Correlation between Body Mass Index and Central Adiposity with Pregnancy Complications in Pregnant Women

Background: The prevalence of obesity is increasing throughout the world. Obesity assessed by body mass index (BMI) has shown to be associated with gestational complications while the relationship using waist circumference (WC) is not clear yet. The present study was aimed to determine the relationship be-tween WC and adverse pregnancy complications.Methods: In this prospective cohort study, 1140 nulliparous pregnant women at 1st trimester of pregnancy referred to health care centers in Tabriz, Iran were enrolled in 2009-2010. Anthropometric indexes including (weight, height and WC) were measured using standardized measures and methods. BMI was clas-sified into normal, overweight and obesity based on WHO classification. Ab-dominal obesity was defined as WC ≥ 88 cm. Pregnancy complication including gestational diabetes, hypertension and preeclamsia. Data were analyzed using SPSS, version 16.Results: Mean of BMI and WC were 24.32±4.08 kg/m2, 81.84±9.25cm at 1st trimester of pregnancy, respectively. Prevalence of overweight (BMI=25-29.9 kg/m2) and obesity (BMI>29.9 kg/m2) was 27.6%, 8.8%, respectively. Abdo-minal obesity based on WC was 34.8%. Significant correlations were found between BMI and WC (r=0.73, P =0.0001). Women with BMI>29.9 kg/m2 and WC>88 cm were more likely to suffer from gestational pregnancy and hyper-tension, as well as preeclampsia and preterm delivery.Conclusion: Early maternal WC similar to BMI is related with pregnancy complications

The Effect of Educational Interventions on Sexual Behavior and Reproductive Health of Women: A Systematic Review

AbstractIntroduction: Reproductive and sexual health and its dimensions are important aspects of health in human life and the World Health Organization emphasizes to promote these section health indexes. Since a review study has not been conducted to identify an appropriate approach for intervention in this field. Therefore, this study was conducted with the aim of systematically reviewing the impact of educational and counseling interventions on sexual function of women.Methods: A comprehensive electronic search was carried out with no time limit until 6 August 2022. All published studies with inclusion criteria by 2021 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, Pubmed, Scopus, SID, and Magiran. The literature search was performed using PRISMA instructions. Cochrane Quality Assessment Scale [adapted for evaluating RCT, interventional studies] was used to evaluate the quality of the articles.Results: From a total of 93 articles obtained from the search in databases, by removing duplicate titles and checking the titles and summaries of the articles, 40 articles were obtained, and finally, after the final review of the full text of the articles, 21 articles were included in the present review. Due to the variety of interventional types in the studies, it was not possible to categorize counseling approaches. Studies showed that interventions based on sexual education and counseling were effective on the outcomes including marital satisfaction, sexual knowledge, sexual satisfaction, marital relationship quality and sexual performance.Conclusions: Designing a comprehensive educational program with an appropriate approach focusing on various aspects of reproductive and sexual health can be an important role in promoting sexual and reproductive health. Therefore, interventional studies are necessary to identify an appropriate intervention approach to enhance reproductive and sexual literacy of couples

Religion, Spirituality and Coping with Breast Cancer: A Phenomenological Study

For downloading the full-text of this article please click here.Background and Objectives: Breast cancer is the most common cancer among women worldwide and in addition to the physical complications, caused multiple mental and emotional challenges for patients. Present study was performed through phenomenological qualitative approach in a sample of Iranian women to deep exploration and better understanding of coping ways that patients use when face with cancer, with a focus on methods based on religion and spirituality based.Materials and Methods: Data were collected through in-depth semi-structured interviews with 27 eligible patients. Interviews were transcribed and analyzed using Van Manen thematic approach. Data collection and analysis were carried out simultaneously. In addition, Maxqda (Ver10) software was used for data management.Results: The mean age of participants was 50±8.77years, ranging from 32 to 68 years. About 22% of these patients had Lumpectomy (remove part of breast tissue) and others (78%), mastectomy (remove of all breast), respectively. By analyzing and extracting the primary codes from the interviews, the final codes were extracted and divided into 6  sub and 2 conceptual categories, and relation between the conceptual categories led to emerge of the study main theme “Transcendence-oriented effort to adjustment”.Conclusion: Breast cancer patients in this study predominantly employed dynamic processes and coping strategies to deal with the reality of disease that had been formed from their religious and spiritual beliefs. Therefore, it is necessary to health care providers, while maintaining respect for patients and considering their spiritual and religious beliefs, make available religious counseling in order to providing spiritual health promotion for patients.Keywords: Spirituality, Religious Attitudes, Coping, Compatibility, Breast Cancer, PhenomenologyFor downloading the full-text of this article please click here

دین، معنویت و مقابله با سرطان پستان: یک مطالعه‌ی پدیدارشناسی

Background and Objectives: Breast cancer is the most common cancer among women worldwide and in addition to the physical complications, caused multiple mental and emotional challenges for patients. Present study was performed through phenomenological qualitative approach in a sample of Iranian women to deep exploration and better understanding of coping ways that patients use when face with cancer, with a focus on methods based on religion and spirituality based. Materials and Methods: Data were collected through in-depth semi-structured interviews with 27 eligible patients. Interviews were transcribed and analyzed using Van Manen thematic approach. Data collection and analysis were carried out simultaneously. In addition, Maxqda (Ver10) software was used for data management. Results: The mean age of participants was 50±8.77years, ranging from 32 to 68 years. About 22% of these patients had Lumpectomy (remove part of breast tissue) and others (78%), mastectomy (remove of all breast), respectively. By analyzing and extracting the primary codes from the interviews, the final codes were extracted and divided into 6  sub and 2 conceptual categories, and relation between the conceptual categories led to emerge of the study main theme “Transcendence-oriented effort to adjustment”. Conclusion: Breast cancer patients in this study predominantly employed dynamic processes and coping strategies to deal with the reality of disease that had been formed from their religious and spiritual beliefs. Therefore, it is necessary to health care providers, while maintaining respect for patients and considering their spiritual and religious beliefs, make available religious counseling in order to providing spiritual health promotion for patients.سابقه و اهداف: سرطان پستان، شایع­ترین سرطان زنان در سراسر دنیا است و بیماران مبتلا را علاوه بر عارضه­های جسمیِ ناشی از این بیماری، با چالش­های متعدد روانی و عاطفی مواجه می­سازد. به منظور کندوکاوی عمیق برای درک بهتر راه­های مقابله با بیماری در مبتلایان به این سرطان، با تمرکز بر روش­های مبتنی بر مذهب و معنویت، مطالعه­ی حاضر با رویکرد کیفی و پدیدارشناسی بر روی نمونه­یی از زنان ایرانی انجام شد. مواد و روش‌ها: اطلاعات از طریق مصاحبه­ی نیمه ساختاریافته­­ی عمیق با 27 بیمار واجد شرایط جمع­آوری شد. مصاحبه­ها رونویسی شد و با استفاده از رویکرد تحلیل تماتیک ون منن مورد تحلیل قرار گرفت. جمع­آوری و تحلیل داده­ها نیز به­طور هم­زمان انجام یافت. همچنین برای مدیریت داده­ها از نرم­افزار مکس کیو دا (نسخه­ی شماره­ی 10) استفاده شد. یافته‌ها: میانگین سنّی شرکت­کنندگان در پژوهش، 77/8±50 سال بود که آن­ها در دامنه­ی سنّی 32 تا 68 سال بودند. در حدود 22% از این بیماران، لامپکوتومی (برداشتن بخشی از بافت پستان) و دیگران (78%)، ماستکتومی ( برداشتن همه­ی پستان) شده بودند. با بررسی و استخراج کدهای اولیه­ی حاصل از مصاحبه­ها، کدهای نهایی استخراج شد و در شش طبقه­ی فرعی و دو طبقه­ی مفهومی جای گرفت، که ارتباط بین این طبقه­های مفهومی منجر به ظهور درونمایه­ی اصلی مطالعه، به نام «تلاش تعالی­گرایانه برای سازگاری» شد. نتیجه‌گیری: مبتلایان به سرطان پستان در این مطالعه به­طور غالب از فرایندهایی پویا و راهبردهایی مقابله­یی برای کنارآمدن با واقعیت بیماری بهره می­بردند، که شکل­گرفته از آموزه­های مذهبی و باورهای معنوی آن­ها بود. بنابراین، لازم است عرضه کنندگان خدمات سلامت به این بیماران، ضمن حفظ احترام بیماران و در نظر گرفتن اعتقادات و نگرش معنوی و دینی آن­ها، امکان دسترسی به مشاوره­های مذهبی را برای ارتقای سلامت معنوی این دسته از بیماران فراهم سازند. &nbsp

Mother’s own milk versus donor human milk: effects on growth and outcomes in preterm neonates

Introduction: The present study compares the effects of mother’s own milk (MOM) and donor human milk (DM) on anthropometric indices, incidence of sepsis, necrotizing enterocolitis (NEC), and feeding intolerance (FI) among preterm neonates.  Methods: Ninety neonates born at 30-32 weeks and hospitalized in the Neonatal Intensive Care Unit were assigned to 3 groups based on their daily milk intake. The first group received only MOM or < 20% DM, the second group received ≥ 20% to < 80% DM, and the third group received ≥ 80% DM.  Results: Weight gain velocity was 1.5 g/kg/day in the group that received ≥ 80% DM and 6.2 g/kg/day in the group that received 80-100% MOM (without a statistically significant p-value). Furthermore, there was no statistically significant difference in height increase among the 3 groups, and no sepsis or NEC were observed in any of the 3 groups either. The incidence of FI was not significantly different among the 3 groups.  Conclusion: Based on the results, DM is as effective as MOM in preventing sepsis, NEC, and FI. Every effort should be made to educate mothers on this subject, provide breastfeeding support, and use pasteurized and appropriately fortified DM

The effect of mindfulness-based counseling on the childbirth experience of primiparous women: a randomized controlled clinical trial

Abstract Introduction Unpleasant childbirth experience is considered as one of the important factors for cesarean preference. Limited studies have been investigated the impact of psycho-based interventions on the childbirth experience and the most effective counseling approach to promote a pleasant childbirth experience has not been clearly identified. Objective The present study aimed to evaluate the impact of mindfulness-based counseling on the childbirth experience of primiparous women. Methods and materials This randomized controlled clinical trial was conducted on 64 primiparous with gestational age of 32 to 34 weeks referred to the perinatology clinic of Al-Zahra and Taleghani educational-treatment hospital, affiliated to Tabriz University of Medical sciences, Iran. Participants were randomly assigned into the intervention and control groups. The intervention group received eight mindfulness-based counseling sessions. The intensity of childbirth pain with VAS (Visual Analog Scale) in the active phase of labor at 8 cm dilatation and the childbirth experience questionnaire were completed by interview after childbirth. Independent t-test and ANCOVA were used to compare the outcomes between the two groups. Results After controlling the effect of confounding variables, the mean score of childbirth experience in the intervention group was significantly higher than that in control group [Mean Difference (MD): 1.79, 95% CI: 2.52 to 1.07, P < 0.01]. The mean score of labor pain in the intervention group was significantly lower than that in the control group after controlling the effect of baseline score and confounding variables [MD: -2.21, 95% CL: -3.35 to -1.10, P < 0.001]. Conclusion The findings indicated that providing mindfulness-based counseling improves the childbirth experience and reduces labor pain during childbirth. However, further randomized clinical trials are needed before making a definitive conclusion. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N9. Date of registration: 16/03/2022, 25/12/1400

The Lived Experience of Iranian Women Confronting Breast Cancer Diagnosis

Introduction: The populations who survive from breast cancer are growing; nevertheless, they mostly encounter with many cancer related problems in their life, especially after early diagnosis and have to deal with these problems. Except for the disease entity, several socio-cultural factors may affect confronting this challenge among patients and the way they deal with. Present study was carried out to prepare clear understanding of Iranian women's lived experiences confronting breast cancer diagnosis and coping ways they applied to deal with it. Methods: This study was carried out by using qualitative phenomenological design. Data gathering was done through purposive sampling using semi-structured, in-depth interviews with 18 women who survived from breast cancer. The transcribed interviews were analyzed using Van Manen’s thematic analysis approach. Results: Two main themes were emerged from the interviews including "emotional turbulence" and "threat control". The first, comprised three sub themes including uncertainty, perceived worries, and living with fears. The second included risk control, recurrence control, immediate seeking help, seeking support and resource to spirituality. Conclusion: Emotional response was the immediate reflection to cancer diagnosis. However, during post-treatment period a variety of emotions were not uncommon findings, patients' perceptions have been changing along the time and problem-focused coping strategies have replaced. Although women may experience a degree of improvement and adjustment with illness, the emotional problems are not necessarily resolved, they may continue and gradually engender positive outcomes

The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial

Abstract Background Successful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic. Method This randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60–90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and intervention groups. Independent t-test and ANCOVA were used to compare the outcomes between two groups. Results According to the ANCOVA results by controlling the baseline values and after the intervention, the mean score of anxiety in the intervention group was lower than that in the control group [Adjusted Mean Difference (AMD): -13.82, 95%, confidence interval (CI): -12.35 to -15.29, (p < 0.001)]. Further, the mean score of postpartum distress after intervention was lower in the intervention group compared with that in the control group [AMD:5.31 95% CI: -3.00 to -7.37 (p < 0.001)]. After the intervention, the mean score of BSE in the intervention group was significantly higher than that in the control group [AMD: 25.57, 95% CI: 22.85 to 28.29 (p < 0.001)]. Conclusion Stress management counseling can improve postpartum anxiety and distress and BSE and increase breastfeeding. However, more studies are needed for a definitive conclusion. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N6. Date of registration: 15/09/2021

The effect of probiotic supplementation on episiotomy wound healing among primiparous women: a triple-blind randomized clinical trial

Abstract Background Probiotics increase the defense power of immune system and accelerate the wound healing process by anti-inflammatory mechanisms at the wound site. The present study aimed at evaluating the effect of Lactobacillus casei oral supplementation on episiotomy wound healing among primiparous women. Methods This triple-blind randomized clinical trial was performed on 74 primiparous women delivered in Alzahra Hospital, Tabriz, Iran. Participants with mediolateral episiotomy (incision length equal to and less than 5 cm) were randomly assigned to the probiotic and placebo groups. The probiotic group received Lactobacillus casei 431 with 1.5 * 109 colony-forming unit /capsule once a day from the day after birth to 14 days. Wound healing as a primary outcome was measured by Redness, Edema, Ecchymosis, Discharge, Approximation and pain as a secondary outcome by the Visual Analogue Scale before discharge, 5 ± 1 and 15 ± 1 days after birth. The data were analyzed using independent t-test and repeated measures one way analysis of variance. Results The mean (standard deviation: SD) score of wound healing in the probiotic group altered from 4.91(1.86) before discharge to 1.55 (0.99) during 5 ± 1 days after birth and reached to 0.95 (0.27) during 15 ± 1 days after birth. Further, the mean (SD) score of wound healing in the placebo group altered from 4.62 (1.99) before discharge to 2.80 (1.20) during 5 ± 1 days after birth and reached to 1.45(0.71) during 15 ± 1 days after birth (adjusted mean difference: -0.50, confidence interval 95%: -0.96 to -0.05, P = 0.03). Conclusion Lactobacillus casei oral supplementation is effective in healing episiotomy wounds. It is suggested to evaluate the effect of topical use of Lactobacillus casei on episiotomy repair and pain in further studies. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20170506033834N7. Date of registration: 11/08/2021

The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women

Abstract Background The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women. Method This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5–7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests. Results The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P  0.05). Conclusion The results of this research indicated that CBT and sexual health education are effective in improving women’s sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women. Trial registration Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir