中本 剛二

Parenting difficulties during the first postpartum year are a public health concern. Early screening mainly uses depressive-symptom measures such as the Edinburgh Postnatal Depression Scale (EPDS), which capture concurrent symptoms but may miss broader psychosocial vulnerability linked to later parenting outcomes. We hypothesised that early multidimensional profiling using the Comprehensive Scale for Parenting Resilience and Adaptation (CPRA) would predict later parenting maladjustment. Data from two longitudinal cohorts (N = 215) were analysed. Maladjustment was defined as an increase of at least mean + 0.5 standard deviation in the Psychological Adaptation to Parenting difficulty score from 1 to 12 months postpartum. Eight predictors, including CPRA domains and demographic factors, were entered into an Elastic Net logistic regression, followed by post-Elastic Net logistic regression. Fifty-repetition Monte Carlo cross-validation identified six stable predictors. The final model showed acceptable, reproducible discrimination (median area under the curve, 0.724; interquartile range, 0.652-0.768). Higher early difficulty in Mother's Cognitive and Behavioural Characteristics was a stable predictor of later maladjustment. Early postpartum CPRA-derived psychosocial profiles may help identify mothers at risk of later parenting maladjustment.

BACKGROUND: One life event that requires extensive resilience and adaptation is parenting. However, resilience and perceived support in child-rearing vary, making the real-world situation unclear, even with postpartum checkups. OBJECTIVE: This study aimed to explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with a classifier based on data on the resilience and adaptation characteristics of mothers with newborns. METHODS: A web-based cross-sectional survey was conducted. Mothers with newborns aged approximately 1 month (newborn cohort) were analyzed to construct an explainable machine learning classifier to stratify parenting-related resilience and adaptation characteristics and identify vulnerable populations. Explainable k-means clustering was used because of its high explanatory power and applicability. The classifier was applied to mothers with infants aged 2 months to 1 year (infant cohort) and mothers with toddlers aged >1 year to 2 years (toddler cohort). Psychosocial status, including depressed mood assessed by the Edinburgh Postnatal Depression Scale (EPDS), bonding assessed by the Postpartum Bonding Questionnaire (PBQ), and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) between the classified groups, was compared. RESULTS: A total of 1559 participants completed the survey. They were split into 3 cohorts, comprising populations of various characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into 5 groups, was generated from the self-reported scores of resilience and adaptation in the newborn cohort (n=310). The classifier identified that the group with the greatest difficulties in resilience and adaptation to a child's temperament and perceived support had higher incidences of problems with depressed mood (relative prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40) compared to the group with no difficulties in perceived support. In the infant cohort (n=619) and toddler cohort (n=461), the stratified group with the greatest difficulties had higher incidences of problems with depressed mood (RP 9.05, 95% CI 4.36-18.80 and RP 4.63, 95% CI 2.38-9.02, respectively), bonding (RP 1.63, 95% CI 1.29-2.06 and RP 3.19, 95% CI 2.03-5.01, respectively), and sleep quality (RP 8.09, 95% CI 4.62-16.37 and RP 1.72, 95% CI 1.23-2.42, respectively) compared to the group with no difficulties. CONCLUSIONS: The classifier, based on a combination of resilience and adaptation to the child's temperament and perceived support, was able identify psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also identified in qualitatively different infant and toddler cohorts, depending on their classifier. The vulnerable group identified in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.

A purpose of this paper is to elucidate unique experiences of pregnancy, childbirth, and childrearing throughinterviews, and explain how these experiences were affected and transformed during the COVID-19 epidemic and howpregnant women and their families responded. In particular, I will review the above experiences of 16 interviewees, andthen follow the process of shaping their experiences of pregnancy, childbirth, and child rearing in relation to theirsurroundings, including the effects of the epidemic, through five interviews with one interviewee over a one-year periodfrom pregnancy to an about six-month postpartum. I will also point out that a qualitative research such as ethnographyand interview surveys can play a role in mediating scenes from specific perspectives to those who cannot see them, insituations with asymmetry and oppression, such as child rearing situations.