Patients with schizophrenia or bipolar disorder have a high risk of developing type 2 diabetes.

To identify predictive factors for hyperglycaemic progression in individuals with schizophrenia or bipolar disorder and to determine whether hyperglycaemic progression rates differ among antipsychotics in regular clinical practice.

We recruited 1166 patients who initially had normal or prediabetic glucose levels for a nationwide, multisite, l-year prospective cohort study to determine predictive factors for hyperglycaemic progression. We also examined whether hyperglycaemic progression varied among patients receiving monotherapy with the six most frequently used antipsychotics.

High baseline serum triglycerides and coexisting hypertension significantly predicted hyperglycaemic progression. The six most frequently used antipsychotics did not significantly differ in their associated hyperglycaemic progression rates over the 1-year observation period.

Clinicians should carefully evaluate baseline serum triglycerides and coexisting hypertension and perform strict longitudinal monitoring irrespective of the antipsychotic used.

The authors report no financial or other relationship that is relevant to the subject of this article. Relevant financial activities outside the submitted work are as follows. I.K. has received honoraria from Astellas, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Nippon Chemiphar, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin; has received research/grant support from AbbVie GK, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, GlaxoSmithKline, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Takeda Pharmaceutical, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin; and is a member of the advisory boards of Dainippon Sumitomo Pharma and Tanabe Mitsubishi Pharma. Y.T. has received speaker's honoraria from Dainippon-Sumitomo Pharma, Otsuka, Meiji-Seika Pharma, Janssen Pharmaceutical, Daiichi-Sankyo Company, UCB Japan and Ono Pharmaceutical. K.U. has received honoraria from Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin. B.Y. has received speaker's honoraria from Otsuka Pharmaceutical and Janssen Pharmaceutical. J. I. has received honoraria from Dainippon Sumitomo Pharma, Eli Lilly, Janssen Pharmaceutical, Meiji Seika Pharma, MSD, Novartis Pharma, Otsuka Pharmaceutical and Mochida Pharma.

This study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan.

Primary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis.

From overall baseline birth outcomes, a preterm birth rate was 4.6% and low-birth-weight rate was 8.8%. Regional analysis revealed that a preterm birth rate was 3.2% (coastal) and 5.0% (inland), respectively, and the rate of low birth weight was 6.5% in the coastal and 8.5% in the inland region. In the risk analysis of low-birth-weight rate and preterm birth rate, the risk in the coastal region could not be considered any higher than in the inland region (adjusted odds ratio 0.91 [0.73-1.14] and 0.85 [0.46-1.59], respectively).

The incidence of preterm birth and low birth weight were not adversely affected by the disaster. Early transfer and intensive medical intervention may have led to those findings. Further survey will be necessary to determine the long-term effects in both mothers and children.

SugawaraJ, IwamaN, HoshiaiT, TokunagaH, NishigoriH, MetokiH, OkamuraK, YaegashiN. Regional Birth Outcomes after the 2011 Great East Japan Earthquake and Tsunami in Miyagi Prefecture. Prehosp Disaster Med. 2018;33(2):215–219.

We aimed to clarify the correlation between the 2011 Great East Japan Earthquake and pregnant women’s awareness of social capital 3 to 9 months after the tsunami disaster.

We analyzed data on responses to a questionnaire by 7451 pregnant women in their second to third trimesters. The proportions of social capital–related items were calculated in the north and south coastal areas of Miyagi Prefecture and were compared with national samples. The factors associated with social capital were estimated by use of multivariate logistic regression analyses.

The proportion of women feeling that they had helpful neighbors was higher (69.0% vs 56.7%, P=0.0005), the proportion of women regarding their communities as safe and secure was lower (51.7% vs 62.4%, P=0.002), and the proportion of women feeling that most people were trustworthy was lower (23.7% vs 32.9%, P=0.006) in the north coastal area than nationwide. Such differences were not observed in the less severely affected south coastal area. Age of 35 years or older, extended family, college or university graduation, and being multiparous were associated with the feeling of having helpful neighbors.

The current status of pregnant women’s awareness of social capital in disaster-affected areas was revealed. Continuous monitoring and support may be necessary to address this issue.(Disaster Med Public Health Preparedness. 2017;11:355–364)

This study aimed to clarify the correlation between the 2011 Great East Japan Earthquake and domestic violence (DV) against pregnant females after the disaster in Miyagi Prefecture, an area damaged by the earthquake and tsunami.

We analyzed 7600 pregnant females from June to December 2011. The incidence of physical and mental DV and the proportions in the inland, north coastal, and south coastal areas of Miyagi Prefecture and nationwide were calculated, and a chi-square test was conducted for comparison. The risk factors for DV were estimated with multivariate logistic regression analyses on a prefecture-wide basis.

The incidence levels for physical DV were found to be 5.9% in the north coastal area, which was significantly higher than in the inland area (1.3%, P=0.0007) and nationwide (1.5%, P<0.0001). There were no significant differences in the incidence of mental DV between the 3 areas in Miyagi Prefecture (inland 15.2%, north coast 15.7%, and south coast 18.8%) or nationwide (13.8%). Experiencing disease or injury in someone close and changes in the family structure were significantly associated with mental DV in Miyagi Prefecture.

Continuous monitoring and support for pregnant females may be necessary to address this issue in disaster-affected areas. (Disaster Med Public Health Preparedness. 2017;11:216–226)

The authors report the results of surveys on the emergency transport or evacuation status of obstetric patients conducted in Miyagi prefecture, one of the major disaster areas of the Great East Japan Earthquake and tsunami.

The surveys examined the damages to maternity institutions, evacuation status and transport of pregnant women, and prehospital childbirths and were conducted in 50 maternity institutions and 12 fire departments in Miyagi.

Two coastal institutions were destroyed completely, and four institutions were destroyed partially by the tsunami, forcing them to stop medical services. In the two-month period after the disaster, 217 pregnant women received hospital transport or gave birth after evacuation. Satisfactory perinatal outcomes were maintained. Emergency obstetric transport increased to approximately 1.4 fold the number before the disaster. Twenty-three women had prehospital childbirths, indicating a marked increase to approximately three times the number of the previous year.

In the acute phase of the tsunami disaster, maternity institutions were damaged severely and perinatal transport was not possible; as a result, pregnant women inevitably gave birth in unplanned institutions, and the number of prehospital births was increased extremely. To obtain satisfactory obstetric outcomes, it is necessary to construct a future disaster management system and to re-recognize pregnant women as people with special needs in disaster situations.

SugawaraJ, HoshiaiT, SatoK, TokunagaH, NishigoriH, AraiT, OkamuraK, YaegashiN. Impact of the Great East Japan Earthquake on Regional Obstetrical Care in Miyagi Prefecture. Prehosp Disaster Med. 2016;31(3):255– 258.

This study aimed to explore the correlation between the 2011 Great East Japan Earthquake and postpartum depression among perinatal subjects in the Miyako region of Iwate, an area damaged by earthquakes and tsunamis.

We retrospectively compared the percentages of women with scores ≥9 on the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS) among 3 groups of women who gave birth prior to the disaster (before-disaster group: n=141), within 3 months after the disaster (within-3-months group: n=70), and 4-6 months after the disaster (4-6-months group: n=89) at the Iwate Prefectural Miyako Hospital. The risk factors for EPDS scores ≥9 were estimated with multivariate logistic regression analyses.

Compared with the before-disaster group, a significantly greater number of women in the within-3-months group had EPDS scores ≥9 at hospital discharge (31.4% versus 9.9%, P<.0001), whereas women in the 4-6-months group did not (10.1% versus 9.9%, P=.96). In both the after-disaster groups, the destruction of their home (adjusted odds ratio [AOR], 3.68; 95% confidence interval [CI], 1.46-9.26) and dissatisfaction with their living conditions (AOR, 3.02; 95% CI, 1.20-7.59) were significantly associated with EPDS scores ≥9.

An increase in postpartum depression was observed after the Great East Japan Earthquake among perinatal women. (Disaster Med Public Health Preparedness. 2015;9:307-312)