مجله دانشکده پزشکی اصفهان
پیاپی 746 (هفته دوم بهمن 1402)

Vaginal infections of mothers during pregnancy can be a threat to the health of the fetus and also increase the chance of abortion. This study aimed to investigate the frequency distribution of Streptococcus agalactiae in the vaginal secretions of women with a history of abortion compared to the control group.

In this descriptive-analytical study, a total of 220 samples of vaginal secretions from women who had abortion and controls were collected. Bacterial isolates were identified using culture and biochemical methods. Then, the antibiogram test of the isolates was performed using the disk diffusion method in Kirby-Bauer agar.

In the present study, 20 isolates of Streptococcus agalactiae (3.64% in the control group and 14.54% in the abortion group) were isolated from vaginal secretions samples. The isolates had the highest sensitivity to the antibiotics Ceftriaxone (30 μg) and Vancomycin (30 μg) and the highest resistance to Clindamycin (2 μg) and Tetracycline (30 μg). Based on the results of the demographic characteristics of the patients, the highest frequency of abortion belonged to blood groups A+ and B+. Urinary tract infection in 55%, vitamin D deficiency in 60%, and stress led to abortion in 75% of women infected with S. agalactiae.

S. agalactiae was observed in the vagina of women with a history of abortion, 3.5 times more common than healthy women. Factors such as the high stress of patients, deficiency of vitamin D levels, and frequent urinary infections during pregnancy can lead to an increase in the risk of abortion in women. The highest resistances were observed in Beta-lactam (Penicillin), Macrolides (Erythromycin), Lincosamides (Clindamycin), and Tetracycline antibiotic groups.

A decline in fertility followed by an increase in the aging of the population is one of the demographic crises. The healthy fertility program aims to increase the overall fertility rate above the replacement level of the programs of the Ministry of Health. Since the preservation and sustainability of the environment is one of the factors affecting the fertility rate. This review study was designed to investigate healthy fertility and environmental sustainability.

In this narrative review in the electronic databases Web of Science, Scopus, PubMed, Science Direct, SID, Magiran, and IranMedex, articles related to healthy fertility and the environment, without language restrictions between the years 2000- 2023, were reviewed. Original descriptive research studies were quality-assessed based on the STROBE checklist. After careful examination of the studies, the contents of the articles were categorized into three areas.

The effects of environmental instability on fertility can be divided into three categories of consequences, which include "female infertility"; "male infertility" and "reduced success of assisted reproductive methods".

The instability of the environment with the pollutants that it imposes on the digestive and respiratory systems of humans through air, water, and soil can affect healthy fertility and intensify the decrease in childbearing rates. Therefore, the focus of reproductive health experts and population and health policy makers to increase education and awareness of environmental risk factors seems necessary.