pregnant women

Considering the importance of the key role of mothers in the family and their significant impact on the health of the family and children and the prevention of maternal mortality, we designed a study to determine the analysis of maternal mortality in the last ten years in North Khorasan province.

This is a descriptive cross-sectional study that examined all the deaths of pregnant mothers in North Khorasan from 2013 to 2023. In this study, the researcher referred to the health centers and teaching hospitals of the province, examined the health records and hospital records of all deceased mothers, and the cause of death checklist was completed. Data analysis was done in descriptive analysis.

The findings showed that in the last 10 years, 48 cases of maternal death have been recorded in North Khorasan province. The maternal death index in North Khorasan province had a downward trend from 2012 to 2015, then an upward trend from 2016 to 2018, and with the COVID epidemic in 2019, it reached its maximum, i.e., 64 per hundred thousand live births. After that, it had a decreasing trend until 2023. The most common cause of maternal death is blood pressure disorders during pregnancy, delivery, and after delivery and in second place is obstetric bleeding.

Maternal mortality increased in North Khorasan province with the COVID epidemic, excluding COVID-19 blood pressure disorders was the most common cause of maternal death in North Khorasan province. Considering the high level of pregnancy blood pressure in North Khorasan province, better management of blood pressure and pre-eclampsia in pregnancy can help in reducing maternal mortality.

Iron deficiency anemia is one of the most common problems during pregnancy that causes premature birth, low birth weight, increased fetal mortality, and increased postpartum hemorrhage. The present study was conducted on the prevalence of iron deficiency anemia and the factors affecting it in pregnant women referring to the health centers of Fanuj city.

In this descriptive-analytical study, 217 pregnant women were selected by stratified sampling method. The amount of hemoglobin was collected by referring to the family file of the pregnant mother and using a checklist including demographic information (8 questions), fertility characteristics (22 questions) and laboratory information (2 questions). Data were analyzed using SPSS (version 22) and Chi-square and Spearman tests.

The prevalence of anemia in the first trimester of pregnancy was 19.8% and in the second trimester, 32.3%. There was a significant difference in the group with and without anemia with education level, family income, body mass index, and pre-pregnancy weight, time of registration of pregnancy, number of pregnancies, number of births, type of previous birth, pregnancy interval, history of urinary infection. There was no significant relationship between mother's age, mother's job, place of residence, prenatal care, number of prenatal cares.

According to the results of the study, there are factors affecting to anemia that can predict it. Therefore, it is important to identify high-risk pregnant women, train them by health personnel and ensure adequate and timely care for them.

 Intrauterine Growth Restriction (IUGR) can increase perinatal mortality by 10 to 25 percent. Scientific evidence has shown that umbilical cord characteristics are vital markers for assessing intrauterine complications. The present study aimed to investigate the relationship between umbilical cord cross-sectional area and intrauterine growth restriction in pregnant women.

In this cross-sectional analytical study, 134 pregnant women were selected through convenience sampling. Patients underwent transabdominal ultrasonography using a Samsung W80 ultrasound device with a 3.5 MHz probe. The diameter and cross-sectional area of the umbilical cord were measured at two points (the junction of the umbilical cord to the abdomen and the free loop) during the third trimester of pregnancy. The results of fetal biometric ultrasound, including BPD, FL, HC, and AC, were also recorded. IUGR was defined as an estimated weight by ultrasound below the 10th percentile for gestational age.

Nineteen infants (14.2%) had IUGR. All biometric indices in the IUGR group were significantly lower than those in the non-IUGR group (p < 0.001). The umbilical cord diameter in the IUGR group (11.52 ± 1.26) was significantly lower than that in the non-IUGR group (14.82 ± 1.45) (p < 0.001). The umbilical cord cross-sectional area was also significantly lower in the IUGR group (125.11 ± 17.2) compared to the non-IUGR group (175.51 ± 31.41) (p < 0.001). There was a direct and significant correlation between both umbilical cord diameter and cross-sectional area with all fetal characteristics (p < 0.001).

The results of the study showed that infants with IUGR had lower biometric indices, and both the diameter and cross-sectional area of the umbilical cord were significantly smaller in these infants. These findings suggest the potential use of umbilical cord measurements as an auxiliary tool in the diagnosis or risk assessment of IUGR.

Group B Streptococcus (GBS), or Streptococcus agalactiae, is a major cause of invasive diseases such as meningitis and septicemia in newborns, as well as various diseases in pregnant women and non-pregnant adults with underlying conditions. This bacterium colonizes the vagina and rectum in 10% to 30% of pregnant women. GBS colonization in pregnant women increases the risk of preterm delivery and transmission of the bacteria to the baby during childbirth. Penicillin is the first-line antibiotic for treating GBS infections, while macrolides (e.g., erythromycin), lincosamides (e.g., clindamycin), and streptogramins have been recommended as alternative treatments. However, the prevalence of antibiotic resistance is rising and could lead to significant clinical challenges. Therefore, this study aimed to investigate the prevalence of resistance to erythromycin and clindamycin, as well as the associated resistance genes, in GBS strains isolated from pregnant women in Iran.

This meta-analysis examines studies focused on resistance to erythromycin and clindamycin in GBS strains isolated from pregnant women. A comprehensive search was conducted across databases, including PubMed, Scopus, Web of Science, SID (Scientific Information Database), and Google Scholar, using keywords such as Streptococcus agalactiae, Group B Streptococcus, antibiotic resistance, erythromycin, clindamycin, MLSB (macrolide, lincosamide, and streptogramin B) resistance, and related terms. Inclusion criteria included sufficient sample size, control of confounding factors, inclusion of the relevant antibiotics, and availability of full-text articles. Data were analyzed using Comprehensive Meta-Analysis software (Biostat V2.2). Heterogeneity between studies was assessed using the I2 index, and a random-effects model was applied due to heterogeneity in the results.

The initial database search identified 241 studies. After removing 41 duplicates, 201 studies were considered for meta-analysis. After reviewing the titles and abstracts, 158 studies were excluded for not meeting the research criteria, leaving 16 studies for final analysis. This meta-analysis investigated the prevalence of resistance to erythromycin and clindamycin, resistance phenotypes, and the genes encoding antibiotic resistance in GBS isolates from pregnant women. All studies included were cross-sectional. The pooled resistance rates for erythromycin and clindamycin were 27.9% (CI95%: 16-43.9) and 28.4% (CI95%: 17-43.5), respectively. Continuous and inducible resistance phenotypes were observed in 17.5% (CI95%: 6.2-40.4) and 10.9% (CI95%: 4.7-23.2) of the isolates. The M and L phenotypes were found in 8.1% (CI95%: 3.9-16) and 4.8% (CI95%: 2.7-8.4) of the isolates, respectively. The prevalence of resistance genes, including ermTR, ermB, and mefA, was 34% (CI95%: 27.4-41.4), 24.5% (CI95%: 3-77.1), and 6.7% (CI95%: 3.9-11.4), respectively.

The study shows an increasing trend of erythromycin and clindamycin resistance in GBS isolates from pregnant women in Iran. Therefore, antibiotic susceptibility testing should be performed before prescribing these antibiotics to prevent the development and spread of resistant strains.

Tobacco health literacy refers to the ability of individuals to understand and use health information related to tobacco. This study aimed to evaluate the effectiveness of education on improving health literacy about the effects of cigarette smoke among pregnant women in 2023.

This quasi-experimental study utilized a pre-test and post-test design with intervention and control groups. The sample comprised 80 pregnant women visiting health centers in Shahrekord, selected through random sampling and divided randomly into intervention and control groups. Data were collected using a tobacco health literacy questionnaire in both pre-test and post-test phases (one month later) and analyzed with SPSS 20 software using paired and independent t-tests.

The paired t-test results indicated a significant increase in the average health literacy scores related to tobacco in the intervention group after training (p=0.000). The independent t-test showed that the post-education average health literacy score in the intervention group was significantly higher than that in the control group (p<0.001).

The findings demonstrate that educational interventions effectively enhance tobacco health literacy among pregnant women, contributing to reduced smoking exposure during pregnancy. These results can inform the design of targeted interventions and educational programs addressing the needs of pregnant women.

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.

Health literacy is known as an important determinant of health and a causal factor in health differences between population groups. The purpose of this study was to investigate the relationship between oral health literacy and oral health status of pregnant women referring to dental clinics of Shiraz University of Medical Sciences.

Methods and Materials:

 The current research was a cross-sectional study on 250 pregnant women aged 18 to 36 years who referred to health care centers covered by Shiraz University of medical sciences. All participants were evaluated in terms of literacy and oral health performance using OHL-AQ standard questionnaire, and oral health status were evaluated by DMFT and OHI indices. SPSS version 22 software was used for data analysis.

The participants were 250 pregnant mothers with an average age of 27.26 ± 4.63. In terms of education and job status, the group with a bachelor's degree with 46.8% and working mothers with 63.6% participated the most. The score of health literacy was 11/47±3/68 (moderate) and the score of health performance was 22/17±3 (moderate). The score of the DMFT index was 8/7±4/8 and the score of the OHI index was 1/17±0/64. A significant and inverse relationship was found between health literacy and health performance with oral and dental health status (P<0.001). The analysis of the regression outcomes indicated that the possession of educational qualifications was typically correlated with enhanced oral health status. The comparative evaluation revealed that both students and employed individuals exhibit oral health metrics akin to those of homemakers, yet they demonstrated superior dental hygiene. Furthermore, a higher level of educational attainment seemed to be inversely related to the prevalence of criminal activities.

It seemed that with the increase in health literacy and health performance, oral and dental health indices decrease and the oral health status of pregnant women would be more appropriate.