مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 102 (هفته چهارم خرداد 1393)

Preterm delivery is the most important cause of neonatal mortality and morbidity. Infections and chronic inflammation are one of the main causes of preterm delivery. C-reactive protein (CRP) is a marker of inflammation that is secreted by hepatic cells in response to inflammatory stimuli. We examined the association between c-reactive protein as a marker of inflammation in pregnant women and risk of preterm delivery This prospective case-control study was conducted between 2011 and 2012 on 200 pregnant women who referred to gynecologists office in Shiraz، Iran. Subjects were divided into three groups: 63 pregnant women who delivered before week 30 of pregnancy، 30 pregnant women who delivered between weeks 30-37 and 107 controls who delivered at term. Serum CRP was evaluated by Immunoturbidimetry Assay method with photometric analyzer in all groups. Data were analyzed by SPSS software version 16 and ANOVA test. P value CRP concentration among women with preterm delivery before 30 weeks of gestation were increased compared to the other two groups (p<0. 05). Also significant difference in CRP concentrations were seen in women with preterm labor before 30 weeks of gestation compared to those who had delivery after 37 weeks (p<0. 05). Increased CRP concentration directly correlates with preterm birth and it seems that CRP can be helpful in identifying women at risk of preterm birth.

Birth defects، premature birth، low birth weight and intrauterine growth retardation are major causes of neonatal death and disability in the other time of life. Because the evaluation of factors influencing pregnancy is an obstetric important issue، therefore، this study aimed to evaluate the impact of air pollution on pregnancy outcomes. A systematic review was carried out to identify published literature from 1990 to 2013 using keywords air pollution، dust storm، human health and pregnancy outcomes in Pubmed، Google Scholars، Springer، Magiran، Science Direct and Iran Medex databases. The evidence was sufficient to infer a causal relationship between particulate air pollution and respiratory deaths in the post neonatal period. Also، air pollution was associated with low birth weight and intrauterine growth retardation. There was a relationship between high level of air pollution and DNA damage in newborns. Also high level of air pollution can increase mortality and morbidity in childhood and an elevated risk of hypertension، coronary heart disease، and non-insulin-dependent diabetes in adulthood. Exposure to air pollution during pregnancy may increase adverse pregnancy outcomes and impact on the growth and health of the other stages of life.

Primary Cytomegalovirus (CMV) infection occurs in 0. 15-2% of all pregnancies and transfers to fetus up to 40% that some of these cases lead to abortion. Acute CMV infection in first trimester causes the most severe damage on fetus. The aim of this study wasinvestigation the distribution of cytomegalovirus infection in spontaneous abortion cases by investigating the frequency of primary، reinfection and reactivated CMV infections in mothers. In this cross sectional study، 40 cases of abortion which were referred to Mehr Fertility Institute of Rasht، Iran during the second 6 month of 2010 were studied for maternal CMV infections (primary، reactivated، and reinfection using ELISA assay to detect antibodies including CMV-IgM، CMV-IgG and CMV-IgG avidity in sera of mothers. Data were analyzed using Chi-square test. P value less than 0. 05 was considered significant. Seroprevalence of positive CMV-IgG in studied women was 100. 0% and all of them had high seropositivity rate (≥60RU/ml) as well. About 7 subjects (17. 5%) had primary infections (CMW-IgM positive with low CMV-IgG avidity). Frequency of primary cytomegalovirus infection in abortions was statistically significant in cases with abortion (p= 0. 0001). Results of the present study showed seropositivity to CMV-IgG even with high titer is not a good indicator for mother immunity and can not avoid occurrence of reinfection. Screening with CMV-IgG in pregnancy in not valuable but regarding to high rate frequency of primary infection in abortions، it seems that survey of pregnant women for these infections with measuring CMV-IgM and CMV-IgG avidity is worthy.