基本情報
- 所属
- 自治医科大学 附属病院総合周産期母子医療センター母体・胎児集中治療管理部 教授
- 学位
- 医学博士(自治医科大学)
- 研究者番号
- 10306136
- J-GLOBAL ID
- 200901062593291379
- researchmap会員ID
- 1000273353
研究キーワード
15研究分野
4経歴
4-
2015年 - 現在
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2007年 - 2015年
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2002年 - 2007年
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1998年 - 2002年
学歴
2-
1981年4月 - 1987年3月
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- 1987年
委員歴
10-
2023年4月 - 現在
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2021年11月 - 現在
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2013年 - 現在
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2021年10月 - 2023年9月
受賞
4-
2012年
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2012年
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2010年
論文
239-
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2024年4月26日OBJECTIVES: To investigate the association between adenomyosis and placenta accreta spectrum (PAS) and to evaluate the effect of assisted reproductive technology (ART) in mediating this association. METHODS: We retrieved data for singleton women from the Japanese nationwide perinatal registry between 2013 and 2019, excluding women with a history of adenomyomectomy. To investigate the association between adenomyosis and PAS among women, we used a multivariable logistic regression model with multiple imputation for missing data. We evaluated mediation effect of ART including in vitro fertilization and intracytoplasmic sperm injection on the association between adenomyosis and PAS using causal mediation analysis based on the counterfactual approach. RESULTS: Of 1 500 173 pregnant women, 1539 (0.10%) had adenomyosis. The number receiving ART was 489/1539 (31.8%) and 117 482/1 498 634 (7.8%) in women with and without adenomyosis, respectively. The proportion of women who developed PAS was 21/1539 (1.4%) in women with adenomyosis and 7530/1 498 634 (0.5%) in women without adenomyosis. Adenomyosis was significantly associated with PAS (odds ratio [OR] 1.95; 95% confidence interval [CI] 1.26-3.00; P = 0.002). Mediation analysis showed that OR of the total effect of adenomyosis on PAS was 1.98 (95% CI 1.13-3.04), OR of natural indirect effect (effect explained by ART) was 1.15 (95% CI 1.01-1.41), and OR of natural direct effect (effect unexplained by ART) was 1.72 (95% CI 0.86-2.82). The proportion mediated (natural indirect effect/total effect) was 26.5%. Adenomyosis was also significantly associated with PAS without previa (OR 1.96; 95% CI 1.23-3.13, P = 0.005). CONCLUSION: Adenomyosis was significantly associated with PAS. ART mediated 26.5% of the association between adenomyosis and PAS.
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Journal of Reproductive Immunology 162 104189-104189 2024年3月
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Journal of Reproductive Immunology 161 104187-104187 2024年2月
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BJOG : an international journal of obstetrics and gynaecology 2023年11月13日OBJECTIVE: To investigate whether conisation increases chorioamnionitis (CAM) and assess whether this risk differs between preterm and term periods. Furthermore, we estimated mediation effects of CAM between conisation and preterm birth (PTB). DESIGN: A nationwide observational study. SETTING: Japan. POPULATION: Singleton pregnant women derived from the perinatal registry database of the Japan Society of Obstetrics and Gynaecology between 2013 and 2019. METHODS: The association between a history of conisation and clinical CAM was examined using a multivariable logistic regression model with multiple imputation. We conducted mediation analysis to estimate effects of CAM on PTB following conisation. MAIN OUTCOME MEASURES: Clinical CAM. RESULTS: Of 1 500 206 singleton pregnant women, 6961 (0.46%) underwent conisation and 1 493 245 (99.5%) did not. Clinical CAM occurred in 150 (2.2%) and 11 484 (0.8%) women with and without conisation, respectively. Conisation was associated with clinical CAM (odds ratio [OR] 3.09; 95% confidence interval (CI) 2.63-3.64; p < 0.001) (risk difference 1.57%; 95% CI 1.20-1.94). The association was detected among 171 440 women with PTB (OR 3.09; 95% CI 2.57-3.71), whereas it was not significant among 1 328 284 with term birth (OR 0.88; 95% CI 0.58-1.34). OR of total effect of conisation on PTB was 2.71, OR of natural indirect effect (effect explained by clinical CAM) was 1.04, and OR of natural direct effect (effect unexplained by clinical CAM) was 2.61. The proportion mediated was 5.9%. CONCLUSIONS: Conisation increased CAM occurrence. Obstetricians should be careful regarding CAM in women with conisation, especially in preterm period. Bacterial infections may be an important cause of PTB after conisation.
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Placenta 141 106-106 2023年9月
MISC
559-
Reproductive Immunology and Biology 31(1-2) 96-96 2016年11月
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Reproductive Immunology and Biology 31(1-2) 135-135 2016年11月
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY 36(3) 340-344 2016年4月To characterise congenital mesoblastic nephroma (CMN), with special emphasis on polyhydramnios and the neonatal prognosis, we summarise 31 CMN patients (30 reported patients and the present patient). CMN was detected at a median of 30 weeks' gestation, and infants were delivered at a median of 34 weeks' gestation. Of 27 patients with available data, 19 (70%) had polyhydramnios, of which 8 required amnio- drainage. Women with amnio-drainage gave birth significantly earlier (30.4 weeks' gestation) than those without polyhydramnios (36.7 weeks' gestation). Thus, CMN was frequently associated with polyhydramnios and this polyhydramnios was associated with a significant increase in the risk of preterm birth. Of 20 patients with available data, the affected-side kidney was 'compressed' in 16 and 'replaced' in 4: polyhydramnios was present in a half vs 100%, respectively, suggesting that a 'replaced' kidney may suggest a more aggressive tumour and may be associated with a poorer prognosis. Univariate analysis showed that early gestational week at diagnosis was the only feature significantly associated with poor prognosis. Thus, polyhydramnios, 'replaced' kidney and early gestational week at diagnosis, may indicate poor prognosis, to which obstetricians should pay attention.
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栃木県母性衛生学会雑誌: とちぼ (42) 13-15 2016年3月40歳(2経妊0経産)。妊娠19週4日に出血と腹部膨満感を主訴に来院し、切迫流産の診断で入院となった。塩酸リトドリンの経静脈投与を66μg/分から開始し、炎症所見が軽快した後、21週0日に緊急マクドナルド頸管縫縮術を行った。その後、子宮収縮や頸管所見に応じてリトドリンを200μg/分まで徐々に増量した。母体の心拍数はリトドリン投与前が80bpm台、投与後が90〜110bpmであった。リトドリン投与55日目、起床時に突然の強い動悸を訴えた。脈拍は150〜170bpm、血圧は118/56mmHg、SpO2は97%、12誘導心電図は心拍数160bpm、R-R間隔は不整でP波を認めず、心房細動と診断した。心房細動の原因を明らかにするため、原因となりうる「心疾患」「電解質異常」「甲状腺機能亢進症」「薬剤」について鑑別診断を行った結果、「心疾患」「電解質異常」「甲状腺機能亢進症」は否定的であり、投与中の薬剤はリトドリンのみであったことから、リトドリンによる薬剤性の心房細動と診断した。
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栃木県産婦人科医報 42 53-55 2016年3月新生児同種免疫性血小板減少症(Neonatal alloimmune thrombocytopenia:NAIT)とは、免疫学的機序により起こる児の一過性血小板減少症であり、同胞罹患率が高い。母親に患児の血小板と反応する抗血小板抗体が証明されることが診断基準の一つであるが、原因抗体が明らかでない同胞発症症例を経験した。臨床経過からNAITが否定できない場合には、原因抗体が不明であっても次の妊娠分娩の際にNAITに準じた慎重な管理が必要である。(著者抄録)
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日本産科婦人科學會雜誌 68(2) 943-943 2016年2月1日
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Reproductive Immunology and Biology 30(1-2) 113-113 2015年11月
書籍等出版物
13共同研究・競争的資金等の研究課題
17-
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日本学術振興会 科学研究費助成事業 2020年4月 - 2024年3月
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国立研究開発法人日本医療研究開発機構 令和2年度 成育疾患克服等総合研究事業-BIRTHDAY 2020年10月 - 2024年3月