تکتم فرقانی

The decrease in childbearing gradually pushes the age structure of the population out of youth and towards old age. This study aimed at investigating the desire to have children and its relationship with health literacy and spiritual health in married women of Fariman City, Iran, in 2023.

In this cross-sectional descriptive-analytical study, 357 married women were selected by multi-stage sampling method. Data were collected based on 4 questionnaires including demographic information, desire for fertility, health literacy, and spiritual health, and were analyzed using SPSS software and descriptive and analytical tests.

The average score of health literacy was 76.89 ± 23.16 (adequate), the average score of willingness to have children was 100.207 ± 12.77, and the average score of spiritual health was 72.53 ± 7.11 (moderate). The results did not show a significant relationship between health literacy and the desire to have children and spiritual health; however, there was a positive and significant relationship between the desire to have children and spiritual health (P = 0.042, r = 0.108). The variables of women's place of residence, education, and occupation had a significant relationship with spiritual health, and the variables of women's education and age had a significant relationship with health literacy (P < 0.001). The most important causes of delay in having children were expressed as economic factors (52.4%), personal factors (32.5%), and cultural factors (5.3%). There was a significant relationship between occupation, income, and education with unwillingness to have children (P < 0.001).

It seems that solving economic problems (employment and income level) as the most important reason for reluctance to have children can lead to an increase in having children. In order to achieve this goal, the joy of becoming a parent can be promoted through promoting spiritual health, and people's negative views on having more children can be corrected in various possible ways, and health interventions can be carried out to increase women's spiritual health.

Various factors, such as proper nutrition of the mother, affect the health of the mother and fetus. Weight gain of the mother during pregnancy is one of the valid criteria to evaluate her nutritional status. Considering that low birth weight babies are more at risk of death due to their special conditions, the present study was conducted aimed to investigate the relationship between BMI and maternal weight gain during pregnancy with neonates' birth weight.

In this retrospective cohort study, the information of all babies born in Fariman city in 2020 (n=2026) along with their mothers was collected through the Sina's electronic health record  (Nutrition review form and breastfeeding consultation form, newborn care form and prenatal care form) and an organized interview, demographic information and weight, birth height, weight, mother's height at the beginning of pregnancy and at the end of pregnancy, mother's BMI, type of delivery, and pregnancy history were collected. Data were analyzed by SPSS statistical software (version 22) and Chi-square, Fisher and Mann-Whitney tests. P<0.05 was considered statistically significant.

There was a significant relationship between mother's BMI, chronic disease, number of mother's pregnancies, number of care provided during pregnancy, use of prenatal supplements, gestational age, type of delivery, multiple births and baby's gender with low birth weight babies (p<0.05). Also, there was a significant difference in mother's BMI, mother's weight at the beginning of pregnancy, weight at the end of pregnancy, and baby's height in two groups of low birth weight and normal weight babies (P<0.05).

The mother's BMI at the beginning of pregnancy and weight at the end of pregnancy can affect the birth weight of the baby, therefore, it is necessary to pay attention to this issue and increasing the level of awareness of the employees of health-medical centers and women of reproductive age.