مجله زنان مامائی و نازائی ایران
سال چهاردهم شماره 4 (مهر و آبان 1390)

Nutritional deficiencies and nutrient intake are determinants of the onset of polycystic ovary syndrome (PCOS). In spite of this, nutrients intake has not been much studied in these patients. Therefore, this study was carried out to assess nutrient intake and food consumption in PCOS subjects and compare it to healthy women. This case-control study was carried out on 60 women (30 PCOS patients and 30 healthy women) who were selected by simple randomized sampling method, after BMI unification in Tabriz Al-Zahra Hospital in 2009. Individuals’ intake was assessed by using three 24 recall questionnaires and food frequency questionnaire. Data were analyzed by Nutrition III and SPSS 13 software using descriptive analysis and independent t test. Mean of energy, carbohydrate, fat, protein, magnesium, calcium and vitamin D intake were higher in healthy subjects than patients (p<0.05). Intake of sodium, zinc, chrome, folate, B12, simple sugars and dietary fiber were not different among two groups. Frequency of milk and dairy products, fruits and nuts consumption in patients were less than the control group (p<0.05). Low intake of Calcium, Magnesium, vitamin D, dairy products, fruits and nuts is noticeable in PCOS women. Considering the effects of mentioned nutrients in metabolic disorders, it is necessary to give nutritional counseling for more intake of these nutrients in PCOS patients.

Complete molar pregnancy is the most common gestational trophoblastic disease That has different incidence rate in different societies and the evaluation of its related risk factors may reveal the reason for these differences. The purpose of the present study was to evaluate some of the risk factors of complete molar pregnancy. A case-control study was performed on 91 cases of complete molar pregnancy (case group) and 295 cases of normal term pregnancy (control group) in Akbarabadi hospital in Tehran city (1996-2006). Subjects were selected by simple sampling method. Then the maternal age, parity and gravidity, blood group and Rh, history of molar pregnancy, consanguinity, history of spontaneous abortion, contraception method and race (Afghan or Iranian), were compared in the two groups. Data was analyzed by SPSS 16 software using Chi-square test, fisher’s exact test and logistic regression. History of molar pregnancy OR, CI 95%=5.7 (1.2-25.6), spontaneous abortion OR, CI 95%=2.1(1.7-2.6), maternal age higher than 35 year OR, CI 95%=2.3 (1.3-3.9) and lower than 20 years OR, CI 95%=1.6 (1.4-1.9), consanguinity OR, CI 95%=1.3 (1.1-1.5), and Iranian race OR, CI 95%= 1.9(1.5-2.4) were found to be risk factors for molar pregnancy. History of molar pregnancy, spontaneous abortion, maternal age, consanguinity and race may be risk-factors for molar pregnancy.

Caesarean section is accompanied with higher risks for mother and baby in comparison with vaginal delivery. The incidence rate of jaundice and cesarean section in recent decades has increased significantly. The aim of this study was to evaluate the relationship between the type of delivery and the jaundice severity in newborns. This descriptive-analytical study was performed on infants with asymptomatic jaundice as the chief complaint who referred to Ghaem hospital in Mashhad, between 2002 and 2009. Complete physical examination and laboratory tests were performed for infants. History of pregnancy and delivery pattern, time of jaundice onset, age at discharge, chief complaint on admission, associated symptoms, duration of hospitalization and treatment were recorded. Eligible infants with idiopathic jaundice were divided into two groups based on the delivery type (normal vaginal delivery and cesarean section). Data were analyzed by Chi-square test, Mann-Whitney test and Kruskal-Wallis test using SPSS 11.5 software. 41.9 percent of newborns with jaundice were born by cesarean section and 58.7 percent were boys. Age and weight at admission, age of jaundice onset and neonatal weight within days 3 to10 was not significantly different between the two groups (p>0.05), while maternal age, birth weight and pregnancy complications showed significant differences (p<0.05). Mean serum bilirubin was 21.3± 4.2 in normal vaginal delivery group and 20.7 ± 4.4 mg/dl in cesarean section group. There is no relationship between the type of delivery and the severity of jaundice in newborns, based on the findings of this study.

Infertility is considered as a crisis in life and can cause severe stress for infertile couples. A variety of approaches has been suggested to manage this kind of stress in couples. This study addressed the effect of collaborative counseling on perceived infertility-related stress in infertile women undergoing IVF in Mashhad.

In this clinical trial, 60 women with primary infertility were selected from Montaserieh Infertility Research Center by convenient sampling and were randomly divided into intervention (29 cases) and control (31 people) groups. Women in intervention group received counseling in five meetings with collaboration of midwife, gynecologist and clinical psychologist. Control group were counseled routinely. Perceived infertility-related stress was measured at the beginning and embryo transfer day using Newton Fertility Problem Inventory that has five subscales. Mann-Whitney test and independent t-test were used for data analysis by SPSS software version 14.

A significant difference was found between two groups in terms of total perceived infertility-related stress score (p<0.048). The amount of stress reduction in intervention group was nearly 3.6 times more than the control group. There was also a significant difference between two groups regarding two the subscales of Fertility Problem Inventory including social concerns (p<0.031) and need for parenthood (p<0.002).

Collaborative counseling can decrease the infertile women's perceived infertility-related stress. Thus, it could be suggested as one of the stress management strategies in infertile women undergoing IVF.

Unwanted pregnancy is a global public health concern that affects women, their families and the society Lack of interest in the causes of unwanted pregnancy and its negative effects can result in serious consequences for public health. The purpose of this study was to examine some of the factors related to unwanted pregnancy among women referring to health care centers of Iranshahr in 2007. This study analytic case-control study was performed on 960Iranian pregnant women who referred to the health care centers of Iranshahr and were chosen by available sampling method. Data was collected using a researcher-made questionnaire containing individual characteristics, fertility behaviors and the method of contraception by interview. Data was analyzed by SPSS (11), using Chi-Square and In depended t-test. Most unwanted pregnancy occurred in women who were above 35 years old, illiterate or with primary school education. There was also a significant relationship between these variables and pregnancy type (p=0.001). 81% of women with unwanted pregnancy applied a contraceptive method before current pregnancy that 39.3% had stopped prevention method before current pregnancy and 60.7% became pregnant while using a contraceptive method.. Most unwanted pregnancy occurred in women who took oral contraceptive pills (61.1%), condom (25.8%) and withdrawals (10.6%), respectively. for improving the quality of family planning services to be necessary holding extensive educational programs about contraceptive methods and the disadvantages of unwanted pregnancy especially for older and illiterate women seem to be necessary.

Excess weight and obesity during pregnancy may be considered as an abnormal situation and can cause obstetric risks for both mother and neonate.. This study was performed with the aim of assessing the effects of mother’s Body Mass Index (BMI) on mother and neonate. This descriptive-analytical cross-sectional study was performed on 272 pregnant women who referred to the health centers of Lar city and were selected by randomized sampling in 11year.Data was collected using a two-part questionnaire by interview. The first part contained demographic questions and the second part had questions on the risk factors related to mothers’ excess weight. Mother’s eight and height was measured at two stages and their BMI was determined at the beginning and the end of pregnancy. Neonates’ weight was determined and recorded after birth in the hospital. Data was analyzed by SPSS version 11 software using descriptive statistical methods and independent t-test. The average of first BMI was 23.4 and the last BMI was 28.3. 74.3% of women had experienced first pregnancy. Neonates’ birth weight reduced with increase in mothers’ BMI (P<0.01). 5.6 %(26) of mothers were overweight at the onset of the study and 35.6 % (105) of them had above normal BMI during pregnancy. Obese women and women with excessive weight gain during pregnancy need special fallow-up and counseling during pregnancy and delivery. Health professionals working with pregnant women should be aware of excess weight problems and give necessary trainings to women.

Considering the importance of domestic violence and lack of information about the role of pregnancy in its occurrence and variations in its relating factors among societies, this study was conducted to determine and compare the frequency of all types of violence before and during pregnancy and explore its relating factors. In this descriptive-analytical study, 190 Iranian pregnant women referring to the health centers and labor hospitals of Mashhad in 2004-2005 were selected by sampling method and entered the study. The questionnaire of evaluating violence before and during pregnancy was prepared by deep interviews with 25 pregnant women based on the qualitative study of violence experience and quantitative data were collected by interviews. Data was analyzed by McNemar and Chi-square test, student t-test and -Mann-Whitney test using SPSS 13 software. The overall rate of different types of violence was respectively 82.9% and 64.1% before and during pregnancy. The most common type of violence was sexual (51.6%) during pregnancy and psychological (67.6%) before pregnancy. Violence during pregnancy didn’t have any relationship with unwanted pregnancy and demographic characteristics, but showed significant relationship with history of violence in the husband’s family (p=.012), marriage without the woman’s consent (p=.004), polygamy (p=.006), history of husband’s penal conviction (p=.000) and addiction (p=.000). Violence against women is among the most common problems during pregnancy and before it and is important threats to the health of both mother and child and family. Training midwives about the methods of client assessment on domestic violence and its related factors, along with counseling and referring the victims of violence are suggested.

Episiotomy is one of the most commonly performed procedures in obstetrics, but the best technique of episiotomy and its clinical benefits remain largely unknown.The aim of this study was determined resistance pain after episiotomy in primiparous woman and related factors. This was a prospective longitudinal study, primary outcome was the frequency of perineal pain on days of interview; second outcomes were determine effective factors of perineal pain. Research data about perineal pain after episiotomy that was conducted at ten academic hospitals in Tehran. This study included 510 primiparous women who gave birth vaginally. Data was collected with interview in 24 h, 10 and 40 days after delivery and after collecting information and filling forms, data was analyzed by SPSS 11.5 and tests such as chi-square, independent sample T-test and Mann-Whitney. The frequency of perineal pain was reported by 96.4% at first day, 63% at 10 days and 25% at 40 days after birth. Perineal pain had significantly related with maternal age in two time, the first day (p=0.001) and the tenth day (p=0.001), the number of steria was related with perineal pain in the first day after birth (p=0.001(, perineal pain in the fourth day after birth was related with first phase duration (p=0.002). The frequency of preneal pain among the women during the third time of postpartum is equal by foreign research. The number of steria and active phase duration are new influence factor on perineal pain that find in this survey, and need to more study about these.