Preventive Care in Nursing & Midwifery Journal
Volume:8 Issue: 1, Spring 2018

Mothers with preterm infants experience numerous stressful problems which can be associated with negative effects on maternal role adaptation.
The present study aimed to evaluate maternal role adaptation in mothers with late-preterm infants and its related factors.
This descriptive-analytical study was conducted in Ayatollah Mousavi Hospital in Zanjan, Iran during June-November 2017. A total of 95 women with preterm infants were selected by convenience sampling method. Data were collected using demographic and maternal role adaptation questionnaires. Finally, the obtained data were analyzed by the SPSS software employing descriptive statistics test and regression models at a confidence level of 95% (P<0.05).
Based on the results, the highest mean of maternal role adaptation belonged to the areas of child dependency and emotional development while the lowest mean was related to the area of concern and anxiety. In addition, the results demonstrated a significant correlation between the degree of maternal role adaptation and its areas such as family income, maternal and parents level of education, parents occupational status, birth weight, Apgar score, the gender of the infant, and delivery method.
In general, the adaptation of mothers with preterm infants was low in the area of concern and anxiety compared to the other areas. Therefore, planning appropriate interventions to strengthen the maternal role is of great importance for the parents who have preterm infants, low level of education, and are unemployed with insufficient income.

Despite the progress of family planning programs, a significant proportion of pregnancies are still unplanned which threatens the different dimensions of community health. Unplanned pregnancy affects parent's-child association. Maternal-fetal attachment provides a model for the child's mental-social function at present and in the future.
This study was conducted to determine the prevalence of unplanned pregnancy and related factors of maternal-fetal attachment in pregnant women referring to Zanjan health centers in 2017.
This descriptive correlational study was part of a clinical trial that was performed on 184 pregnant women who referred to health centers for routine prenatal care from October to February 2017 in Zanjan, Iran. Using multi-stage sampling method, health centers of Zanjan were divided into three categories based on social and economic situation. Then, from each category, three centers were selected, randomly. The inclusion criteria comprised being pregnant, satisfaction to participate in the study, have at least reading and writing skills, lack of the history of obstetric complications, psychological disease and medicine use, lack of known psychological disease, lack of narcotic substances abuse, and living in Zanjan City. Data collection tool included demographic checklists and maternal-fetal attachment questionnaire, which completed in self-report method. The data of this study were analyzed by appropriate statistical tests by SPSS v.16 software.
Among the participants 58.2% of women had planned pregnancy, 36.4% had unplanned pregnancy, and 5.4% had unwanted pregnancy. Maternal-fetal attachment scores were significantly higher in the planned pregnancy group 84(75-93) than the unplanned pregnancy group 57(54-60) and unwanted pregnancy group 56(48-64) (P˂0.001). The highest sub-scale in the planned pregnancy group was related to the attributing characteristics and intentions. Also, the most subscale in unplanned and unwanted pregnancies related to giving of self. There was a significant relationship between age, education, socioeconomic level, number of pregnancies, number of children and contraceptive method with type of pregnancy (P˂0.001).
Based on the results of the study, it seems that reduction in unplanned pregnancy will enhance the maternal-fetal attachment and will improve the mother role and social-psychological health of the child.

Given the importance of sex drive in marital satisfaction, evaluating the effectiveness of easy and cost-effective therapies in this regard is essential.
The present study aimed to evaluate the effectiveness of cognitive-behavioral counseling (CBC) based on film therapy on the marital satisfaction of women with low sex drive.
This clinical trial was conducted on 300 women referring to health centers, and 50 women with low sex drive were selected based on the inclusion criteria via permuted block randomization. The selected subjects were allocated to the intervention (n=25) and control (n=25) groups. The intervention group received seven sessions of CBC based on film therapy, while the control group received no intervention. Data were collected using the marital satisfaction scale proposed by Afrooz before and after the intervention. Data analysis was performed in SPSS version 20 using Chi-square and MANCOVA.
The results of Chi-square indicated that the groups were homogeneous in terms of demographic characteristics. In addition, the intervention and control groups had no significant difference in terms of marital satisfaction before the intervention. However, in the post-intervention phase, marital satisfaction significantly increased in the intervention group compared to the control group.
According to the results, CBC based on film therapy could improve marital satisfaction. Therefore, it is recommended that this therapeutic approach be adopted to enhance the relationship of the couples with low sex drive.

It seems that in vaginal delivery, serum leptin level increases as a cortisol-dependent factor due to the stress of the embryo. Studies have shown that if the level of serum leptin is low, the risk of chronic metabolic diseases, cardiovascular diseases, hypertension, and obesity in the mother and the baby will increase.
The aim of this study was to determine the relationship between serum leptin levels in pregnancy and the type of delivery.
This study was a descriptive-analytic study which adopted a longitudinal approach to examine 45 mothers in the first and second trimester of pregnancy in Tehran in 2015. The participants were selected by means of cluster random sampling. After obtaining consent from the mothers, their blood samples were collected at 6-12 and 15-20 weeks of pregnancy and their serum leptin levels were determined. The mothers’ examination continued after their delivery. Finally, the mothers were divided into two groups including the vaginal delivery group (24 participants) and the cesarean group (21 participants). Independent-Samples t-test, Pearson test, regression test, and Lambda test were used to analyze the data. SPSS was employed to carry out analyses at P value<0/05 level.
The mean values of the serum leptin level in the first trimester and second trimester were higher in the normal delivery group in comparison with the cesarean group. Nonetheless, there was not a significant relationship between the serum leptin level and the type of delivery despite the fact that there was a statistically significant relationship between the type of delivery and the changes in leptin levels during pregnancy and these changes were reported more frequently in the normal delivery group in comparison with in the cesarean group (P value=0.021).
Based on the results of this study, leptin level changes during pregnancy can have a predictive role in the mothers’ type of delivery. However, further studies with larger samples are required to confirm the extent and type of this role.

Physiological and psychological impacts of pregnancy may relate to anxiety symptoms in nulliparous women. An effective communication between couples can have protective effects against anxiety in this period.
The present study intended to assess the relationship between communication skills and the anxiety during pregnancy in nulliparous women.
This study adhered to a descriptive cross-sectional design. In this study, 100 nulliparous women of 18 to 40 years old were selected through a two-stage cluster sampling in Health Centers of Sari, Iran (2014-2015). We used the Spielberger's questionnaire to measure pregnancy anxiety and Queendom's questionnaire to assess couples' communication skills. Statistical-descriptive methods and Pearson correlation coefficient were used to analyze the data.
The mean age of the women participating in the study was 27.15±4.69. The results showed that there was a negative significant correlation between communication skills and state (r=-0.45, p<0.01) and trait anxiety (r=-0.51, p<0.01). However, there was no significant relationship between one of the subscales of communication skills (assertiveness) and state and trait anxiety.
This study indicated a negative correlation between communication skills and pregnancy anxiety. Strong communication skills could diminish pregnancy anxiety and eventually lead to higher psychological health.

Mood disorders constitute a prevalent problem during postnatal period. Nonetheless, three is not adequate information on the underlying mechanism of postpartum depression (PPD).
Therefore, this study aimed to investigates the role of early maladaptive schemas (EMSs) and premenstrual syndrome (PMS) in mothers with postpartum depression (PPD) referring to health centers in Mashhad.
In order to carry out this cross-sectional study purposeful sampling was used to select 179 mothers who referred to health centers in Mashhad during February, March, and April of 2018 and met the relevant criteria of study as the participants. Participants completed Young’s Early Maladaptive Schema, Premenstrual syndrome (PSST) and the Edinburgh Depression Scale. Descriptive statistics and stepwise regression analysis were used to analyze the data with SPSS version 20.
The participants ranged in age from 19 to 41 and their mean age was 29.7±8/7.  This group of participants consisted of 106 mothers who had experienced their first delivery, 42(24.4%) mothers who had experienced their second delivery, and 24(14%) mothers who had experienced their third delivery. The results revealed that PMS (P<0/001; r=0.56) and EMSs (P<0/05; r=0.65) had significant correlations with PPD. PMS and EMSs together predicted 42% of the variance of PPD.
The findings of this study suggests that PMS and EMSs affect mothers’ PPD.

Postoperative Nausea and Vomiting (PONV) is one of the common and unpleasant complications after surgery. Menstrual cycle may be one of the factors which affect the incidence of PONV.

The aim of this study was to determine the relationship between different phases of menstrual cycle and PONV.

The present study was a cross-sectional descriptive study and involved 70 women, 15-45 years old, ASA (American Society of Anesthesiologists) class I and II and were candidates for elective open cholecystectomy. The first day of the previous menstrual period was considered the first day of the cycle, and the patients were divided into two phases: days one to 14 constituted the proliferative and the follicular phases and days 14 to the last day of the cycle constituted the luteal phase. The patients’ general anesthesia was accomplished in a standard way. After the end of operation and the transfer of patients to the recovery room, their rate of nausea and vomiting during recovery, within the first two hours, and within the first two to six hours of their transfer to the department was examined and recorded. The Rhodes index was used to determine the severity of nausea and vomiting. The data were analyzed by means of descriptive statistics, chi-square test, and independent t-test using SPSS 17 software.

Based on the results of this study, the severity of PONV during recovery, the first two hours, and the first two to six hours after the transfer of participants to the department did not significantly differ among the different phases. Moreover, there was not a significant difference between the occurrence of nausea and vomiting and the menstruation phases regardless of its severity in mentioned time periods. The received amount of anti-nausea or anti-vomiting medication (i.e. Plasil in this study) was higher in the proliferativefollicular phase in the first 24 hours (p value=0.011).

This study showed that menstrual phase does not affect the incidence and severity of PONV.

Lead exposure is one of the global health problems, especially among pregnant women.

In this regard, the present study aimed to investigate the correlation between blood lead and blood indicators in healthy pregnant women.

This correlational study was conducted on 80 pregnant women hospitalized in Ayatollah Mousavi Hospital in Zanjan during 2015. After receiving informed consent, 3.5 mL of their blood samples were taken for measuring the blood lead and indicators. Then, Symex was used to analyze hematologic indicators, followed by utilizing potentiometric method and Ion3 to measure blood lead level. Finally, data were analyzed by SPSS software, (version 22) applying Pearson correlation coefficient and linear regression. A Pvalue of less than 0.05 was considered statistically significant.

The mean blood lead of the subjects was 6.24±1.74 μg/dL. Based on the results, a significant correlation was found between blood lead and hemoglobin (Hb: r=-0.39, P<0.001), mean corpuscular volume (MCV: r=-0.26, P=0.02), mean corpuscular hemoglobin (MCH: r=0.27, P=0.013), mean corpuscular hemoglobin concentration (MCHC: r=-0.327, P=0.003), and platelet number (Plt: r=0.359, P= 0.001). However, no significant correlation was observed between blood lead and other platelet and blood indicators.

Overall, blood lead affects blood indicators. Therefore, it is suggested to plan and implement strategies to reduce exposure to lead in the environment, especially for pregnant women.