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Faculty of Medicine School of Medicine Department of Developmental and Urological-Reproductive Medicine, Obstetrics and Gynecology |
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DOI Koutarou
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Degree 【 display / non-display 】
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MD.Ph.D ( 2013.3 University of Miyazaki )
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学士（医学） ( 2000.3 鹿児島大学 )
Papers 【 display / non-display 】
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Doi K., Kodama Y., Matsuzawa S., Goto T., Muraoka J., Fujisaki M., Yamada N., Taniguchi H., Furuta K., Kawagoe Y., Kaneko M., Katsuragi S., Ikenoue T., Sameshima H.
Early Human Development 216 106495 2026.5
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Early Human Development
Objective: The ultimate goal of perinatal care is to ensure that infants survive without neurological impairment. Despite advances in medical technology and healthcare systems that have markedly decreased perinatal mortality, cerebral palsy has shown only a gradual decline in recent population-based studies. The aim of this study was to use a pathway classification system to analyze brain injury cases detected at or beyond 35 weeks' gestation and to clarify temporal changes in the incidence and causal pathways of intrapartum brain injury and its contributing factors in Miyazaki Prefecture, Japan. Methods: Of 151,558 births recorded in Miyazaki Prefecture from 2001 to 2015, 303 cases of brain injury were registered in the regional perinatal case-review system. Of these, 134 were detected at ≥35 weeks. Brain injury was categorized as congenital anomalies, antepartum, intrapartum, or neonatal onset. Each case was further classified using a pathway system that considered distal and proximal risk factors. Temporal trend analysis was performed across three consecutive 5-year intervals (2001–2005, 2006–2010, and 2011–2015). Results: Of the 134 cases, 25% were classified as intrapartum-related, 23% as antepartum-related, and 5% as neonatal-related. Overall, the incidence of brain injury at ≥35 weeks decreased significantly over time. Significant downward trends were observed in total cases and intrapartum-related brain injury, with the reduction in intrapartum cases being especially pronounced. Antepartum-related brain injury declined more gradually. Further analysis revealed that the incidence of hypoxia-related intrapartum brain injuries decreased over time, whereas bacterial infection-related intrapartum cases were observed only in the earliest epoch. Conclusions: This population-based study identified temporal changes in perinatal brain injury detected at or beyond 35 weeks' gestation over 15 years. The incidence of perinatal brain injury declined significantly, particularly intrapartum-related cases with hypoxia-related injury. These improvements might reflect advances in regionalized perinatal care, the establishment of perinatal centers, or multidisciplinary education and training. Further efforts to optimize intrapartum assessment and management would contribute to continued reductions in severe perinatal brain injury.
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村岡 純輔, 土井 宏太郎, 當瀬 ちひろ, 吉本 望, 松澤 聡史, 桂木 真司
Case Reports in Obstetrics and Gynecology 2026 4556829 2026.3
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley
A 44-year-old Japanese woman with no history of uterine surgery or trauma was admitted for pregnancy termination at 20 weeks due to a fetal abnormality. A vaginal gemeprost pessary was administered into the posterior fornix under prescribed doses. During the second day of treatment, she developed hemorrhagic shock from a uterine rupture (UR) in the lower myometrial segment, with the uterovesical serosa remaining intact. She required massive transfusion therapy and a hysterectomy and was initially recovering. However, 3 days postoperation, she exhibited significant abdominal bleeding due to rupture of a uterine artery pseudoaneurysm (UAP), which required hemostatic surgery. This novel case highlights the risk of UR during second-trimester medical abortion (STMA) with gemeprost, even in unscarred uteri. Detection of cervical displacement via vaginal examination may lead to the diagnosis of UR. Laparotomy should be performed following cardiovascular collapse, even if an ultrasonography could not reveal intraperitoneal bleeding. Additionally, the varied anatomical damage to the uterus can result in complicating the conventional surgical approach and contributing to the formation of a pseudoaneurysm. Such extraordinary cases are best managed by experienced clinicians and skilled surgical teams.
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Population-Based Study of Prenatal Detection of Critical Congenital Heart Disease in Kyu-Yama Region of Japan. Reviewed
Nagata H, Kitadai Y, Hara T, Shinya M, Sugitani Y, Takahashi M, Doi K, Okada S, Shimabukuro A, Doi H, Kozuma Y, Hamada T, Kawamura J, Nishihara T, Teramachi Y, Kan N, Maeno Y, Nishibatake M
Pediatrics international : official journal of the Japan Pediatric Society 68 ( 1 ) e70467 2026.1
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
DOI： 10.1111/ped.70467
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土井 宏太郎, 鮫島 浩
Hypertension Research 48 110 - 120 2025
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Nature
This multicenter prospective study investigated seasonal variation in home blood pressure (HBP) values during pregnancy and its effect on the risk of hypertensive disorders of pregnancy (HDP) and developed trimester-specific upper limits of HBP according to season for pregnant women. Low-risk women with singleton pregnancies were recruited at six university hospitals and five maternity clinics before 13 weeks’ gestation. HBP was measured by a sphygmomanometer twice daily and recorded online using a mobile application. HBP was evaluated according to season (winter, spring, summer, and autumn) and gestational age. Of 705 women recruited, 603 were finally included in the analysis. Mean diastolic HBP values were lowest in summer and highest in winter throughout pregnancy (mean difference between summer and winter, 3.4–4.6 mmHg). Mean systolic HBP values were also lowest in summer and highest in winter except during the early period of the second trimester (mean difference between summer and the highest season, 2.8–3.4 mmHg). HDP was diagnosed in 32 women (5.3%). The risk of HDP was significantly higher in women who delivered in spring and autumn but not in winter compared with summer. The rounded upper limit of HBP for summer was 120/80 mmHg in the first trimester, 120/75 mmHg in the second trimester, and 125/80 mmHg in the third trimester and 125/85 mmHg, 125/80 mmHg, and 130/85 mmHg, respectively, for other seasons. Systolic and diastolic HBP were lowest in summer throughout pregnancy. Seasonal variation should be considered when interpreting HBP and the risk of HDP during pregnancy.
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村岡 純輔, 金子 政時, 土井 宏太郎, 児玉 由紀, 鮫島 浩
Microbiology Research 13 ( 3 ) 598 - 608 2022.8
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG
Abstract
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.
Books 【 display / non-display 】
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Preterm Labor and Delivery
Koutarou Doi（ Role： Joint author）
Springer 2019.3
Responsible for pages：89-94 Language：English Book type：Scholarly book
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Obstetrical and Gynecological Therapy, The role of university of miyazaki in perinatal emergencies
Koutarou Doi, Tsuyomu Ikenoue,Syuuichi Tokunaga（ Role： Joint author）
NAGAI SHOTENN 2010.4
Language：Japanese Book type：Scholarly book
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The JAPANESE JOURNAL OF PERINATAL CARE 2010
Koutarou Doi, Masatoki Kaneko （ Role： Joint author）
medica syuppann 2010.1
Language：Japanese Book type：Scholarly book
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perinatal emergencies, Obstetrical DIC
Koutarou Doi, Seishi Furukawa, Hiroshi Sameshima（ Role： Joint author）
IGAKU SHOIN 2010.1
Language：Japanese Book type：Scholarly book
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周産期管理
土井宏太郎、鮫島浩（ Role： Joint author , 第8章 前置胎盤・癒着胎盤）
メディカ出版 2009
Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
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遺伝カウンセリングでつなぐ未来の医療と家族の健康
土井宏太郎
サンテ宮崎 2025
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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妊娠中のアセトアミノフェン使用と児の自閉症,ADHD,知的障害に関する検討(海外文献から)
土井宏太郎
産婦人科の実際 73 ( 7 ) 744 2024.7
Authorship：Lead author Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal)
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遺伝学的検査と遺伝カウンセリング
土井宏太郎
日州医事 2024
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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梅毒と妊娠
土井宏太郎
宮日新聞きゅんと 2023
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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【外来時・入院時】切迫早産妊婦
土井宏太郎
ペリネイタルケア 2022.9
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
Presentations 【 display / non-display 】
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胎児評価の扉；やさしく学ぶ出生前検査と胎児心エコー
土井宏太郎
宮崎県産婦人科病医院従事者研修会第29回ひむかセミナー 2026.3
Event date： 2026.3.7 - 2026.3.8
Language：Japanese Presentation type：Oral presentation (invited, special)
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胎内発生神経障害のCTG所見
土井宏太郎
日本母体胎児医学会第3回胎児心拍数陣痛図セミナー 2025.9.27
Event date： 2025.9.27 - 2025.9.28
Language：Japanese Presentation type：Oral presentation (general)
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レベル1 初めて学ぶ胎児心エコーの扉
土井宏太郎
第10回九州山口胎児心臓研究会 2025.9.13
Event date： 2025.9.13
Language：Japanese Presentation type：Oral presentation (general)
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周産期に活かす！初めて学ぶ遺伝医学の扉
土井宏太郎
宮崎県産婦人科病医院従事者研修会第28回ひむかセミナー 2025.3.1
Event date： 2025.3.1 - 2025.3.2
Language：Japanese Presentation type：Oral presentation (general)
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遺伝医学と生命倫理～周産期遺伝カウンセリングの現場から～
土井宏太郎
宮崎県医師会母体保護法指定医師研修会 2025.2.8
Event date： 2025.2.8
Language：Japanese Presentation type：Oral presentation (general)