مجله زنان مامائی و نازائی ایران
سال بیست و چهارم شماره 13 (اسفند 1400)

The association of maternal vitamin D status with preterm labor has been considered in the recent decade, although reported findings have been inconsistent. This study was performed aimed to compare serum 25-hydroxy vitamin D levels between women with idiopathic preterm labor and women with term labor.

This case-control study was performed in 2020 on 60 women aged 18-35 years who had referred to Bentolhoda Hospital in Bojnourd for delivery. Serum levels of 25-hydroxyvitamin D were determined in 30 women with idiopathic preterm delivery with gestational age of 28 to 37 weeks (case group) and 30 women with term delivery (control group) by sandwich ELISA. Patients' information including demographic information, clinical status and pregnancy history were collected through a questionnaire. Data were analyzed by SPSS 16 software (version 16) and Chi-square and Pearson correlation coefficient test. P<0.05 was considered statistically significant.

About fifty-six (93.4%) of the participating mothers had some degree of vitamin D deficiency. Previous history of abortion, still birth and previous preterm labor were not associated with preterm labor, but primigravida increase the risk of preterm labor up to 8 times. The mean 25 (OH) D in women with preterm labor was higher than control group (19.8±8.9 vs. 14.52 ± 5.4 ng/ml, P = 0.007).

Although serum vitamin D level in mothers with preterm labor was significantly higher than those with term labor, but due to the limitations of this study, we cannot rule out the possibility of vitamin D deficiency as a risk factor for preterm labor.

Shivering following spinal anesthesia is caused by a disturbance in body temperature regulation that increases tissue oxygen consumption and cardiopulmonary activity. So far, various methods have been used to reduce and treat it. Magnesium sulfate is a common drug used in pregnant women that also has anti-shivering properties. This study was performed with aim to compare the effectiveness of intravenous magnesium sulfate with bolus infusion in the prevention of shivering after cesarean section.

This interventional clinical trial study was performed in 2017 on 300 pregnant women with term pregnancy, singleton pregnancy, and ASA class I clinical anesthesia in the United States who underwent elective cesarean section at Ayatollah Rouhani Hospital in Babol. The subjects were divided into 3 groups who immediately after spinal anesthesia received 30-minute infusion of magnesium sulfate, bolus injection of magnesium sulfate and normal saline, respectively. P< 0.05 was considered statistically significant.

Overall, shivering in 30, 60, 75 and 90 minutes were significantly lower in the magnesium sulfate infusion group than the bolus and control injection groups, (p=0.018) for the infusion group and (p=0.038) for the bolus group.

The prevalence of shivering significantly reduced by injection of magnesium sulfate. Compared to the method of administration of magnesium sulfate, administration of the drug by infusion within 30 minutes to reduce the incidence of shivering was significantly superior to the bolus administration of the drug and is recommended in patients with a previous history of intraoperative shivering.

A healthy diet plays an important role in the prevention of gestational diabetes (GDM); the genetic background is also effective in the pathogenesis of GDM. Adiponectin is a hormone that has a wide range of effects on carbohydrate, fat and protein metabolism. This study was performed aimed to investigate the interaction effect of major dietary patterns and adiponectin gene polymorphism on biochemical factors in healthy pregnant women and those with gestational diabetes.

This case-control study was performed in 2018-2019 on pregnant women referring to the gynecological ward of hospitals/clinics in Jahrom city, Fars province. 387 healthy pregnant women and 306 pregnant women with GDM completed the food frequency questionnaire. The principal component analysis method was used to extract the major dietary patterns. In addition, blood biochemical factors were measured and genomic DNA was extracted. PCR-RFLP technique was used to identify rs266729 polymorphism of adiponectin gene. Data were analyzed using SPSS (version 22.0). Multifactorial analysis of variance was use to study the interaction of major dietary patterns and adiponectin gene polymorphisms with different biochemical factors. P<0.05 was considered statistically significant.

No significant relationship was observed between the frequency of rs266729 polymorphism and GDM (p> 0.05). The level of high density lipoprotein-cholesterol (HDL-C) in the quartiles of the "Fruits and Dairy Products" dietary pattern showed a significant difference in GDM women (p = 0.048). Fasting blood sugar and triglyceride levels in the quartiles of the "Fruits and Dairy Products" dietary pattern showed significant differences for different rs266729 polymorphism genotypes in the gestational diabetes group (p-interaction: 0.033 and 0.002, respectively).

in accordance with the adiponectin genotype in pregnant women, consumption of balanced amounts of fruits and dairy products has an effective role in preventing GDM.

Infertility and its individual and social problems are considered as one of the important problems of couples. About half of all infertility is due to male factors. Based on various studies, air temperature can affect male fertility, so the present study was conducted aimed to determine the amount of sperm DNA fragmentation of men referring to Umm Al-Banin Infertility Center in Dezful by different seasons.

In this retrospective study, the statistical population included all men who referred to the infertility center in Dezful for semen analysis between 2013 and the first half of 2020. Information about the variables including age, number of children, job, education, diseases, addiction, different seasons and sperm DNA fragmentation was collected by the researcher using a checklist. Data were analyzed using SPSS statistical software (version 24) and Chi-square and one-way ANOVA tests. P<0.05 was considered statistically significant.

No significant relationship was found between sperm DNA fragmentation and different age groups, number of children, types of occupations, level of education, underlying diseases, addiction and finally different seasons and months of the year (P> 0.05).

According to the results, there is no relationship between different seasons and sperm DNA fragmentation in men.

The serum level of Anti Müllerian hormone (AMH) is a powerful test for predicting ovarian response that reflects not only the size of the primary follicle but also the quality of the oocytes. This study was conducted aimed to determine the relationship between serum AMH levels and the quality of oocytes obtained from IVF cycles in patients using IVF in Zahedan infertility center.

This descriptive-analytical study was performed in 2017-2018 on 108 infertile women who were candidates for IVF in Zahedan. Patients were selected by census and entered the study. Patients' files were extracted and the necessary information such as age, oocytes quality and serum AMH levels were extracted and recorded in the patient's information form. Data were analyzed by SPSS software (version 19) and Chi-Square test and ANOVA. P< 0.05 was considered statistically significant.

The mean serum AMH level of patients was 3.81 ± 3.26 ng/ml. 87 patients (80.6%) had oocyte quality (A), 80 patients (74.1%) had B quality, 34 patients (31.5%) had C quality and one patient (0.9%) had D quality. The mean age was not significantly associated with serum AMH levels and oocytes quality (P> 0.05).

AMH levels are associated with oocyte quality in IVF cycles, while age was not associated with AMH levels and oocyte quality. Therefore, AMH levels are an indicator of the quality of oocyte in IVF cycles.

Pelvic organs prolapse is one of the most common disorders in women. There are conflicting studies on the relationship between mode of delivery and pelvic organ prolapse. Therefore, this study was performed with aim to determine the relationship between mode of delivery and pelvic organ prolapse in women.

This cross-sectional study was performed on 250 women referring to the health-treatment centers in Mashhad. Data collection tools included the researcher-made questionnaire (demographic and midwifery information and the form of recording observations and examinations). The necessary examinations were performed to determine the prolapse of pelvic organs as well as its severity and type. Data were analyzed using SPSS software (version 16) and Mann-Whitney, Chi-square and Spearman correlation coefficient tests. P <0.05 was considered statistically significant.

Based on univariate regression results, in women with normal delivery compared to cesarean section, the chance of having a degree 2 cystocell compared to zero is 23.67 times, the chance of having a second degree rectus cell to zero is 31.13 times, the degree 2 anterocell to zero is 12.21 times and degree 2 uterine prolapse to zero is 7.38 times (p <0.001). In terms of frequency of prolapse, in the normal delivery group, grade 1 cystocele (54.4%), grade 1 uterine prolapse (52%) and grade 1 rectocele (46.4%) had the highest frequency, and in the cesarean delivery group, grade 1 uterine prolapse (57.6%), grade 1 cystocele (52%) and grade 1 rectocele (36.0%) were more common.

The frequency and severity of pelvic organ prolapse was higher in women with normal delivery than cesarean section.

The purple line as a purple point around anus that occurs in the majority of women during labor is one of the non-invasive methods for evaluation of labor progress. This study was performed aimed to determine the diagnostic accuracy of purple line alteration in prediction of labor progress in active phase of labor.

This diagnostic power study was conducted in 2012 on 258 pregnant women with term pregnancy in vertex presentation and beginning of active phase of labor with the appearance of a purple line who were hospitalized in Ommolbanin Hospital. Vaginal examination and purple line observation in the active phase of labor were measured each hour. Sensitivity, specificity, positive and negative predictive value were calculated after determining the cut-off point. Data were collected using the questionnaires: personal-pregnancy information and labor progress form and information about the purple line. Data were analyzed by SPSS statistical software (version 16), ROC curve, sensitivity, specificity, positive and negative predictive value. P<0.05 was considered statistically significant.

Increasing the purple line length at each stage of the cervical dilation was associated with the labor progression at that stage. In 3-5 cm cervical dilation, the length of the purple line ≥85 mm was associated with a sensitivity of 93%, specificity 100% and positive predictive value 100%, negative predictive value 33.3% and validity 93.22% with labor progress at the same stage and had the highest diagnostic value

Measurement of purple line alteration in the first stage of labor that is, in 3-5 cm cervical dilation, ≥85 mm, 6-8 cm cervical dilation ≥101.5 mm and 9-10 cm cervical dilation ≥110.5 mm was associated with most sensitivity with cervical dilatation and is recommended as a non-invasive method to predict clinical  labor progress in the first stage of delivery.

Phenylketonuria (PKU) is the most common inherited metabolic disease in Iran that can be prevented by prenatal diagnostic tests (PND). This study was performed aimed to determine the incidence of PKU and the effect of implementing a prevention program on reducing its incidence in the population covered by Kerman University of Medical Sciences.

This was a descriptive study on health system research. All PKU carrier couples and patients covered by Kerman University of Medical Sciences in 2019 were studied. Data were obtained from the national form of epidemiological study of genetic diseases and genetic surveillance form from the Deputy Minister of Health. Frequency tables and graphs were used to describe the information.

In this study, 68 patients and 63 carrier couples were covered and 37 (60.6%) carrier couples were at risk of having a sick child and all of them were under the care of health care centers. For 91.9% of them and 61.9% high-risk relatives, the type of gene mutation was determined. PND tests were performed on 28 (87.5%) pregnant women. Seven affected fetuses were diagnosed, all of which were aborted with parental consent. 32 high-risk couples (86.5%) used safe method of contraception. The 13-year incidence of PKU in the whole region was 1.13 and the expected incidence was 1.36 per 10,000 live births.

Implementation of prevention program had an effect on reducing the incidence of PKU. The high frequency of consanguineous marriages can affect the high incidence of PKU. It is necessary to identify the patient's relatives who are at risk of having a sick child (consanguineous marriage), refer them to a genetic counseling center and determining their status can be effective in reducing the incidence of the disease.

It has been proposed that regular exercise training is effective methods to reduce the levels of oxidative stress and its disorders. Therefore, this study was performed aimed to evaluate the changes of some total antioxidant capacity and lipid peroxidation markers following the combined with high intensity interval training in sedentary postmenopausal women.

This semi-experimental study was performed  in 2020 on 45 sedentary menopause women  in Bonab city. The subjects were randomly assigned to 3 groups: high-intensity interval training, combined exercise training and control. Exercise training programs were done in 3 nonconsecutive days for twelve week. Blood samples were collected 48 hours before and after exercise training and the level of malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured. Data were analyzed by SPSS software (version 24) and correlated t-test and Covariance of analysis (ANCOVA) test. P<0.05 was considered statistically significant.

There were no differences between three groups in the physical physiological indices at the beginning of the study (p>0.05). The twelve week of both type of exercise training methods significantly decreased the MDA and significantly increased the TAC levels in sedentary menopause women  (p<0.05). While, there were no significant differences in these indicators during the study period in the control group. However, there were no significant difference between two exercise training methods (p>0.05). Moreover, significant correlation was observed between the changes of this markers with the changes in some of body composition indices in training groups (p<0.05).

Performing 12 weeks of combined and high intensity interval training can lead to increase of total antioxidant capacity and decrease lipid peroxidation indicators, therefore, it can be recommend these exercises training methods for postmenopausal women to improve oxidative stress.

Hormonal changes during pregnancy affect the sleep-wake cycle and sleep structure and lead to sleep disorders. Ruminants and anxiety are two negative thoughts that can affect the quantity and quality of sleep and cause sleep disorders. Therefore, this study was conducted with aim to determine the relationship between disturbing thoughts (rumination, worry) and sleep quality of pregnant mothers.

This cross-sectional descriptive study was performed in 2019 on 190 pregnant mothers referring to the health centers in Isfahan. Data collection tools were the questionnaires of ruminant, anxiety and sleep quality. Data were analyzed by SPSS software (version 22) and Spearman and regression tests. P<0.05 was considered statistically significant.

In pregnant mothers participating in the study, the mean overall score of sleep quality was 2.57±5.60, mental rumination was 9.62±1.43 and anxiety was 33.52±3.37. Based on the results of Spearman test, there is a significant inverse relationship between all dimensions of sleep quality and overall sleep quality score with the overall score of mental rumination and anxiety (p=0.001).

There was a significant relationship between rumination disturbing thoughts and anxiety with the quality of sleep in pregnant mothers. For this purpose, by examining the components of disturbing thoughts and their relationship with the quality of sleep in pregnant mothers, an effective step can be taken to improve the quality of sleep of pregnant women.

Chlamydia trachomatis is the cause of chlamydial infection of the genital tract and trachoma and is the most common bacterial infection transmitted through sexual contact and the most important and costly non-viral sexually transmitted disease. This infection is a common cause of urethritis in men and cervicitis in women, and many complications such as infertility and ectopic pregnancy have been reported. This study was performed aimed to evaluate the frequency of anti-chlamydia antibodies in asymptomatic women of childbearing age referred to health centers in Mashhad.

This cross-sectional study was performed in 2016 on 93 women referring to the health care centers of Mashhad University of Medical Sciences. Anti-chlamydia IgG antibodies were tested in these samples by ELISA method. Data were analyzed using SPSS software (version 16) and Fisher Freeman Halton Exact test. P<0.05 was considered statistically significant.

A total of 93 women were evaluated. The mean serum level of antibody was 0.35±0.36 ng/dl and accordingly 6.5% (n=6) had a positive result. Also, the relationship between infection and age (p=0.209) and living area (p=0.239) of ​​these people was examined, but no significant relationship was found.

According to the results of the present study, the frequency of anti-chlamydia antibodies was considerable in women of reproductive age referred to the health centers in Mashhad. Due to this prevalence and high complications of this infection in case of no treatment, it is recommended that the Chlamydia Trachomatis screening program be performed routinely even for asymptomatic individuals.

Vaginal atrophy is one of the relatively common problems in menopausal ages and a major health concern in this group of women. Several studies have been done in the field of herbal medicine in this subject, but different findings have been reported on the efficacy of these methods. This study was performed aimed to review the studies on the effect of herbal medicines on vaginal atrophy in postmenopausal women.

In this systematic review and meta-analysis, published articles in databases of PubMed, Scopus, Magiran, Cochrane, web of science, SID and Google scholar were reviewed between 2000-2020 using English key words of "vaginal Atrophy, vaginal Atrophy treatment, clinical trial, herbal medicine, complementary medicine, traditional medicine”. Data were analyzed using STATA software (version 11) in %95 confidence interval. Odds ratio index and Peto method were used to combine studies and perform meta-analysis.

Meta-analysis results showed that in all studies, herbal intervention improved the symptoms of vaginal atrophy (P<0.001). So that the odds of improving itching, dryness and burning in the intervention group compared to the control group was (OR=12.53, %95 CI: 5.82-26.98), (OR=7.21, %95 CI: 4.72-11.02), and (OR=18.56, %95 CI: 8.94-38.55), respectively. Also, the odds of improving dyspareunia, improving maturity index of vaginal cells and lowering vaginal PH in the intervention group compared to the control group was (OR=25.38, %95 CI: 13.79-46.69), (OR=24.30, %95 CI: 13.61-43.37) and (OR=23.30, %95 CI: 13.05-41.59), respectively.

Based on meta-analysis results, the effect of using herbal medicines on vaginal atrophy in postmenopausal women is statistically significant and the use of herbal remedies can be a good substitute for chemical drugs, because this method is accepted in postmenopausal women more than chemical drugs due to the side effects of hormone therapy.