society of Perinatal and Neonatal Medicine 55 ( 3 ) 755 - 759 2019.9

Language：Japanese Publishing type：Research paper (scientific journal)

CD39 downregulation in chronic intervillositis of unknown etiology Reviewed

Yuichiro Sato, Kazunari Maekawa, Murasaki Aman, Atushi Yamashita, Yuki Kodama, Yohei Maki,Hiroshi Sameshima, Yujiro Asada

Virchows Archiv 475 357 - 364 2019.9

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1007/s00428-019-02598-6

Neonatal lupus presenting with abnormal intrapartum fetal heart rate patterns: A case report Reviewed

Junsuke Muraoka, Yuki Kodama, Tomoko Yamaguchi, Hajime Taniguchi, Nozomi Shiiba, Emi Kino, Rie Yamashita, Kaori Michikata, Madatoki Kaneko, Hiroshi Sameshima

Journal of Pediatric Health Care 2 ( 1 ) 27 - 28 2019.4

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

C4d Deposition in Fetal Vessels of the Placenta in Neonatal Lupus Syndrome. Reviewed

Yuichiro Sato , Tomoko Yamaguchi, Jyunsuke Muraoka, Hajime Taniguchi, Atsushi Kisanuki, KazunariMaekawa, Atushi Yamashita,Murasaki Aman, Yuki Kodama, Hiroshi Sameshima , Yujiro Asada

Case reports in obstetrics and gynecology 2019 5863476 2019.3

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1155/2019/5863476

Neonatal lupus presenting with abnormal intrapartum fetal heart rate patterns: A case report Reviewed

Muraoka J, Kodama Y, Yamaguchi T, Taniguchi H, Shiiba N, Kino E, Yamashita R, Michikata K, Kaneko M, Sameshima H.

Journal of Pediatric Health Care Medicine 2 ( 1 ) 27 - 28 2019.3

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

超早産児における脳室内出血の背景因子の検討 Reviewed

紀愛美、児玉由紀、山下理絵、金子政時、鮫島浩

日本産婦人科・新生児血液学会誌 28 ( 2 ) 71 - 76 2019.3

Language：Japanese Publishing type：Research paper (scientific journal)

治療開始スコアとしての産科DICスコアの有効性についての検討 Reviewed

松澤聡史、川越靖之、児玉由紀、古川誠志、鮫島浩

日本産婦人科・新生児血液学会誌 28 ( 2 ) 49 - 53 2019.3

Language：Japanese Publishing type：Research paper (scientific journal)

Manual removal of placenta in women having unpredictable adherent placenta Reviewed

Furukawa S, Fujisaki M, Maki Y, Oohashi M, Doi K, Sameshima H

Journal of Obstetrics and Gynaecology Research 45 ( 1 ) 141 - 147 2019.1

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1111/jog.13805

新生児けいれんを契機に診断された家族歴のない血友病の1例 Reviewed

河野猛嗣、児玉由紀、山下理絵、紀愛美、椎葉望、金子政時、鮫島浩、松澤聡史、大橋昌尚、堂福美佳、山田愛、木下真理子、上村幸代、盛武浩

宮崎県医師会医学会誌 42 ( 2 ) 163 - 168 2018.12

Authorship：Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)

Oral diatrizoate acid for meconium-related ileus in extremely preterm infants Reviewed

Kaori Michikata, Yuki Kodaa, Masatoki Kaneko, Hiroshi Sameshima, Tsuyomu Ikenoue, Seiro Machigashira, Motoi Mukai, Motofumi Torikai, Kazuhiko Nakame

Pediatrics International 60 ( 8 ) 714 - 718 2018.8

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

DOI： 10.1111/ped.13606

脳性麻痺発祥の防止に対する助産所・診療所と専門病院との連携 Reviewed

池ノ上, 児玉由紀, 山下理絵, 土井宏太郎, 鮫島浩

公衆衛生 82 ( 7 ) 544 - 547 2018.7

Language：Japanese Publishing type：Research paper (scientific journal)

Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation Reviewed

Fujisaki M., Furuta K., Ohhashi M., Furukawa S., Kodama Y., Kawagoe Y., Sameshima H., Ikenoue T.

Journal of Perinatal Medicine 45 ( 7 ) 117 - 121 2017.10

Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1515/jpm-2016-0190

Temporal trends in perinatal mortality and cerebral palsy: A regional population-based study in southern Japan Reviewed

Fetal left ventricular non-compaction cardiomyopathy with ascites: A case report Reviewed

Junsuke Muraoka, Yuki Kodama, Hiroshi Sameshima, Kaori Michikata, Satoshi Matsuzawa, Masanao Oohashi, Masatoki Kaneko, Mayumi Akaki, Yuichiro Sato

Journal of Obstetrics and Gynaecology Resarch 43 ( 9 ) 1481 - 1484 2017.9

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

DOI： 10.1111/jog.13381

Population-based studyによる周産期医療の現状と展望 Invited Reviewed

児玉由紀

宮崎県医師会医学会誌 41 ( 2 ) 71 - 77 2017.9

Language：Japanese Publishing type：Research paper (scientific journal)

Kodama Y., Sameshima H., Ikenoue T.

Brain and Development 38 ( 4 ) 386 - 391 2016.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Brain and Development

© 2015 The Japanese Society of Child Neurology. Aim: The prevalence of cerebral palsy (CP) has not decreased in developed countries over the past 30 years. We examined gestational age-specific trends in the prevalence of CP. Methods: This unselected, population-based study was conducted in Miyazaki prefecture, Japan (10,000 deliveries annually), where 102,999 deliveries were registered between 2001 and 2010. Of these, 312 were stillbirths (≥22 weeks of gestation), 126 were neonatal deaths (<28 days of birth), and 214 infants were determined to be at risk of CP at peer-review conferences. Survival and neurological damage were compared for two 5-year periods, 2001-2005 and 2006-2010, and infants were classified according to gestational ages. Results: Stillbirths and neonatal deaths decreased significantly during both periods. Likewise, the number of registered high-risk cases of CP decreased by 30.2%, from 126 to 88 cases. After excluding congenital anomalies, the corrected CP prevalence was 1.5 per 1000 (78/51,889) and 1.3 per 1000 (67/51,110), for the two periods, which was not a significant difference. The number of extremely preterm infants (22-25 weeks) did not change over the 10-year period, whereas that of moderately preterm infants (26-36 weeks) increased, and that of term infants significantly decreased (p < 0.01). In term infants, asphyxia decreased from 18 to 7 cases (p < 0.05). Conclusions: Perinatal deaths and CP decreased in prevalence during both 5-year periods, and the CP prevalence was 2.1 per 1000 births. Furthermore, fewer term infants were at high risk for CP mainly because of the reduced prevalence of asphyxia.

DOI： 10.1016/j.braindev.2015.10.002

The Regional Centralization of Electronic Fetal Heart Rate Monitoring and Its Impact on Neonatal Acidemia and the Cesarean Birth Rate Reviewed

Michikata K., Sameshima H., Urabe H., Tokunaga S., Kodama Y., Ikenoue T.

Journal of Pregnancy 2016 3658527 2016

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Pregnancy

© 2016 Kaori Michikata et al. Objective. The improvement of the accuracy of fetal heart rate (FHR) pattern interpretation to improve perinatal outcomes remains an elusive challenge. We examined the impact of an FHR centralization system on the incidence of neonatal acidemia and cesarean births. Methods. We performed a regional, population-based, before-and-after study of 9,139 deliveries over a 3-year period. The chi-squared test was used for the statistical analysis. Results. The before-and-after study showed no difference in the rates of acidemia, cesarean births, or perinatal death in the whole population. A subgroup analysis using the 4 hospitals in which an FHR centralization system was continuously connected (compliant group) and 3 hospitals in which the FHR centralization system was connected on demand (noncompliant group) showed that the incidence acidemia was significantly decreased (from 0.47% to 0.11%) without a corresponding increase in the cesarean birth rate due to nonreassuring FHR patterns in the compliant group. Although there was no difference in the incidence of nonreassuring FHR patterns in the noncompliant group, the total cesarean birth rate was significantly higher than that in the compliant group. Conclusion. The continuous FHR centralization system, in which specialists help to interpret results and decide clinical actions, was beneficial in reducing the incidence of neonatal acidemia (pH < 7.1) without increasing the cesarean birth rate due to nonreassuring FHR patterns.

DOI： 10.1155/2016/3658527

Histological severity of fetal inflammation is useful in predicting neonatal outcome

劇症１型糖尿病の診断基準を満たした妊娠中の急性発症１型糖尿病 Reviewed

紀愛美、児玉由紀、大橋昌尚、河野典子、古川誠志、鮫島浩、池ノ上克、卜部浩俊、道方香織、蓮田淳

糖尿病と妊娠 16 ( 1 ) 57 - 62 2016

Language：Japanese Publishing type：Research paper (scientific journal)

当科における34週未満の前期破水症例の周産期予後 Reviewed

12) 村岡純輔、大橋昌尚、松澤聡史、藤崎碧、道方香織、児玉由紀、金子政時、鮫島浩、池ノ上克

九州連合産科婦人科学会雑誌 67 44 - 44 2016

Language：Japanese Publishing type：Research paper (scientific journal)

原因疾患別胎児水腫症例の検討 Reviewed

11) 椎葉望、山田直史、山口智子、村岡純輔、松澤聡史、藤崎碧、大橋昌尚、道方香織、児玉由紀、金子政時、鮫島浩、池ノ上克

九州連合産科婦人科学会雑誌 67 43 - 43 2016

Language：Japanese Publishing type：Research paper (scientific journal)

Chronic histiocytic intervilositis 同胞例における周産期予後の比較 Reviewed

10) 村岡純輔、金子政時、松澤聡史、大橋昌尚、住吉香恵子、道方香織、児玉由紀、鮫島浩

日本周産期・新生児医学会雑誌 52 ( 1 ) 125 - 129 2016

Language：Japanese Publishing type：Research paper (scientific journal)

Preterm labor and neonatal sepsis caused by intrauterine Helicobacter cinaedi infection Reviewed

Maki Y, Furukawa S, Kodama Y, Sumiyoshi K, Kino E, Sameshima H

J Infect Chemother 22 ( 6 ) 414 - 416 2016

Language：English Publishing type：Research paper (scientific journal)

Trends in perinatal death and brain damage: A regional population-based study in southern Japan, 1998-2012 Reviewed

5) Yamashita R, Kodama Y, Sameshima H, Doi K, Michikata K, Kaneko M, Ikenoue T.

Austin Pediatr 3 ( 4 ) 1 - 5 2016

Language：English Publishing type：Research paper (scientific journal)

Hydrops fetalis associated with congenital cytoplasmic body myopathy Reviewed

Kodama Y, Sameshima H, Kaneko M, Kawaguchi H, Ikeda T, Ikenoue T

Obstet Gynecol cases Rev 3 ( 7 ) 1 - 3 2016

Language：English Publishing type：Research paper (scientific journal)

劇症１型糖尿病の診断基準を満たした妊娠中の急性発症１型糖尿病 Reviewed

紀愛美、児玉由紀、大橋昌尚、河野典子、古川誠志、鮫島浩、池ノ上克、卜部浩俊、道方香織、蓮田淳

糖尿病と妊娠 16 ( 1 ) 57 - 62 2016

Language：Japanese Publishing type：Research paper (scientific journal)

Yamada N., Sato Y., Moriguchi-Goto S., Yamashita A., Kodama Y., Sameshima H., Asada Y.

Placenta 36 ( 12 ) 1490 - 1493 2015.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Placenta

© 2015 Elsevier Ltd. Intrauterine inflammation contributes to neonatal infection-related morbidity. A new histological framework of placental inflammation has recently been proposed; however, the association between this method and clinical findings has not been defined. To assess the clinical relevance of this system, we studied placental findings in 272 singleton neonates born at less than 34 weeks gestation. The incidences of sepsis, intraventricular hemorrhage, chronic lung disease, and necrotizing enterocolitis increased in a stepwise fashion with severity of placental inflammation. After adjusting for gestational age, a high grade of fetal inflammation was significantly associated with chronic lung disease and necrotizing enterocolitis.

DOI： 10.1016/j.placenta.2015.10.021

Intrapartum fetal heart rate patterns preceding terminal bradycardia in infants (> 34-weeks) with poor neurological outcome: A regional population-based study in Japan

Kodama Y., Sameshima H., Yamashita R., Oohashi M., Ikenoue T.

Journal of Obstetrics and Gynaecology Research 41 ( 11 ) 1738 - 1743 2015.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research

© 2015 Japan Society of Obstetrics and Gynecology. Aim Intrapartum fetal bradycardia necessitates immediate operative delivery. Our aim was to investigate the hypothesis that some non-reassuring fetal heart rate (FHR) patterns were present before the onset of terminal bradycardia in infants who developed subsequent brain damage. Material and Methods From a population-based study of 65-197 deliveries, 190 stillbirths, 115 neonatal deaths, and 136 neurologically high-risk infants were registered by the Miyazaki Perinatal Conference. There were 15 cases of neurologically high-risk infants born at > 34-weeks of gestation exhibiting intrapartum terminal bradycardia. Focusing on the brain-damaged infants, we retrospectively analyzed FHR patterns for at least 1-h prior to the bradycardia. Results Brain damage (cerebral palsy [n-=-11] and mental retardation [n-=-2] ) was diagnosed at 2-years old in 13 out of 15 neurologically high-risk infants. Two infants had bradycardia on admission. In the remaining 11 infants, FHR patterns were reassuring in six (55%) and non-reassuring in five (45%), including late decelerations (n-=-4) and variable decelerations (n-=-2). Clinically relevant factors in the non-reassuring group included intrauterine infection (n-=-3), malpresentation with umbilical cord coiling (n-=-1), and unknown causes (n-=-1). Clinically relevant features in the reassuring group included cord prolapse (n-=-1), vaginal breech delivery (n-=-1), shoulder dystocia (n-=-1), rupture of membranes (n-=-1), and unknown causes (n-=-2). Conclusion More than half of the brain-damaged infants born at > 34-weeks of gestation who exhibited intrapartum terminal bradycardia had unremarkable FHR patterns before abrupt-onset bradycardia. For those with non-reassuring patterns preceding bradycardia, intrauterine infection was the major sentinel event.

DOI： 10.1111/jog.12797

Amniocentesis for threatened preterm labor with intact membranes and the impact on adverse outcome in infants born at 22 to 28 weeks of gestation

Maki Y., Furukawa S., Kodama Y., Sameshima H., Ikenoue T.

Early Human Development 91 ( 5 ) 333 - 337 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Early Human Development

© 2015 Elsevier Ireland Ltd. Background: It remains unclear whether performing amniocentesis to detect intra-amniotic infection is useful for improving neonatal outcomes. Aims: To determine the efficacy of amniocentesis on the neonatal outcomes in women exhibiting threatened preterm labor and intact membranes. Study design: Retrospective cohort study. Subjects: A total of 174 women with threatened preterm labor and intact membranes at 22 to 33. weeks of gestation. Women with obvious clinical chorioamnionitis, multifetal pregnancy and/or major anomalies were excluded. Outcome Measures: Neonatal short- and long-term outcomes. Results: Sixty-seven women underwent amniocentesis (Tap group), while the remaining 107 did not. The prevalence of a positive Gram stain or a positive culture result was 10% in the Tap group. The overall outcomes were not statistically different between the two groups, with the exception of borderline significance (p = 0.052) in long-term outcomes, favoring the Tap group. We performed a subgroup analysis focusing on infants born at 22-28. weeks of gestation. Consequently, the Tap group had better neonatal outcomes than the no-Tap group with respect to both short-term (OR 0.19, 95%CI 0.07-0.55) and long-term (OR 0.15, 0.05-0.46) outcomes. A multivariate analysis revealed that after adjusting confounding factors, the gestational age at delivery (OR 0.4, 0.3-0.7) and amniocentesis (OR 0.1, 0.02-0.3) remained significantly different. Conclusions: Amniocentesis is useful for improving neonatal outcomes in infants born at 22-28. weeks of gestation to women exhibiting preterm labor and intact membranes.

DOI： 10.1016/j.earlhumdev.2015.03.006

Impact of new gestational diabetes mellitus criteria on stillbirth: A regional population-based study in Japan

Impact of Skin Lesions on Morbidity and Mortality in Extremely Premature Infants in One Tertiary Center in Southern Japan. Reviewed

Yamada N, Kodama Y, Kaneko M, Sameshima H, Ikenoue T

J Neonatal Biol 4 ( 3 ) 2015

Language：English Publishing type：Research paper (scientific journal)

Histological severity of fetal inflammation is useful in predicting neonatal outcome. Reviewed

Yamada N, Sato Y, Moriguchi-Goto S, Yamashita A, Kodama Y, Sameshima H, Asada Y.

Placenta 36 ( 12 ) 1490 - 1493 2015

Language：English Publishing type：Research paper (scientific journal)

Did antepartum hypoxic insult caused by fetal vessel thrombosis influence the procalcitonin level in umbilical blood? A case report. Reviewed

2) Kaneko M, Yamauchi A, Yamashita R, Sato Y, Kodama Y, Sameshima H.

J Obstet Gynecol Res 41 ( 11 ) 1839 - 1842 2015

Language：English Publishing type：Research paper (scientific journal)

Early onset nontypable Haemophilis influenzae sepsis in a preterm newborn infant. Reviewed

○ Kaneko M, Yamashita R, Suzuki T, Kodama Y, Sameshima H, Ikenoue T

Clinical Case Reports 4 ( 7 ) 2014

Language：English Publishing type：Research paper (scientific journal)

Prospective study of the MD-twin score for antepartum evaluation of monochorionic diamniotic twins and its correlation with perinatal outcomes. Reviewed

Oohashi M., Kaneko M., Sameshima H., Kodama Y., Ikenoue T.

J Obstet Gynecol Res 40 ( 3 ) 711 - 717 2014

Language：English Publishing type：Research paper (scientific journal)

Kodama Y., Sameshima H., Ohashi M., Ikenoue T.

Journal of Obstetrics and Gynaecology Research 39 ( 7 ) 1242 - 1245 2013.7

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research

Aim: The aim of this study was to determine whether the new gestational diabetes mellitus (GDM) criteria increase the prevalence of diabetes-mellitus- related stillbirths by using a regional population-based approach. Material and Methods: A retrospective, population-based study was conducted to assess 114 036 deliveries from 2000 to 2010 in Miyazaki, Japan. During this period 318 stillbirths occurred after 22 weeks of gestation. Of these cases, 236 were examined to determine the cause of death. The remaining 82 cases were not fully investigated. In particular, we investigated the prevalence of pregestational diabetes mellitus and GDM among the stillbirths. We also applied new GDM criteria to evaluate the impact of these factors on stillbirth. Results: Of the 236 stillbirths, 47% were due to an explainable cause. Application of previous criteria indicated two cases of pregestational diabetes mellitus and three GDM cases in the remaining unexplained stillbirths. By applying new GDM criteria, the GDM count increased to 17. Conclusions: In an unselected population in southern Japan, the application of new GDM criteria resulted in a 5.7-fold increase (from 2.4% [3/126] to 13.5% [17/126]) in the number of GDM cases in unexplained stillbirths. Even in women with a mild degree of GDM, proper management of both mother and fetus could reduce the number of unexplained stillbirths. © 2013 The Authors.

DOI： 10.1111/jog.12055

宮崎県の周産期医療に関するpopulation-based 研究 Invited

児玉由紀

九州連合産科婦人科学会雑誌 64 56 - 60 2013

Language：Japanese Publishing type：Research paper (scientific journal)

Perinatal death and neurological damage as a sequential chain of poor outcome Reviewed

Doi K, Sameshima H, Kodama Y, et al.

Journal of Maternal Fetal Neonatal Medicine 25 ( 6 ) 706 - 709 2012.6

Language：English Publishing type：Research paper (scientific journal)

Congenital infantile fibrosarcoma in a very low-birth-weight infant Reviewed

Mukai M., Sameshima H., Kodama Y., Yamashita R., Kaneko M., Ikenoue T., Matsufuji H., Kondo K., Chijiiwa K.

Journal of Pediatric Surgery 47 ( 4 ) e1 - 4 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Pediatric Surgery

We describe a prenatally diagnosed case with congenital infantile fibrosarcoma, which is a rare malignant tumor, of which there have been only 14 cases reported in the English literature. A giant mass on the left thigh was detected at 24 weeks' gestation by prenatal ultrasonography. Because of its rapid growth and nonreassuring fetal status in utero, the baby was delivered by cesarean delivery at 27 weeks' gestation. The case was complicated by hemorrhagic anemia, coagulopathy, and cardiac failure, and a tumor resection was performed on day 3. As of age 2.5 years, he was healthy without evidence of recurrence. Because some fetal cases with congenital infantile fibrosarcoma have a poor prognosis, termination of pregnancy at an appropriate time and postnatal early treatment are crucial for successful treatment. © 2012 Elsevier Inc.

DOI： 10.1016/j.jpedsurg.2011.11.052

Intrapartum fetal heart rate patterns in infants (≥ 34 weeks) with poor neurological outcome

Kodama Y., Sameshima H., Ikeda T., Ikenoue T.

Early Human Development 85 ( 4 ) 235 - 238 2009.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Early Human Development

Background: Cases suggestive of non-acidemia related cerebral palsy (CP) are likely misdiagnosed as acidemia related CP because of the presence of nonreasuring fetal heart rate (FHR) patterns. Aims: Our purpose was to compare intrapartum FHR patterns between the cases of neurological damage and the cases without disability after severe metabolic acidemia and neonatal encephalopathy, and also to compare the FHR patterns between cases with CP due to asphyxia and cases with CP of other etiology in infants born after 34 weeks. Study design: From 1998 to 2003, our peer review conferences determined 136 infants with high-risk factors for neurological impairment in the unselected 65,197 live births. High-risk infants were chosen according to our criteria. Among them 58 were eligible infants because they were born at ≥ 34 weeks of gestation and also had legible FHR traces. Outcome measures: Incidence of nonreassuring FHR patterns. Results: Fifteen infants were acidemia related and 43 were non-acidemia related high-risk infants. Ten of the 15 acidemia infants developed CP and all had shown bradycardia ≥ 13 min with a nadir < 80 bpm. In the 43 non-acidemia infants, 35 had CP, mental retardation, epilepsy, or hearing loss and 74% (26/35) of them had shown nonreassuring FHR patterns. Incidence of severe bradycardia was significantly elevated in the acidemia related CP compared with acidotic infants without disability, and those with non-acidemia related CP. Conclusions: Even in infants with non-acidemia related CNS impairments, who were born at ≥ 34 weeks of gestation, 74% had shown intrapartum nonreassuring FHR patterns. © 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.earlhumdev.2008.10.007

Deaths of early-onset, invasive sepsis in full-term infants in Miyazaki: nine cases from a regional population-based analysis from 1998-2006.

Sameshima H, Kodama Y, Kaneko M, Ikenoue T, Miyazaki Perinatal Data Group.

Japanese journal of infectious diseases 61 ( 5 ) 400 - 1 2008.9

Language：Japanese Publishing type：Research paper (scientific journal)