مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 216 (هفته سوم آبان 1395)

Over the past decades, the rate of caesarean section has increased in industrialized and developing countries. There are many reasons for the global rise in caesarean section rates, but an important and influential factor is the fear of childbirth. Fear of childbirth itself is created for reasons such as fear of pain and low self-efficacy of childbirth. Therefore, this study was performed with aim to determine the effectiveness of cognitive-behavioral therapy on fear of childbirth, fear of pain, self-efficacy of childbirth and tendency toward caesarean section in nulliparous women.
This clinical randomized study was performed on 25 nulliparous women in Mashhad. The subjects were assigned to two groups of case and control. 9 sessions of cognitive-behavioral therapy was performed on intervention group by the researcher (clinical psychologist). Wijma fear of childbirth questionnaire, self-efficacy of childbirth questionnaire and fear of pain Scale were used as tools in post and pretest. Women's tendency to mode of delivery was assessed by a question at the beginning of sampling and at the end of treatment. In addition, the final mode of delivery was asked by phone call at the end of pregnancy. Data were analyzed by SPSS software (16 version) and covariance analysis and Fisher exact test. P Fear of childbirth, fear of pain, tendency to cesarean and cesarean rate ere reduced in the intervention group compared with the control group (P Cognitive-behavioral therapy decreases unnecessary cesarean sections by reducing the fear of childbirth, fear of pain and increasing self-efficacy of childbirth.

According to the importance of prenatal care and its effect on maternal health and priority of prevention to treatment, it is necessary to promote the quality of prenatal care and improvement of the quality of services isn’t possible without considering the user's views. So, this research was done with aim to determine the rate of pregnant women's satisfaction of presented prenatal care at Ahvaz health care centers.
This descriptive study was performed on 588 pregnant women referred to Ahvaz health centers in 2012. Sampling was performed by randomized convenience method. Data were gathered by researcher made questionnaire with interviewing to the mothers. Data were analyzed by descriptive statistics and SPSS (version 18).
282 women (48%) were completely satisfied, 296 (50.3%) relatively satisfied and only 10 (1.7%) were dissatisfied from presented prenatal care.
The majority of pregnant women are satisfied from presented prenatal care.

Low birth weight (LBW) is one of the most important adverse consequences of pregnancy and also of the serious health problems in the world. Although several risk factors are reported for this phenomenon¡ but some problems during previous pregnancies could be considered as LBW predisposing factors. This study was performed with aim to determine the relationship between maternal and neonatal factors during previous pregnancies and low birth weight in Iran through a systematic review and meta- analysis study.
In this systematic review and meta-analysis study¡ the information about the relationship between maternal and neonatal factors with low birth weight during previous pregnancies in Iran was independently extracted from all articles published from 1996 to the end of 2015 by searching in databases of SID¡ Medline¡ ISI¡ Irandoc¡ Google Scholar¡ Pubmed¡ Scopus¡ Science Direct¡ Web of Science and Magiran by using relevant key words and their combinations by two trained researchers. Data analysis was performed using random and fixed effects model in meta-analysis and Cochrane software STATA (version 11.1) and SPSS (version 16) were used to assess the publication bias from funnel plot and heterogeneity studies. P In the initial search of 48 papers¡ 21 articles were selected to enter the study. There was significant relationship between the history of abortion¡ history of the birth of a neonate with LBW¡ unwanted pregnancy¡ parity and number of pregnancy. The history of low birth weight during previous pregnancies with OR: 2.68 (CI95%: 2.12- 3.39) and the number of mother’s pregnancy with OR:1.12 (CI95%: 0.94- 1.34) had the most and the least relationship with low birth weight newborns¡ respectively.
According to significant relationship between the history of abortion¡ the history of low birth weight¡ unwanted pregnancy¡ the number of pregnancy and parity with birth of LBW newborns¡ health and medical directors can prevent the birth of LBW neonates by more attention to high risk mothers and taking appropriate actions.