1. RELATION OF FATIGUE TO DEPRESSION AND MATERNAL ROLE ATTAINMENT 1 MONTH AFTER CHILDBIRTH IN JAPANESE FIRST- TIME MOTHERS OVER AGE 35 Background and purpose: Recently, the number of first-time mothers over age 35 has been increasing in Japan. This study aimed to examine the relation of fatigue to depression and maternal role attainment at 1 month after childbirth in Japanese first-time mothers over age 35. It was part of a longitudinal study on physical and psychosocial health in the 4 months following childbirth. Methods: 【 Subjects 】 Twenty-one first-time mothers over age 35 were surveyed 1 month after childbirth. 【 Date Collection 】 Survey items included the self-report Accumulated Fatigue Checklist （ Ministry of Health, Labour and Welfare,2004 ）, Edinburgh Postnatal Depression Scale Japanese version （ EPDS ）（ Okano et al,1996 ）, Maternal Role Confidence Scale and Maternal Role Satisfaction Scale （ Maehara, 2005 ） during the postpartum period, and background and daily life activities of the mothers. 【 Ethical Consideration 】 The Chiba University Graduate School of Nursing Institutional Review Board approved the study. All subjects provided informed consent. Conclusion: Level of fatigue in first-time mothers over age 35 was related to depression, low maternal confidence, and low maternal satisfaction at 1 month after childbirth. Nursing support programs that promote postpartum recovery and maternal role attainment following childbirth should be further developed. Result: ・ Table 1 shows demographic obstetric data of the subjects. ・ Subjects were divided into three groups according to accumulated fatigue scores: （ 1 ） low fatigue, 0 to 4 points （ 33.3% ） ; （ 2 ） moderate fatigue, 5 to 10 points （ 23.8% ） ; and （ 3 ） high fatigue, 11 to 20 points （ 33.3% ）. No significant differences were observed in the background factors between groups. ・ EPDS scores in the high fatigue group （ M=8.3, SD=2.4 ） were significantly higher （ p<.01 ） than in the moderate fatigue group （ M=3.4, SD=3.0 ） and low fatigue group （ M=2.6, SD=1.7 ） [ see Figure1 ]. ・ Maternal role confidence scores in the high fatigue group （ M=50.6, SD=8.5 ） were significantly lower （ p<.05 ） than in the moderate fatigue group （ M=51.2, SD=5.1 ） and low fatigue group （ M=64.1, SD=9.4 ） [ see Figure2 ]. ・ Maternal role satisfaction scores in the high fatigue group （ M=27.3, SD=3.7 ） were significantly lower （ p<.05 ） than in the moderate fatigue group （ M=30.2, SD=2.5 ） and low fatigue group （ M=33.3, SD=2.6 ）. Table 1. Demographics and obstetric data of the subjects （ N=21 ） Figure 2. Maternal Role Confidence Scale and Maternal Role Satisfaction Scale score according to Accumulated Fatigue （ Maternal Role Confidence Scale score ： 20 ～ 80, Maternal Role Satisfaction Scale score ： 9 ～ 36 ） Sakajo A., Mori E. ， Maehara K. ， Iwata H. ， Ozawa H. ， Morita A. ， Maekawa T., Tsuchiya M. Chiba University Graduate School of Nursing, JAPAN M+SD, n （ % ） Age （ years ） 37.0±2.5 Occupation Employed Unemployed 6 （ 28.6 ） 15 （ 71.4 ） Education High school college University or higher 5 （ 23.8 ） 6 （ 28.6 ） 10 （ 47.6 ） Marital status Married Single 21 （ 100.0 ） 0 （ 0.0 ） History of mental disease Yes No 2 （ 9.5 ） 19 （ 90.5 ） Treatment history for infertility Experience Inexperience 5 （ 23.8 ） 16 （ 76.2 ） Model of delivery Vaginal delivery （ normal ） Vacuum extraction Cesarean section 7 （ 33.3 ） 8 （ 38.1 ） 6 （ 28.6 ） Problems during pregnancy Occur Not 8 （ 38.1 ） 13 （ 61.9 ） Problems during delivery Occur Not 6 （ 28.6 ） 15 （ 71.4 ） Newborn problems Occur Not 3 （ 14.3 ） 18 （ 85.7 ） Type of feeding Breastfeeding Mixed Bottle 2 （ 9.5 ） 19 （ 90.5 ） 0 （ 0.0 ） Times of feeding per day ＜ 10 ≧ 10 9 （ 42.9 ） 12 （ 57.1 ） Support person Husband/mother/ mother-in-law Nobody 14 （ 66.7 ） 7 （ 33.3 ） **p<.01 （ n=19 ） Figure 1. EPDS score according to Accumulated Fatigue （ EPDS score ： 0 ～ 30 ） Correspondence: Emi Mori, RN, RM, PhD Professor of Department of Parent and Child Nursing, Graduate School of Nursing, Chiba University 1-8-1 Inohana, Chuo-ku, Chiba city, 280-8672, Japan Email: mori@faculty.chiba-u.jp This study was supported by a Funding Program for the Next Generation World-Leading Researchers （ No. LS022 ）, from the Cabinet Office and the Japan Society for the Promotion of Science, Japan. EPDS score * * *p<.05 （ n=19 ） * *