Factors of Having Difficulties Raising 3-Year-Old Children in Japan: Usefulness of Maternal and Child Health Information Accumulated by the Local Government.

Kimiko Tagawa,Miwako Tsunematsu,Masayuki Kakehashi

doi:10.3390/children8121084

Abstract

Background: Difficulties raising children may be associated with depressive tendencies and abuse by parents, for which maternal and child health information may be useful. We clarified factors related to difficulties in raising children at the time of the 3-year-old child health checkup. Method: This was a retrospective cohort study. We used maternal and child health information collected from the time of pregnancy notification until the 3-year-old child health checkup. The subjects were the parents of 507 children who were born and eligible for the 3-year-old child health checkup between September 2013 and October 2017. Logistic regression and ROC analyses were performed. The dependent variable was “having difficulties raising children at the 3-year-old health checkup”. Result: Eleven factors were clarified as risk factors. Three major factors among them were having difficulties raising children at the 18-month-old checkup (adOR, 6.3; 95%CI, 3.0–13.9), actions are at the child’s own pace and adult instructions are difficult to follow at the 18-month-old health checkup (adOR, 5.0; 95%CI, 1.3–25.4), and EPDS score ≥ 2 (adOR, 3.4; 95%CI, 1.5–8.1). The AUC of this predictive model was 0.86. At a cutoff value of 0.387, the sensitivity was 79.7% and the specificity was 77.6%. Conclusion: Having difficulties raising children at the 3-year-old health checkup has factors from the time of pregnancy and requires continued support. It was possible and useful to use maternal and child health information when screening high-risk parents.

Highlights

Japan has taken many measures against the declining birthrate in the wake of the so-called “1.57 shock” when the total fertility rate reached 1.57 in 1990
It is expected to be useful for reporting to the national government, and for daily maternal and child health work, and the utilization of maternal and child health information was mentioned as an issue for “Healthy Parents and Children 21 (Second Phase)”
We considered maternal and child health information to be important and decided to examine its usefulness

Summary

Introduction

Japan has taken many measures against the declining birthrate in the wake of the so-called “1.57 shock” when the total fertility rate reached 1.57 in 1990. According to the 2015 Japanese National Fertility Survey, the ideal number of children for a couple is 2.32 and the planned number of children is 2.01, and the reason for this difference is that more than 20% of married couples whose wives are in their 30s answered “Can’t bear mentally/physically the burden of childrearing anymore” [2] Based on this result, child-rearing involves psychological and physical burdens. Difficulties raising children may be associated with depressive tendencies and abuse by parents, for which maternal and child health information may be useful. We clarified factors related to difficulties in raising children at the time of the 3-year-old child health checkup. Conclusion: Having difficulties raising children at the 3-year-old health checkup has factors from the time of pregnancy and requires continued support. It was possible and useful to use maternal and child health information when screening high-risk parents

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Conclusion