Iranian Pregnant Women Research Articles

Maternal Fasting Plasma Glucose, Age and Body Mass Index as Prediction of Gestational Diabetes Mellitus in Iran

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy that can lead to adverse outcomes. In this retrospective cohort study, maternal fasting blood sugar (FBS) in the second trimester of pregnancy, body mass index (BMI), and age were assessed as potential screening indicators of later GDM. Methods: The study population included information on 4007 Iranian pregnant women documented by the Integrated Health Record System (SIB) record system (2019-2020). Results: In the adjusted analysis, FBS maintained a significant relationship with GDM (P ≤0.001). In the simple ROC analysis, the AUC (SE) of FBS for the prediction of GDM was 0.905(0.09), and considering the cut-off point as 85.95, sensitivity (Se) and specificity (Sp) were equal to 0.81 and 0.71, respectively, but by stillbirth, abortion, prematurity, neonatal weight, height, and head circumference not obtained acceptable AUC (≥.60) for detection of FBS cut-off point. The cut-off point of FBS in the presence of maternal age (AUC>0.6) and BMI (AUC>0.6) by GDM was 83.75(Se= 86.4%, Sp= 80.0%). Conclusion: Based on the evidence presented, maternal weight and BMI are important in predicting hyperglycemia leading to GDM. It is necessary to conduct more precise national studies to standardize the FBS cut-off point by controlling age and BMI variables.

Evaluation of validity and reliability of coronavirus preventive behaviors in pregnant women based on health belief model

Background and Objectives: The coronavirus disease 2019 (COVID-19), which spread from China, had a high prevalence and mortality rates and affected all age groups. Pregnant women were among the affected people. This study aims to design and evaluate the validity and reliability of a tool for measuring the preventive behaviors of pregnant women in Iran against COVID-19 based on the health belief model (HBM). Methods: This descriptive-applied study was performed on 20 pregnant women in Qom, Iran in 2021. The questionnaire was sent to the participants electronically using the prepared link. The validity was assessed based on the opinions of 9 faculty members, and reliability was assessed using the test re-test method (Pearson’s correlation coefficient) and Cronbach’s α. Results: The final draft had 44 questions; 5 items related to perceived sensitivity, 6 items related to perceived severity, 8 items related to perceived benefits, 8 items related to perceived barriers, 8 items related to cues of action, and 9 items related to self-efficacy. Cronbach’s α for the overall scale was 0.87, and the Pearson correlation coefficient was 0.86. Conclusion: The designed HBM-based tool has acceptable validity and reliability for measuring preventive behaviors against COVID-19 in pregnant women in Iran. It can be used in other relevant studies. Further similar studies in Iran during the COVID-19 pandemic are needed.

Effect of continuity of team midwifery care on maternal and neonatal outcomes: a quasi-experimental study in Iran

Midwife-led continuity of care models have been linked to better clinical outcomes in certain developed countries. However, there is a paucity of research on these models in developing nations. This quasi-experimental study was conducted on primiparous women who referred to one private midwifery center and two public hospitals in Ahvaz, Iran to evaluate the effect of team midwifery care on maternal and neonatal outcomes of pregnant women in Iran. Two hundred women were allocated either into the experimental (n = 100) or control (n = 100) groups. Women in the experimental group, received team midwifery care, while women in the control group, received routine care. Data were collected using a demographic questionnaire, Mackey questionnaire, and a checklist. Women in the team midwifery care group experienced significantly higher rates of normal vaginal birth and exclusive breastfeeding compared to women in the control group. No statistically significant difference was observed between the two groups in terms of the rate of induction of labor and postpartum hemorrhage. The duration of labor was longer in the team midwifery care compared to the control group. Women in the team midwifery care group had a significantly higher rate of exclusive breastfeeding at six weeks postpartum compared to the control group (80 vs. 61%, p = 0.001). After excluding women with ruptured membranes and prolonged pregnancies, neonates in the intervention group had significantly higher first- and fifth-minute Apgar scores (p < 0.0001), and a lower rate of admission to intensive care unit in the intervention group compared to the control group (1 vs. 9%, p = 0.04). Also, women in the team midwifery group had skin-to-skin contact significantly earlier than those in the control group (33.87 ± 66.26 min vs. 111.98 ± 247.31 min, p = 0.578). Given the positive impact of continuous team midwifery care on maternal and neonatal outcomes, its implementation in maternity care systems, particularly in countries like Iran with high cesarean section rates, is strongly recommended.

Predictors of tobacco use among pregnant women: a large-scale, retrospective study

ObjectiveTo investigate the predictors of smoking among pregnant women in Iran, focusing on health literacy and associated socioeconomic factors.MethodsThis retrospective cohort study included 103,042 pregnant women aged 18–45 years who attended healthcare centers affiliated with Mashhad University of Medical Sciences for routine prenatal and postnatal checkups between 2017 and 2020. Data were collected from the Sina Electronic Health Record System (SinaEHR®), which recorded sociodemographic characteristics, medical history, and lifestyle behaviors, including tobacco use.ResultsSmoking prevalence was 0.9%. Women with undergraduate or higher education had significantly lower odds of smoking (OR = 0.36; 95% CI = 0.28–0.47) compared to those with primary education or less. Maternal age was marginally associated with increased smoking risk (OR = 1.01; 95% CI = 1.00-1.03). While unemployment showed an increased crude risk for smoking, this was not significant after adjustment (adjusted OR = 1.02; 95% CI = 0.86–1.21). Strong associations were found between tobacco use and alcohol consumption (OR = 46.3; 95% CI = 24.8–83.4) and opium addiction (OR = 23.4; 95% CI = 14.5–36.3). Chronic disease history also increased smoking odds (OR = 1.51; 95% CI = 1.17–1.92).ConclusionLower education, substance use, and chronic disease are significant predictors of smoking among pregnant women in Iran. Targeted interventions to improve health literacy and address these factors are essential to reduce tobacco use during pregnancy.

Risk factors for postpartum readmission: a prediction model in Iranian pregnant women

BackgroundPostpartum readmissions (PPRs) are an important indicator of maternal postpartum complications and the quality of medical services and are important for reducing medical costs. The present study aimed to investigate the risk factors affecting readmission after delivery in Imam Ali Hospital in Amol, Iran.MethodsThis retrospective cohort study was conducted on the mothers who were readmitted after delivery within 30 days, at Imam Ali Hospital (2019–2023). The demographic and obstetrics characteristics were identified through the registry system. Univariate and multivariate logistic regressions with odds ratios (ORs) and 95% CIs were carried out. To identify the most important variables by machine learning methods, a random forest model was used. The data were analyzed using SPSS 22 software and R (4.1.3) at a significant level of 0.05.ResultsAmong 13,983 deliveries 164 (1.2%) had readmission after delivery. The most prevalent cause of readmission after delivery was infection (59.7%). The chance of readmission for women who underwent elective cesarean section and women who experienced labor pain onset by induction of labor was twice and 1.5 times greater than that among women who experienced spontaneous labor pain, respectively. Women with pregnancy complications had more than 2 times the chance of readmission. Cesarean section increased the chance of readmission by 2.69 times compared to normal vaginal delivery.ConclusionThe method of labor pain onset, mode of delivery, and complications during pregnancy were the most important factors related to readmission after childbirth.

Food Insecurity among Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

Estimating the prevalence of food insecurity among vulnerable sub-groups, especially pregnant women, is significant. This study aimed to estimate the pooled prevalence of food insecurity among Iranian pregnant women and to determine its related factors. This study constitutes a systematic review and meta-analysis of cross-sectional studies involving pregnant women, published between January 2000 and September 2022, in English and Persian on seven databases. Finally, 14 studies were analyzed and synthesized, with the results presented in the form of forest plots. Heterogeneity was investigated using the I2 index and the meta-regression to evaluate variables suspected of causing heterogeneity. Statistical analysis and synthesis were performed using Stata-16. The pooled prevalence of food insecurity among Iranian pregnant women was 45% (95% confidence interval: 37-54%). In a multi-variable meta-regression model, p values were significant for the year of data collection and the type of the questionnaire. The adjusted I2 and R2 indices were estimated at 84.47 and 51.46%, respectively. The prevalence of food insecurity among Iranian pregnant women has been estimated at half a million. Given the high prevalence of food insecurity among pregnant women in Iran, we propose the inclusion of food insecurity screening for this vulnerable demographic within the primary healthcare package. Additionally, we advocate for the allocation of food subsidies to pregnant women confronting food insecurity.

Factors effecting on health-promoting behaviors in iranian pregnant women and their husbands: the actor-partner interdependence model (APIM)

IntroductionPregnancy is an important period of life for women and their husbands as the couple’s health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM).Materials and methodsThis descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier’s Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker’s Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM.ResultsThe pregnant women’s marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491–0.998, p < 0.001) and their husbands’ (β = 0.210, 95% Cl: 0.030–0.726, p = 0.048). Pregnant woman’s depressive symptoms also negatively affected their health-promoting behaviors (β=-0.088, 95% Cl: -0.974–0.074, P = 0.236) and their husbands’ health-promoting behaviors (β=-0.177, 95% Cl: -0.281 – -0.975, P = 0.011). Furthermore, the husband’s marital adjustment only positively affected his studied behaviors (β = 0.323, 95% Cl: 0.0303–0.895, P < 0.001) but did not affect the pregnant woman’s health behaviors. The husband’s depressive symptoms had a negative impact on his studied behaviors (β = 0.219, 95% Cl: -0.122 – -0.917, P = 0.001) and did not affect the pregnant woman’s depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman’s marital adjustment scores positively affected her studied behaviors and her husband (β = 0.071, 95% Cl: 0.042–0.278, P = 0.015) by decreasing her depression score. Therefore, the husband’s marital adjustment score positively affected his studied behaviors by decreasing his depression score (β = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife’s health-promoting behaviors.Discussion and conclusionThese findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands’ symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.

Prevalence of Group B Streptococcus Colonization in Pregnant Women in Iran: A Systematic Review and Meta-Analysis

Introduction: Group B Streptococcus (GBS) or Streptococcus agalactiae is one of the main causes of invasive infections such as meningitis and septicemia in infants. Genital colonization with group B streptococci has been related to increased risk of premature delivery, and premature infants are at greater risk of disease. There is limited information about the prevalence of rectovaginal GBS colonization in pregnant women in Iran. The aim of the present study was investigating the prevalence of group B streptococcus colonization in pregnant women in Iran. Methods: Information of this study was attained by searching on databases including PubMed, Google Scholar, Scopus, Web of Science and SID using relevant keywords and without time limit. Then, the studies containing the inclusion criteria were reviewed. The data were analyzed using Comprehensive MetaAnalysis software (Biostat V3). Heterogeneity between studies was investigated with the I2 index and based on the results of heterogeneity, the random effect model was implemented in order to determine the prevalence of GBS in pregnant women. Results: Out of 231 articles, 15 articles were included in the study. The analysis of 15 studies showed that the prevalence of GBS in Iranian pregnant women was 12.2% (95% CI: 9.9-15.1). Conclusion: In order to prevent the invasive neonatal disease, screening for GBS colonization is recommended for pregnant women in 35–37 weeks of gestation. Regarding the lack of preventive strategies for GBS infections in Iran, national guidelines should be established to guide the obstetricians, midwives, and nurses on the prevention of GBS infections.

Mental health and its relationship with quality of life in pregnant Iranian women with a history of primary infertility

Introduction: Considering the relatively high prevalence of infertility and its numerous psycho-social problems, the present study was conducted with the aim of investigating stress, depression, and anxiety and their relationship with the quality of life in pregnant women with a history of primary infertility. Method: This descriptive-analytical cross-sectional study was conducted on 120 pregnant women with a history of primary infertility who referred to the infertility clinic of Al-Zahra Hospital in Tabriz. Eligible participants were selected using a convenient sampling method. Data were collected using an individual-social questionnaire, the Cohen's Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Vandenberg's Pregnancy-Related Anxiety Questionnaire, and Quality of Life Gravidarum. Data analysis was done in SPSS24 software using Pearson and Spearman correlation tests, independent t-test, one-way ANOVA, and multivariate linear regression. Results: The median (percentile 25-75) of perceived stress score in mothers was 44.0 (40.2-46.0). The mean±standard deviation scores of anxiety, depression, and quality of life were 66.1±11.4 (score range: 17-119), 16.3±3.2 (score range: 0-30), and 32.3±5.2 (score range: 9-63), respectively. There was no significant correlation between perceived stress and depression and quality of life; however, a significant negative correlation was observed between anxiety and quality of life. Conclusion: The results of the present study indicated a decrease in mental health in pregnant women following primary infertility. Moreover, anxiety scores had a significant and inverse correlation with quality of life. Therefore, it seems necessary to provide programs to improve the mental health of these women along with routine pregnancy care by health care providers.

Design and psychometric evaluation of organizational determinants of prenatal dental services questionnaire in Iran.

The quality of prenatal dental services is essential for improving the oral health of both mothers and children. However, a lack of a reliable tool to assess the quality of prenatal oral care has hindered research in this area. To address this gap, the study aimed to validate the Organizational Determinants of Prenatal Dental Services Questionnaire (OD_PDS) in Iranian pregnant women. Literature reviews, interviews, and a cross-sectional survey with 300 pregnant women were conducted. To evaluate the validity; face, content and construct validity were assessed. Cronbach's alpha coefficient and the Test-retest method were used for reliability assessment. The final version of the OD_PDS comprises 12 items, and four subscales, which are Costs (four items), Access to Equipment and services (three items), Review of the service delivery process (two items), and Professional Behavior (three items). Questions with a factor loading of less than 0.3 were excluded. The obtained fit indices were acceptable (X2/pdf=3.383, RMSEA: 0.089, CFI=0.869, and TLI=0.820). The content reliability was demonstrated by Cronbach's α =0.702 and 0.713 and the ICC = 0.724. The current study indicates that the OD_PDS is a valid and reliable tool for Prenatal Dental Services assessment in health centers.

Determinants of Non-Acceptance of the COVID-19 Vaccine During Pregnancy in Pregnant and Postpartum Women: A Descriptive Cross-Sectional Study.

The rate of COVID-19 vaccination hesitation among Iranian pregnant women is around 50%. The objective of the present study was to determine the reasons for the refusal of COVID-19 vaccination among pregnant and postpartum women. This descriptive cross-sectional study was performed on 304 pregnant and postpartum women in the comprehensive health centers of Yazd, Iran, between October 2022 and April 2023. Researchers collected the data of unvaccinated women through phone calls using a validated questionnaire. Data was collected using a questionnaire consisting of baseline characteristics and reasons for refusing vaccination. Descriptive statistics were used to analyze the data using SPSS version 22. The mean age of the pregnant and postpartum women participating in this study was 28.31 ± 6.47 years. The most common reasons for refusing the COVID-19 vaccine included fear of harming the fetus (32.2%), fear of side effects in the mother (25.7%), disbelief in COVID-19 disease and vaccine (13.8%), lack of information about the vaccine (12.8%), and negative opinions of the media and society (12.8%). Less common reasons included husband's disagreement (8.2%), history of COVID-19 infection (6.9%), gynecologists' disagreement (6.3%), history of infertility (5.9%), and underlying disease (3.3%). Astonishingly, among participants who did not inject a booster dose of the vaccine, 76% reported they didn't receive any training and recommendation on booster dose injection from health providers. Findings highlight that the most common reasons for refusing the COVID-19 vaccine were fear of harming the fetus and fear of side effects in the mother.

Seroprevalence of Measles and Rubella IgG Antibodies in Children and Pregnant Women in Iran

Background: Complete immunization against Rubella and Measles (MR) in pediatrics is achieved using 2 doses of the Measles, Mumps, and Rubella-containing vaccine (MMR) in Iran at 12 and 18 months of age, where more than 95% of children under 5 years of age are vaccinated. Antibody waning in mothers and older children, and genetic diversity in immune responses may render them susceptible to infections. Objectives: This study aimed to investigate the diversity in immunoglobulin G (IgG) antibody levels against these two viruses in pregnant women, infants younger than 2 months, children at 6, 12, and 18 months, and 5 - 6 years of age in Iran. Methods: This study was conducted on serum specimens sent to the National Reference Laboratory for Measles and Rubella in Tehran, Iran, from children under 2 months (n: 50), 6 (n: 54), 12 (n: 54), and 18 (n: 39) months, and 5 - 6 years old (n: 49), as well as women at 37 weeks of pregnancy (n: 53), from May to December 2020. Rubella and Measles-specific IgG were measured using an enzyme-linked immunosorbent assay kit. Results: Among serum samples from different provinces of Iran, the lowest positive level of Measles IgG was observed in children aged 6 and 12 months (7.41%), while the highest positive level was found in children aged 18 months (84.62%). For Rubella, the lowest IgG-positive level was seen in children aged 11 - 13 months (11.11%), while the highest positive level was observed in the 5 - 6 years old group (83.67%). Antibody levels against measles and rubella were higher in pregnant women than in children. Conclusions: Measles and Rubella antibody titers were lower in children 12 months before vaccination and reached a positive level in children aged 18 months post-vaccination. Whereas, lower Measles IgG levels in 5 - 6 years old children compared to 18 months old children may be due to waning antibodies. Pregnant women exhibited high levels of protection against these viruses (more than 80% had positive rubella IgG), as anticipated from outcomes of the national vaccination program in 2004.

Relationship of domestic violence with pregnancy symptoms and pregnancy experience in Iranian pregnant women: a cross-sectional study

ObjectiveViolence has had adverse effects on the physical and psychological dimensions of pregnant women. This study was conducted with the aim of determining the relationship of domestic violence with pregnancy...

Health Literacy and Care Behaviors Among Iranian Pregnant Women: A Systematic Review

Background: Prenatal care and care behaviors can affect pregnancy outcomes. In this regard, it is crucial to identify the variables that can influence the care behaviors of pregnant women. The literature review reveals that extensive research has been conducted on the association between health literacy and care behaviors among pregnant women in Iran. However, these studies have not yet been evaluated and summarized comprehensively. Consequently, the present study aimed to investigate the impact of health literacy on care behaviors in pregnant women in Iran. Methods: This systematic review encompassed a comprehensive search of various English-language databases, including Pub Med, Scopus, Web of Science, Google Scholar, and ProQuest. The search was conducted using MESH keywords related to health literacy, along with other relevant keywords. Furthermore, Persian language databases, namely SID, Magiran, and Irandoc, were searched using the appropriate keywords. The collected data were subjected to qualitative analysis. Results: Finally, 19 articles were included. The findings showed that pregnant women with higher levels of health literacy exhibited improved adherence to various care behaviors. These behaviors included following a nutritious diet, using recommended supplements, practicing preventive measures for urinary infections, initiating prenatal care promptly, and maintaining good oral and dental hygiene. Conclusion: Health literacy is a significant factor influencing care behaviors during pregnancy. Therefore, it is recommended to incorporate health literacy as a crucial consideration when designing interventions aimed at enhancing care behaviors among pregnant women.

Background Characteristics and Cognitive Factors as Determinants of Oral Health in Pregnant Women, Tehran, Iran: A Cross-Sectional Study.

Objectives: Pregnancy can lead to oral health issues, yet many women remain unaware of the potential negative impact on their pregnancy. This study aimed to assess the dental and periodontal health of pregnant women in Tehran, Iran, and identify its associated factors. Materials and Methods: A cross-sectional study was conducted with 221 pregnant women attending 12 randomly selected public health centers in Tehran, Iran. A self-administered questionnaire gathered data on background characteristics, oral health knowledge, and self-reported health. Periodontal status, oral hygiene, and dental health were assessed using bleeding on probing (BOP), simplified oral health (OHI-S), and decayed-missing-filled teeth (DMFT) indices. Statistical analysis included simple and multiple linear regression (P<0.05). Results: The participants' ages ranged from 18 to 42 years (mean: 27.9 years, SD: 5.5). On average, participants scored 4.1 out of 11 (SD: 1.7) for general oral health knowledge and 1.62 out of 4 (SD: 0.9) for knowledge about oral health during pregnancy. The mean DMFT was 8.28 (SD: 5.7), with 65.6% of women having fair oral hygiene according to the OHI-S. Participants reporting poor general health had more debris (B: 0.276, P=0.043), while those with higher general oral health knowledge had fewer missing teeth (B: -0.183, P=0.048). Conclusion: Despite partial free oral health care provided to pregnant women in Iran, the dental and periodontal conditions of the participants were unsatisfactory. Implementing motivational educational programs within the primary health care system could be instrumental in improving the oral health of pregnant mothers.

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

BackgroundBeing obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery.MethodsIn this study Pregnant women (< 14 weeks’ gestation) (n = 38 per group) are recruited either from one of the obesity clinic (exposure group = with a history of bariatric surgery) or primary healthcare clinics in Tehran city (comparison group = pregnant women with obesity and and no history of bariatric surgery). Dietary intake and nutrient status are assessed at < 14, 28, and 36 weeks. Maternal and fetal/neonatal outcomes are compared between the two groups, including gestational diabetes, preeclampsia, preterm labor, intrauterine growth restriction, severe nausea and vomiting, abortion, placenta previa and abruption, venous thrombosis, vaginal bleeding, cesarean delivery, meconium aspiration, and respiratory distress. Maternal serum levels of ferritin, albumin, zinc, calcium, magnesium, selenium, copper, vitamins A, B9, B12, and 25-hydroxy Vit D are checked during 24th to 28th weeks. Maternal and neonatal outcomes, including height, weight, head circumference, fetal abnormality, infection, small or large fetus, low birth weight, macrosomia, NICU admission, and total weight gain during pregnancy, are measured at birth. Maternal and offspring outcomes, including weight, height, head circumference, total weight gain during pregnancy, newborn diseases, postpartum bleeding, breastfeeding, and related problems, are assessed 6 weeks after delivery. Child's weight, height, and head circumference are followed at 2, 4, 6, 8, 10, and 12 months after birth. Maternal stress, anxiety, and depression are assessed with the DASS-21 questionnaire, and physical activity is evaluated using the PPAQ questionnaire in the first and third trimesters.DiscussionBy assessing the levels of micronutrients in the blood of pregnant women along with the evaluation of pregnancy outcomes, it is feasible to gain a more accurate understanding of how bariatric surgery affects the health and potential complications for both the mother and the fetus/newborn. This information can help specialists and patients make more informed decisions about the surgery. Additionally, by examining issues such as stress, anxiety, and depression in women undergoing surgery, this study can contribute to recognizing these problems, which can also affect pregnancy outcomes.

Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study

ObjectivesThis study aimed to gain a comprehensive understanding of the determinants that influence oral healthcare behaviours among Iranian pregnant women.Study designQualitative study.SettingComprehensive health service centres.ParticipantsA sample consisting of all people...

Introducing an Antenatal Care Electronic Health System for Low and Middle Income Countries: A Cross-Sectional Study on 1217 Iranian Pregnant Women.

Maternal health care is one of the main challenges worldwide, especially in low- and middle-income countries (LMICs) such as Iran. In this cross-sectional study, we introduce an electronic health software for maternal care that is active under the supervision of the Valiasr Reproductive Health Research Center of Tehran University of Medical Sciences in providing maternal health education to Iranian pregnant women. In addition to describing the details of this open-source software and encouraging LMICs health policymakers to develop such software, this manuscript also provides a cross-sectional report and statistical analysis on anonymous Iranian pregnant women who registered in this system. Since 2015, we have launched an electronic health software in Iran called "niniMED Pregnancy Calendar" in Persian. This system has multiple educational and motivational features for pregnant women, including momentary weight recommendations based on pregnancy week and recommended dates for common tests during pregnancy according to the first day of the last menstrual period in Jalali calendar format. Additionally, we measured user satisfaction with this system using a questionnaire. From 2015 to 2017, 1,217 anonymous Iranian pregnant women registered in this system. The average age of pregnant Iranian women was 30.67 years (30 years and 8 months). Users had a body mass index (BMI) of 24.68 kg.m-2, which had a significant direct relationship with their gestational age (P=5.81e-05) and indicated an improvement in appropriate weight for Iranian women compared to previous studies. We showed that there was a significant direct relationship between the age of Iranian pregnant women and the likelihood of a high-risk pregnancy (P=0.008). We also observed a significant inverse relationship between pregnancy week and their tendency to receive pregnancy-related education (P=0.018). Finally, we found that more than 88% of pregnant Iranian women assessed membership in such systems as completely useful for pregnancy. The development of such electronic health systems for informing pregnant women can provide low-cost maternal education to LMICs pregnant women and potentially assist in managing weight gain during pregnancy and reducing associated risks. It can also be widely accepted by pregnant women.

Transplacental Transfer Efficiency of SARS-CoV-2-Specific IgG Antibodies in Iranian Seropositive Mothers: A Monocentric Study in Karaj, Iran

Background: Passively acquired maternal antibodies through the placenta and/or breastfeeding may protect neonates against SARS-CoV-2 before they are considered eligible for active immunization. Objectives: This study aimed to determine the concentration and correlation of maternal and cord blood anti-SARS-CoV-2 IgG antibodies in Iranian seropositive women. In this preliminary study, attempts were also made to assess the effects of some variables on the transplacental transfer efficiency. Methods: From September 2021 to November 2021, pregnant women presenting to Kamali Hospital in Karaj, Iran, were enrolled in this monocentric study. The maternal and neonatal demographic characteristics were collected. The maternal and cord blood spike protein-specific antibody levels, measured at delivery (119 paired samples), were evaluated by the enzyme-linked immunosorbent assay (ELISA). Results: Based on the transplacental antibody transfer ratios, the participants were divided into 2 groups: Transfer ratio ≤ 1 (n = 53) and transfer ratio &gt; 1 (n = 66). The results revealed that anti-SARS-CoV-2 IgG antibodies were transferred across the placenta in all seropositive pregnant Iranian women, and a significant correlation was found between maternal and cord blood-specific IgG antibody levels (r = 0.9646; P &lt; 0.05). A relatively efficient transplacental transfer ratio was observed in Iranian seropositive women (transfer ratio &gt; 1 in 66 out of 119 individuals; 55.46%). Although there were significant differences in the transplacental transfer ratio regarding the neonatal birth weight and maternal body mass index (BMI), more extensive investigations with a larger sample size are needed to confirm the significant association of these variables with the transplacental transfer efficiency of specific SARS-CoV-2 IgG antibodies. Conclusions: The present study highlighted the importance of vaccination during pregnancy to improve neonatal immune responses against SARS-CoV-2.

Knowledge, Perceptions and Desire to Pain Relief in Labor among Iranian Pregnant Women

Background: One way to promote vaginal delivery and reduce unnecessary caesarean section, is paying attention to labor pain relief techniques. The aim was to investigate factors affecting the desire of pregnant women for painless delivery. Methods: This descriptive study was conducted on 325 pregnant women who referred to prenatal clinics in 2020 and met the inclusion criteria. Data were collected using researcher-made questionnaire on painless delivery. Data analysis was performed using SPSS v.21. Results: Most of respondents (74%) were between 20-29 years old. 19.69% of participants were nulliparous and 62.76% had diploma. 72% were housewives. 56.61% of the participants had not enough information about pain relief in labor. Only 14 people of whom had information, (9.92%) desired to experience pain relief in labor. Many of the respondents 90.76% were worry about the effects of pain relief on their unborn. 44.68% of participants, who had information about pain relief in labor; got their information regarding the pain relief in labor internet sources. Conclusions: Due to the low level of awareness of pregnant women to use painless delivery and labor pain relief techniques, it is recommended that the necessary measures be taken in order to increase women’s knowledge of the benefits and limitations of painless delivery. Plain language summary: Labor pain is the most painful experience in many women’s lives. It causes a large number of unnecessary cesareans. There are different kinds of pain relief methods. However, it is used a little. This study investigated the information, attitude and tendency to pain relief in labor among pregnant women. It was declared that participants have a few information. They were unwilling to use pain relief methods duo to their probable side effects. So it is felt educational sessions about painless delivery during prenatal care.