Prevalence and Predictors of Cesarean Section in Zanjan-Iran during 2014-2016

Background: The increased prevalence of cesarean section (C–section) is a global epidemic. Objectives: The aim of this study was to determine the prevalence and demographic, fertility, and childbirth-related factors of C–section in Zanjan province, Iran,-from 21 March 2014 to 19 March 2016. Methods: This study was a descriptive analytic study, carried out in 2014–2016, which gathered 41, 265 registered childbirth data in Zanjan province hospitals and from country electronic childbirth register system. Data were analyzed using descriptive, univariate and multivariate logistic binominal regression. Results: according to the findings, the prevalence of C–section was 40.1%. The odds of having C–section went up with increasing maternal age (OR=1.026), gravidity (OR=0.670), and gestational age (OR=0.093), while it decreased with an increased parity, end educational level up to high school graduate. In contrast, higher educational (OR=3.064) level increased the odds of having C–section. Living in the urban areas (OR=1.855) also increased the oddsof C–section. Diabetes (OR=1.990), preeclampsia or eclampsia (OR=2.350), hypertension (OR=1.983), and thyroid disorders (OR=2.289) increased the odds of having C–section. Newborns with low birth weight (OR=1) and macrosomia (OR=2.663), and boys (OR=1.107) were delivered more via C–section. Among the interventions during labor, induction (OR=1.131) and stimulation of labor (OR=0.269) reduced the odds of C–section (P<0.05). Conclusion: C–section rate is very high in Iran and its association with different variables can be a basis for planning and policymaking in order to reduce the C–section rate, particularly in Zanjan province

Prevalence of unplanned pregnancy and factors related to maternal-fetal attachment in Zanjan, 2017

Background: Despite the progress of family planning programs, a significant proportion of pregnancies are still unplanned which threatens the different dimensions of community health. Unplanned pregnancy affects parent's-child association. Maternal-fetal attachment provides a model for the child's mental-social function at present and in the future. Objectives: This study was conducted to determine the prevalence of unplanned pregnancy and related factors of maternal-fetal attachment in pregnant women referring to Zanjan health centers in 2017. Methods: This descriptive correlational study was part of a clinical trial that was performed on 184 pregnant women who referred to health centers for routine prenatal care from October to February 2017 in Zanjan, Iran. Using multi-stage sampling method, health centers of Zanjan were divided into three categories based on social and economic situation. Then, from each category, three centers were selected, randomly. The inclusion criteria comprised being pregnant, satisfaction to participate in the study, have at least reading and writing skills, lack of the history of obstetric complications, psychological disease and medicine use, lack of known psychological disease, lack of narcotic substances abuse, and living in Zanjan City. Data collection tool included demographic checklists and maternal-fetal attachment questionnaire, which completed in self-report method. The data of this study were analyzed by appropriate statistical tests by SPSS v.16 software. Results: Among the participants 58.2% of women had planned pregnancy, 36.4% had unplanned pregnancy, and 5.4% had unwanted pregnancy. Maternal-fetal attachment scores were significantly higher in the planned pregnancy group 84(75-93) than the unplanned pregnancy group 57(54-60) and unwanted pregnancy group 56(48-64) (P˂0.001). The highest sub-scale in the planned pregnancy group was related to the attributing characteristics and intentions. Also, the most subscale in unplanned and unwanted pregnancies related to giving of self. There was a significant relationship between age, education, socioeconomic level, number of pregnancies, number of children and contraceptive method with type of pregnancy (P˂0.001). Conclusion: Based on the results of the study, it seems that reduction in unplanned pregnancy will enhance the maternal-fetal attachment and will improve the mother role and social-psychological health of the chil

Reproductive variables and Correlation between Irrational Parenthood Cognition and Destructive Behaviors of Marital Relationship in Infertile Women

Background: Reproductive variables may play an important role on the correlation between irrational parenthood cognition (IPC) and destructive behaviors of infertile couple. Objectives: The aim of this study was to determine the correlation between IPC and destructive behaviors by reproductive variables in primary infertile women. Methods: The study was descriptive-analytic. 183 cases of primary infertile women living in Zanjan-Iran and attended to the Infertility Clinic in Ayatollah Mousavi Hospital were investigated from 2015 to the end of 2016. The instrument included a three-part questionnaire of individual and reproductive information, IPC, and the destructive behaviors of marital relationship based on Glaser's choice theory. Data were analyzed by SPSS software using descriptive and Pearson correlation test (P<0.05). Results: There was a significant direct correlation between IPC and destructive behaviors of marital relationship in infertile women (r=0.47, p<0.001). Based on reproductive variables, the highest correlation was observed in the subgroups of less than 10 years elapsed from the diagnosis of infertility, less than 10 years from the onset of infertility treatment, and the expectation of pregnancy under 10 years, a history of twice unsuccessful in vitro fertilization, a tendency to pregnancy due to the pressure of the others and the cause of the unknown infertility (P<0.05). Correlation between IPC and all components of destructive behaviors was significant (p<0.001). Conclusion: Identifying infertile women with high IPC and destructive behaviors is important to educate regarding life skills and provide counseling services

Relationship between social support with anxiety, depression, and stress in pregnant women attending to health care centers in Zanjan-Iran in 2015-2016

Background: Pregnancy is associated with many emotional, physical, and social changes in women’s lives which may have an effect on the outcomes of pregnancy, so identifying moderating factors such as social support may have a preventing role on unintended outcomes of pregnancy. Objectives: The purpose of this study was to determine the relationships between social support with anxiety, depression, and stress in pregnant women. Methods: In this correlational study 249 pregnant women attending to health care centers in Zanjan-Iran, during 2015-2016 were selected using a multi-stage sampling method. Data was collected using three questionnaires including demographic characteristics, Wax social support (social support ftom family, friends, and others) and DASS-21 scale. The data were analyzed using descriptive and inferential statistics with SPSS software version 16. Results: The average age of the participants were 27.57±5.56 years. The average of total perceived social support of pregnant women was 77.42±10.66, among which the most perceived social support was from the family (29.04%). Data analyses revealed weak negative and significant relationship between total social support and depression (r=-0.17) and stress (-0.13), as well as between social support from others and depression (r=-0.14) in pregnant women (P<0.05). Conclusion: Although, in this study pregnant women received the most social support from the family, only a weak relationship was found between the total score of social support and social support by others with depression and stress. Therefore, it is recommended that more research be done on the type of social support of Azari pregnant wome

The effect of solution-focused counseling on violence rate and quality of life of pregnant women at risk of domestic violence: a randomized controlled trial

Background: Domestic violence during pregnancy as one of the most common social problems and major challenges of health systems can affect the health of the mother and fetus. The study aimed to compare the two groups of intervention based on solution-focused counseling and control in terms of violence and quality of life amounts in women who had experienced domestic violence. Methods: A randomized controlled trial on 90 pregnant women was blocked into two intervention groups (n = 45) and a control (n = 45). The intervention group received six counseling sessions with a solution-focused approach. Study tool included conflict tactics scale (CTS- 2) and short form health survey (SF-36). The tools were completed once before the intervention and again 6 weeks after the end of the counseling sessions by the participants of both groups. The P-value less than 0.05 was considered statistically significant. Results: A total of 82/90 pregnant women were analyzed. The results showed that median and interquartile range (IQR) of physical, psychological and sexual violence significantly decreased in the intervention group than the control group (Ps = 0.001). Moreover, quality of life scores significantly improved in the intervention group compared to the control group (P = 0.001). Conclusion: Solution-focused counseling could be an effective approach to reduce the amount of violence and increase the quality of life in women exposed to domestic violence. Trial registration: Iranian Registry of Clinical Trials IRCT2017040628352N4. Date of registration: August 20th 2017. © 2021, The Author(s)

Sexual Function and Sexual Behavior in Women with Breast Cancer Having Sexual Distress, Zanjan, Iran

Background: Sexual relationships of women with breast cancer are affected by diagnostic and therapeutic procedures. Objectives: The aim of this study was to assess sexual function and sexual behavior in women with breast cancer having sexual distress in Zanjan in 2015-2016. Methods: This cross sectional study was part of a larger study, which was performed on 75 women with breast cancer in the oncology clinic of Valiasr hospital and Mehraneh charity clinic. Sampling was based on a purposeful approach. Data were collected using a demographic questionnaire, Sexual Function Questionnaire (FSFI), and indigenous sexual behavior questionnaire in women of reproductive age (SBQ). Data were analyzed using the Chi-squared and Spearman-Pearson tests. Results: A majority of the women (77.3%) had an undesirable sexual function and orgasm dysfunction (65.3%). Besides, it was found that the majority of women had low to moderate sexual behavior. The correlational analyses related to sexual function and sexual behavior and their sub-scales showed that there was only a significant positive relationship between the sexual capacity subscale and the total sexual function scale (P<0.005). Conclusion: Women with breast cancer had sexual dysfunction and behavior. Designing and implementing related counseling programs may help to reduce sexual distress, improve sexual function and marital satisfaction, and enhance the quality of life of affected women

Targeted Gene Panel Sequencing for Early-onset Inflammatory Bowel Disease and Chronic Diarrhea

Background: In contrast to adult-onset inflammatory bowel disease (IBD), where many genetic loci have been shown to be involved in complex disease etiology, early-onset IBD (eoIBD) and associated syndromes can sometimes present as monogenic conditions. As a result, the clinical phenotype and ideal disease management in these patients often differ from those in adult-onset IBD. However, due to high costs and the complexity of data analysis, high-throughput screening for genetic causes has not yet become a standard part of the diagnostic work-up of eoIBD patients. Methods: We selected 28 genes of interest associated with monogenic IBD and performed targeted panel sequencing in 71 patients diagnosed with eoIBD or early-onset chronic diarrhea to detect causative variants. We compared these results to whole-exome sequencing (WES) data available for 25 of these patients. Results: Target coverage was significantly higher in the targeted gene panel approach compared with WES, whereas the cost of the panel was considerably lower (approximately 25% of WES). Disease-causing variants affecting protein function were identified in 5 patients (7%), located in genes of the IL10 signaling pathway (3), WAS (1), and DKC1 (1). The functional effects of 8 candidate variants in 5 additional patients (7%) are under further investigation. WES did not identify additional causative mutations in 25 patients. Conclusions: Targeted gene panel sequencing is a fast and effective screening method for monogenic causes of eoIBD that should be routinely established in national referral centers.info:eu-repo/semantics/publishedVersio