نوزاد

This year’s World Health Day theme provides an opportunity to further highlight the critical importance of the first 1,000 days of life. The first 1,000 days of life, from pregnancy through a child's second birthday, is considered the first and most important university for every individual. During this period, pregnant mothers and infants require physical, nutritional, and emotional care. The seeds of many non-communicable diseases, including cardiovascular diseases, infertility, and autism, are sown during this critical time. Social problems, such as alcohol addiction, suicide, and divorce, are also not exempt from this rule. Various countries worldwide are actively raising public awareness about this golden and irreversible period. In Iran, the general public, healthcare providers, and policymakers must also recognize the importance and sensitivity of this vital period. Increased awareness can lead to improved preconception health care, prenatal care, and nurturing care during early childhood. By prioritizing these stages, we pave the way for a brighter future for the next generation.

 Vitamin D can play a vital role in fetal heart development. This study investigated serum vitamin D levels in mothers of infants with congenital heart diseases. 

This study was a case-control study in which 50 mothers of infants with congenital heart defects (case group) and 50 mothers of healthy infants (control group) were examined. The required information for the study included maternal age, vitamin D supplementation, duration of supplementation, family history of congenital heart disease, and serum vitamin D levels. The collected information was then analyzed..

The mean serum vitamin D level in the case group was higher than the control group, but there was no statistically significant difference (P = 0.182). There was no significant relationship between the severity of vitamin D deficiency and the presence of congenital heart disease. (P = 0.695). The mean serum vitamin D level in the cyanotic group was higher than the asiatic group, but there was no significant difference according to the independent t-test (P = 0.42). Also, there was no significant relationship between the severity of vitamin D deficiency in the mother and cyanotic or asiatic status of the newborn (P = 0.102). The duration of vitamin D supplementation in the case group was slightly longer than in the control group and was significantly associated with the presence of heart defects in the newborn (P = 0.026). In the case group, there were more people with a history of congenital heart disease in their first-degree relatives than in the control group and was significantly associated with the presence of congenital heart disease in the newborn (P < 0.001).

In this study, significant relationship was found between vitamin D supplementation and its blood level in the mother with congenital heart disease in the newborn. However, since vitamin D deficiency in the body can cause serious complications in the individual, it is recommended that pregnant women, especially in the first trimester of pregnancy, consume sufficient vitamin D supplements.

Follow-up care for discharged preterm infants is crucial to improving neonatal health, but it has faced challenges in the healthcare system of Iran. This study aimed to develop a post-discharge follow-up program for preterm infants. 

This strategic study was conducted at Isfahan University of Medical Sciences from April 2022 to February 2024 in five main stages: (1) Interviews with 42 neonatal care experts (including neonatologists, nurses, and developmental care specialists) to assess the needs and problems in following-up of preterm infants after discharge, (2) Using the Delphi technique for the prioritization of problems identified in the previous stage using expert opinions, (3) Using the SWOT analysis to identify the strengths, weaknesses, opportunities, and threats to the current post-discharge follow-up plans, (4) Using the root cause analysis (RCA) tree diagram for a deeper analysis of the components identified in the previous stages, and drafting the follow-up program, and (5) Validation of the program based on the opinions of a panel of experts. 

Four main themes were identified: Mothers’ poor caregiving empowerment, ineffective post-discharge follow-up planning, lack of psychological support for mothers, and insufficient maternal education. Based on the Delphi technique, the first two themes had the highest priority. The SWOT analysis showed weaknesses in two categories: Mothers’ caregiving and the follow-up care providing system. Using the RCA tree diagram, the weaknesses in mothers’ caregiving had four main categories: Weakness in learning about breastfeeding, post-discharge complications, factors disrupting maternal education, and mothers’ physical and mental stress. Regarding the weakness in the follow-up care providing system, there were two categories of “insufficient access to post-discharge services for infants” and “frequent visits to medical centers”. Based on the opinions of an expert panel, the use of telemedicine for program implementation was recommended.

The post-discharge follow-up program for preterm infants can be used by policymakers in the Iranian Ministry of Health to improve the follow-up care of infants after discharge.

Substance abuse during pregnancy has become a significant health issue that poses potential risks to the physical and mental health of both mothers and newborns. Regarding to the rising prevalence of maternal substance abuse and the crucial role of clinical indicators during childbirth, this study was conducted with aim to examine the relationship between maternal substance abuse and clinical indicators during childbirth.
In this descriptive-analytical study, information on 276 mothers referring to maternity hospitals of Birjand in 2023 was extracted based on a checklist and questionnaire and were placed into two groups: healthy pregnant mothers and pregnant mothers with substance abuse. The clinical indicators of the newborn at birth were collected using the checklist and mothers’ demographic information through a researcher-made questionnaire. Statistical analysis was conducted using SPSS software (version 26) and Mann-Whitney U and Chi-square tests. P<0.05 was considered significant.
Of the healthy mothers, 92 (65.7%) had a natural delivery, compared to 73 (53.7%) of mothers with a history of substance abuse. Maternal age (P<0.001) and the heart rate of infants at birth (P=0.010) were higher in the substance abuse group, whereas head circumference (P<0.001), birth weight (P<0.001), and maternal gestational age (P=0.006) were greater in the healthy group. The Apgar scores at first and fifth minutes did not reveal any statistically significant differences between the groups of healthy mothers and those with a history of substance abuse (P>0.05).
Substance abuse in pregnant mothers is linked to higher rates of preterm birth and lower infant head circumference, birth weight, and maternal gestational age. Timely identifying at-risk mothers and providing counseling can help alleviate strain on the healthcare system and prevent negative health outcomes for newborns.

Hearing impairment in neonates is one of the most significant public health challenges that can lead to substantial consequences, including delayed language and cognitive development and a reduced quality of life. This study aimed to determine the prevalence of hearing impairments in neonates in Iran using a systematic review and meta-analysis.

PubMed, Scopus, Web of Science, Science Direct, SID, and Magiran databases were systematically searched until January 2025. A hand search was also conducted in relevant review articles and key study sources. The language of the studies was limited to Persian and English. Risk of bias in the studies was assessed using the Newcastle-Ottawa Scale checklist. Data analysis was performed using Comprehensive Meta-Analysis version 3 software.

A total of 26 studies, including 341,944 neonates, were selected and included in the study. The results of the meta-analysis showed that the prevalence of hearing impairment and hearing loss in neonates was 0.8% (95% confidence interval [CI]: 0.004–0.01, p < 0.05) and 2% (95% CI: 0.007–0.08, p < 0.05), respectively. The prevalence of hearing impairment in male and female neonates was 5% (95% CI: 0.02–0.12, p < 0.05) and 3% (95% CI: 0.01–0.08, p < 0.05), respectively. Publication bias was observed in the study (p < 0.05).

The findings of the present study demonstrate that hearing impairment in neonates is a serious health problem in Iran that requires immediate attention and intervention. Preventive and diagnostic measures should be prioritized to help improve the hearing status of neonates and prevent its negative consequences on their development.

Ovarian cysts are one of the most common abdominal masses in female fetuses and infants. Among the ovarian cysts in infants, serous cystadenoma is extremely rare, with only a few reported cases in the literature. Here, we report a case of a neonatal ovarian serous cystadenoma treated with surgical cystectomy and confirmed by histopathological examination. The antenatal ultrasonography (USG) in the third trimester had shown an abdominal cyst on the right side of the abdomen. After birth, the entire cyst was removed during laparotomy. On gross examination, an unilocular cyst measuring 4×3.5×3.5 cm with a wall thickness of 0.3 cm was noted. Microscopic examination revealed epithelial cells with a papillary pattern, regular cell layers, and ischemic changes due to hemorrhagic infarction. This study emphasizes the significance of prenatal evaluation, timely diagnosis, and considering the potential risk of complications.

Neonatal pain can have serious consequences for infants' health. The aim of this study was to evaluate the effect of an empowerment program on improving nurses' knowledge, attitude, and performance in managing neonatal pain.

This semi-experimental, pre-post intervention study without a control group was conducted on nurses working in the neonatal intensive care unit of Shahid Montazeri Hospital, Najafabad, and Shahid Beheshti Hospital, Kashan, in 2022. Nurses were divided into 4 groups of 10 and received 4 empowerment sessions (in the form of educational classes and two 90-minute sessions per week) on neonatal pain management. Before, immediately after, and one month after the educational intervention, nurses completed questionnaires on knowledge, attitude, and performance. Data were analyzed using t-tests and repeated measures ANOVA using SPSS version 21 software.

Intra-group analysis showed a significant effect of time on knowledge, attitude, and performance scores, and the mean scores of nurses' knowledge, attitude, and performance differed significantly between the three time points (P=0.001). Moreover, the Bonferroni post hoc test showed that the comparison of the mean scores of knowledge (F=65.82), attitude (F=24.42), and performance (F=49.88) between the pre- and immediate post-intervention, as well as the mean scores of these scores before and one month after the intervention, showed a significant increase (P=0.001). However, the comparison of the mean scores of knowledge (P=0.07), attitude (P=0.98), and performance (P=0.99) immediately after and one month after the intervention was not significant.

According to the results of the present study, the empowerment program led to a significant increase in nurses' knowledge, a more positive attitude, and improved performance in the field of neonatal pain management, and this improvement was sustained over time. Therefore, it seems that holding empowerment sessions for nurses can lead to improved quality of care for infants and reduce their pain experience.

Iron deficiency anemia is one of the most common problems during pregnancy and an important risk factor for the health of mother and fetus. Iron deficiency anemia can be caused by lack of iron intake, absorption impairment, and loss of iron or increased need for it. The present study was conducted with aim to investigate the effect of maternal iron deficiency anemia during pregnancy on infants’ anthropometric indices at birth.

This cross-sectional study was conducted in 2018-2019 on 630 mothers referred to the health care centers in Zahedan and their infants. The data collection tool was a researcher-made form which recorded the maternal and infant demographic information, maternal iron deficiency anemia, and infants’ anthropometric indices at birth. Data were analyzed by SPSS software (version 22) and Chi-square and t-tests. P<0.05 was considered significant.

The prevalence of iron deficiency anemia in the studied mothers was 18.9%. There was a significant relationship between maternal iron deficiency anemia and infants’ birth weight (P<0.05). However, there was no significant relationship between maternal anemia with infant’s length size and head circumference at birth (P>0.05).

Given the clear effects of maternal iron deficiency anemia on the health of infants, it seems necessary to pay more attention to maternal nutrition during pregnancy and to be careful about the timely use of iron supplements in pregnant women.

Low sleep quality is associated with a decrease in the body's immunity level and an increase in inflammatory markers. This study aimed to investigate the relationship between periodontal diseases and sleep quality.

In this analytical-cross-sectional study, two groups of 40 individuals (with and without periodontal disease) were selected from patients referred to the Faculty of Dentistry of Isfahan Azad University. After obtaining consent, the periodontal condition of the patients was checked. People's evaluation criteria include a gingival index, pocket probing depth, and loss of clinical adhesion level. Indicators were performed by an examiner using a periodontal probe in four areas of each tooth (mesiobuccal, buccal, distobuccal, and lingual). Sleep quality questionnaire (The Pittsburgh Quality Index) and depression, anxiety, and stress assessment questionnaire (Depression, Anxiety, Stress Scale: DASS) were completed by two groups. Data were analyzed using chi-square, Independent T, Mann-Whitney, and Fisher’s exact test (α = 0.05).

Independent T-test did not show a significant difference in the average age of the two groups (P = 0.787). According to the Mann-Whitney test, the sleep quality score of patients with periodontal disease was significantly higher than that of people without the disease (P < 0.001), and this score was observed more in people with the disease based on gender, different age groups, and employed and unemployed people.

Therefore, the treatment of one can be effective in the treatment of another and ultimately improve the individual's life.

Jaundice is a common condition in newborns caused by bilirubin accumulation, which can lead to severe complications, including brain damage. This study aimed to identify risk factors for severe jaundice requiring blood transfusion, as such procedures carry potential risks.

Data were reviewed for 3,266 infants admitted for jaundice at Quds Hospital in Qazvin from 2017 to 2022, of whom 49 required blood transfusions. Information was collected from medical records and maternal questionnaires.

Among the 49 infants, 66% were male, 36% were preterm, and 49% were firstborn. The most common maternal blood type was O+ (20 cases), while A+ was the most frequent blood type among infants (21 cases). Notably, 71.4% of cases involved blood type incompatibility between the infant and mother. Delivery methods included 32 vaginal births and 17 cesarean sections. G6PD deficiency was present in 18% of the infants, and 78% of parents had no familial relationship.

ABO incompatibility was the primary cause of blood transfusion (19.94%), followed by Rh incompatibility (6.1%) and G6PD deficiency (5%). These findings highlight the importance of identifying and managing risk factors for severe jaundice to minimize the need for blood transfusion and its associated risks.

Cytomegalovirus is one of the most significant causes of infection in infants, leading to congenital disabilities, developmental disabilities, hearing loss, and even death. This study aimed to determine the prevalence of cytomegalovirus infection among infants in Iran through a systematic review and meta-analysis.

PubMed, Scopus, Web of Science, Science Direct, Scientific Information Database, as well as Magiran electronic databases were searched to find relevant articles published up to September 2024. A hand search was also conducted on primary review sources and key studies. The languages of the studies were limited to Persian and English. Bias assessment of the studies was performed using the Newcastle-Ottawa Scale checklist. Data analysis was conducted using Comprehensive Meta-Analysis software version 3.

A total of 15 observational studies, including 5889 infants were included in the analysis. The results of the meta-analysis showed that the prevalence of cytomegalovirus in infants was 3% (95% confidence interval [CI]: 0.01–0.10; P < 0.05). Additionally, the prevalence of cytomegalovirus in male and female infants was 2% (95% CI: 0.004–0.10; P < 0.05) and 3% (95% CI: 0.007–0.16; P < 0.05), respectively. No statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the year of publication of the studies (P > 0.05). However, a statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the sample size of the studies (P < 0.05). Publication bias was noted in the study (P < 0.05).

The findings showed that cytomegalovirus prevalence is high in infants, and comprehensive surveillance programs are necessary for the effective management and prevention of cytomegalovirus infections in infants.

One of the factors influencing in anthropometric indices of newborns is placental position. Considering the importance of the placenta in the blood supply and development of the fetus and the results obtained in this field, the present study was conducted with aim investigate the relationship between placenta placement and newborn anthropometric indices.

This prospective and observational study was conducted in 2023 on pregnant women referred to the prenatal clinic of Mustafa Khomeini Hospital. The information of pregnant mothers and newborns was recorded through interview and the information of placental location was extracted from the ultrasound report of the third trimester. Data analysis was done using SPSS statistical software (version 16) and Kruskal-Wallis and chi-square tests. P<0.05 was considered significant.

In this study, 154 pregnant women with mean age of 31.80±5.50 years and gestational age of 38.58±0.86 weeks were studied. The highest frequency of the placenta location was in the anterior part (42.59%) and the lowest in the lateral part (9.88%). No significant relationship was found between the location of the placenta and anthropometric indices and gender of the baby (P>0.05). There was a significant relationship between the placenta location and gravidity (P=0.030).

In this study, no significant relationship was found between the placenta location and the anthropometric indices of the newborn.

Due to specific metabolic changes during pregnancy, identifying pregnancy risks and timely intervention can improve the health of the mother and baby. The best results for preventing gestational diabetes are achieved through lifestyle measures early in pregnancy. Today, abnormal fasting plasma glucose (FBS) is routinely measured in early pregnancy, but its association with pregnancy outcomes is ambiguous. This study aims to investigate the incidence of gestational diabetes mellitus and other pregnancy outcomes in women with FBS levels in the first trimester of pregnancy.

This prospective descriptive study was conducted on 230 women with singleton pregnancies at the clinic of Imam Khomeini Hospital in Sari in 2022. After obtaining informed consent, blood samples were collected from pregnant women in the first trimester of pregnancy, and FBS levels were recorded. Additionally, between the 24th and 28th weeks of pregnancy, women underwent a re-examination based on the results of the 75g glucose tolerance test (OGTT). Based on FBS levels, women were divided into two groups: normal (92-100 mg/dL) and abnormal (101-126 mg/dL). All mothers were followed up during pregnancy, and on average, 2 days after giving birth, the pregnancy outcomes of both the mother and the baby were recorded. Data were analyzed using SPSS version 22 software.

The mean and standard deviation of mothers' age in the mothers of the normal FBS group were 31.05 ± 5.61 years, and in the mothers of the abnormal FBS group, it was 32.46 ± 6.24 years. The number of pregnancies in 64% (n=80) and 51.4% (n=54) of mothers was less than or equal to two pregnancies, and the number of deliveries was less than or equal to 2 births in 75.2% (n=94) and 66.7% (n=70) respectively. The most common underlying disease was hypothyroidism, which was present in 20% of mothers with normal FBS and 21% of mothers with abnormal FBS. The results showed that in weeks 24 to 28 of pregnancy, 56.5% (n=130) of mothers had impaired oral glucose tolerance tests, which was statistically significant (P=0.048). The relationship between stillbirth (P=0.593), IUGR fetus (P=0.392), blood pressure disorders related to pregnancy (P=0.904), neonatal hypoglycemia (P=1), liquid ammonia level in the 28th week of pregnancy (P=0.915) and the 36th week of pregnancy (P=0.537), and the Apgar score of the first minute (P=0.514) and the fifth minute (P=0.296) were not significant with abnormal FBS in the first pregnancy. There was a substantial relationship between impaired OGTT and first-pregnancy FBS, and 69.5% of mothers with first-pregnancy FBS in the range of 101-126 mg/dL had impaired OGTT (P<0.0001). Also, the type of cesarean delivery (P=0.037) insulin intake (P=0.031), and gestational age less than 37 weeks at the time of delivery (P=0.047), had a significant relationship with the first FBS of pregnancy.

The results showed that FBS in the first trimester is related to gestational diabetes and pregnancy outcomes and can be used as a simple and low-cost screening test to identify pregnancies at risk of GDM and some adverse pregnancy outcomes, including the type of delivery. Insulin and gestational age should be assessed at the time of delivery.

Pregnant women with HTLV-1 are mostly asymptomatic. Mother-to-child transmission mainly occur through breastfeeding. The present study was carried out with aim to identify HTLV-1 in pregnant women and its adverse maternal and neonatal outcome.

In this systematic review, 126 English articles on the topic of HTLV-1 infection in pregnant women and newborns were searched through SID, Magiran, PubMed, Scopus, Google Scholar, and web of science databases using keywords until March 2024. Finally, 10 articles based on the inclusion criteria including: articles with reporting, diagnosis and treatment of HTLV-1 infection in pregnant women and articles reporting the effects of HTLV-1 on fetuses and infants, diagnosis and treatment of HTLV-1 infection in infants were selected.

In the review, most of the pregnant women infected with HTLV-1 were asymptomatic. Despite the case reports of abortion, premature birth, intrauterine growth restriction, stillbirth, infant death secondary to pneumonia and congenital hydrocephalus, in large comparative studies, there was no significant difference in the incidence of adverse outcomes between the two groups of healthy and affected women (P>0.05). It seems that mother's survival after delivery is strongly affected by diseases caused by HTLV-1, especially Adult T-cell leukemia (ATL). A high mortality rate among pregnant mothers with ATL after delivery has been reported.

Considering the high mortality rate of pregnant mothers with ATL after delivery, careful monitoring of the health of women with ATL seems reasonable. It is recommended to develop a protocol to reduce the vertical transmission of infection in endemic areas.

One of the common drugs used in modern anesthesia, especially during pregnancy, is ketamine, which is used to control chronic pain by inhibiting the N-methyl-D-aspartate receptor. Therefore, in this study, we investigate the effects of injected ketamine on the histological changes of the hearts of rats born to exposed mothers.

This study was conducted as a laboratory experiment on 15 female Wistar rats. These rat were divided into three groups of 5 including control, short-term and long-term groups, and after induction of fertility, 10 baby rats were randomly selected from each group and subjected to cardiac tissue dissection and sampling.

In the short-term dose group, cellular characteristics and heart tissue were normal, and no clear changes were observed compared to the control group, but in some areas, there were small intercellular spaces with a decrease in density. In the long-term dose group, a slight inflammatory process was seen in some areas, but there were no changes in the cells, cytoplasm, and nuclei.

Although the long-term exposure of mother rat to ketamine can cause mild inflammation and moderate hyperemia in the heart tissue of newborn rat, and the short-term exposure of mother rat to ketamine causes mild changes in heart muscle tissue like long-term exposure but these changes have not been noticeable.

Regard to the importance of sepsis in newborns, the lack of a specific biomarker for this disease, and the increasing role of calcitonin in recent years, we conducted this study to evaluate the diagnostic value of procalcitonin in newborns with sepsis.

A pediatric infectious diseases specialist confirmed the diagnosis and included newborns with neonatal sepsis in this study. We collected two cc of peripheral blood from the newborns to measure procalcitonin along with other routine tests. We analyzed the quantitative and qualitative data using SPSS software version 22 by the Chi-square, Fisher, and U Mann-Whitney tests.

The study included 51 newborns. Of these, 29 (56.9%) were female and 22 (43.1%) were male. The mean gestational age was 33.2 ± 3.14 weeks, and the mean birth weight of the newborns was 2028 ± 894 grams. Of the 51 infants, only 4 infants (7.8%) had positive blood cultures, 36 infants (76.5%) had positive CRP tests, and 16 infants (31.4%) had positive procalcitonin tests. The mean procalcitonin level in infants with positive blood cultures was 0.56 ± 0.71 ng/ml, and in infants with negative cultures, it was 0.268 ± 0.37 which was a statistically significant difference (p = 0.029).  

We concluded that the procalcitonin test serves as a valuable marker for diagnosing neonatal sepsis. However, neonatal sepsis is an acute life-threatening condition and diagnostic tests for this disease should have higher sensitivity, and procalcitonin cannot serve as the sole diagnostic marker.

Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome.

This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data.

Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%.

Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested.

Neonatal Resuscitation training is one of the main trainings for people who are responsible for taking care of newborn, then how to implement and choose the right model for training is very important. Therefore, it is important to use innovative approaches in Resuscitation training that lead to improving and maintaining the knowledge and skills of learners. The present study was performed with aim to determine the effect of Educare training on the level of knowledge and performance of neonatal resuscitation in undergraduate midwifery students.

This semi-experimental study pre-and post-intervention was carried out in 2022 on 30 undergraduate midwifery students of the School of Nursing and Midwifery. The training was done by the Educare method using theory training and holding a 1-day workshop. Examining the level of knowledge and practice of students was done using a checklist and a researcher-made questionnaire after confirming the validity and reliability before/immediately/and two weeks after the practical training. Data analysis was done using STATA software (version 12) and Independent t-test and analysis of variance with repeated measures. P<0.05 was considered statistically significant.

The neonatal resuscitation knowledge score in midwifery students immediately and two weeks after the training significantly increased compared to before the training (p=0.001). The neonatal resuscitation performance score immediately and two weeks after training significantly increased compared to before training. There was a significant difference between knowledge and performance scores in three stages (p=0.001).

The educare method has improved the neonatal resuscitation knowledge and performance of midwifery students, so it is recommended to design and use this method for training other clinical skills in midwifery students.

Due to the possible complications of a persistent ductus arteriosus (PDA), the treatment of the PDA will be necessary, depending on the opinion of the treating physician. Medical or surgical treatment can be used in this regard. In recent years, acetaminophen has been considered a medication with fewer potential side effects.  The present study aimed to compare acetaminophen with ibuprofen in the patent ductus arteriosus in neonates admitted to training hospitals in Khorramabad.

A total of 28 neonates were included in this retrospective cohort study. The required data were collected by studying the patients' files. The PDA in newborns was diagnosed by primary echocardiography by the attending physician. Thereafter, 12 and 16 cases were treated with ibuprofen and acetaminophen, respectively. After completing the treatment period on days 3 and 5, the attending physician performed echocardiography to check PDA closure. Data were analyzed in SPSS software (version 24) using descriptive indices of mean, standard deviation, frequency, percentage, Fisher's exact test, and Mann-Whitney U test.

In this study, the frequency of affected male neonates was the same as that of affected female newborns (n=14; 50%). The mean weight scores of neonates in acetaminophen and ibuprofen groups were obtained at 2831/25±918/49 and 2241/5 ±868/9 gr, respectively. All newborns in both groups were treated; thereafter, 23 cases recovered with 3-day treatment and 5 neonates with 5-day treatment. No significant complications were observed in patients.

The effect of acetaminophen on PDA closure was similar to that of ibuprofen. The need for 5-day treatment was higher in the acetaminophen group; nonetheless, no significant side effects were reported in any newborn. According to this study, acetaminophen can be a good alternative to ibuprofen in the treatment of PDA.