Obstetrics & Gynecology
Is Maternal-fetal Attachment Education Effective in the Success of Breastfeeding? A Randomized Clinical Trial Study
Breastfeeding represents the most enduring investment in the physical cognitive and social development of children. Maternal-fetal attachment (MFA) is suggested to be a predictor of breastfeeding. The study aimed to evaluate the impact of a maternal-fetal attachment (MFA) training program on breastfeeding success among nulliparous women in Iran.
This clinical trial study was conducted on 70 pregnant women referred to two maternity clinics in Tehran Iran. Using the randomized sampling method two perinatal care services in the north of Tehran were selected for recruiting the subjects into control and intervention groups. The eligible women completed the demographic and reproductive and Cranley’s MFA questionnaire. Then the intervention group received two MFA education sessions while the control group received routine prenatal education. Cranley’s MFA questionnaire was filled up again one month after the educational intervention. The breastfeeding success questionnaire and the Breastfeeding practice-related questionnaire were also completed in the 8th week of postpartum. Data were analyzed by using SPSS 22 and parametric and non-parametric tests.
Seventy women aged 30.67 ± 3.69 years participated in the study. There was no significant difference in MFA scores between the intervention and control groups prior to the intervention (89.03 ± 7.83 vs 89.66 ± 11.3; p = 0.7 respectively). However a significant difference was observed between the intervention and control groups one month after the MFA education intervention (89.91 ± 8.23 vs 97.86 ± 9.72; p <0.001 respectively). The results also revealed a significant difference between the intervention and control groups in terms of breastfeeding success at eight weeks postpartum (64.71 ± 9.99 vs 71.11 ± 11.05; p <0.001 respectively).
Maternal-Fetal attachment education is effective on the success of breastfeeding. This finding could be used in breastfeeding promotion programs meaning that providing MFA education can help breastfeeding promotion among mothers.
MFA education not only improves maternal-fetal attachment behaviors but also increases the success of breastfeeding and so it is suggested to be integrated into the maternal-child health services.
IRCT20120122008801N22; Registration date: 05/03/2018
Back Pain Severity in Women with Sexually Transmitted Diseases: A Cross-Sectional Study
Back pain is one of the main causes of disability most of which is caused by non-specific factors. There is a relationship between infections and back pain. The present study was conducted to detect the association between the severity of back pain and sexually transmitted diseases (STDs) in women.
This cross-sectional descriptive study was conducted among women with STDs referred to the selected clinics in Shahrekord city in 2022. After confirming the STD by a gynecologist the questionnaire was completed by the clients in a private environment. The research tool consisted of a demographic questionnaire a checklist related to medical and fertility records and a disability questionnaire for low back pain. The pain intensity was categorized into four levels: no pain mild moderate and severe. Data were analyzed using SPSS software (version 25) and the chi-square test and analysis of variance. p<0.05 was considered statistically significant.
A total of 310 women were included in the study. The mean age of the women was 37.04 ± 7.88 years and the mean number of pregnancies was 2.43 ± 1.40. The overall prevalence of back pain was 71.9% with 28.1% reporting no pain 22.9% reporting mild pain 24.5% reporting moderate pain and 24.5% reporting severe pain. There was a statistically significant association between the severity of back pain and the type of delivery menstrual status menstrual complications history of medical illness history of drug use travel abroad by self or spouse alone previous history of sexually transmitted infections multiple sexual partners type of sexual activity the use of condoms the number of sexual partners of the spouse the history of sexually transmitted infection in the spouse and job risk (p < 0.05). Also significant associations were observed between the severity of back pain and the type of sexually transmitted disease suffering from cervicitis burning and frequent urination vaginal discharge unusual mass in the groin area abdominal pain pain during intercourse pain in the perineum and anal discharge (p < 0.05) while there was no significant association with post-coital bleeding genital ulcer or vulvovaginal itching (p > 0.05).
Health service providers should consider the examination and diagnosis of STDs when patients present with symptoms of back pain. In addition policymakers and health care providers should work to prevent STDs and their consequences including back pain by adopting educational and support policies thereby reducing the burden of disease on the health care system.
Cognitive Behavioral Therapy on Sexual Function in Women with Vaginismus Disorders: A Systematic Review
Vaginismus is characterized by involuntary tightening of the pelvic floor muscles around the vagina and requires appropriate management. This review systematically evaluates the effectiveness of cognitive behavioral therapy in treating sexual dysfunction in patients with vaginismus.
PRISMA guidelines were used to compile a systematic review. A search of the ScienceDirect PubMed ProQuest and Google Scholar databases was conducted to find English-language studies published between 2002-2023 that examined the effects of cognitive behavioral therapy and its effects on the sexual function of women with vaginismus. The included studies were assessed for quality using the Mixed Methods Appraisal Tools (MMAT) and data were analyzed narratively.
A total of 5 studies including a total of 288 women with vaginismus were included in the review. The majority of studies included women with vaginismus according to DSM-IV-TR diagnostic criteria. The duration of the treatment and outcome measurements varied.
Cognitive-behavioral therapy has an effect on sexual satisfaction sexual functions and marital adjustment as well as reducing levels of depression and anxiety symptoms in women with vaginismus. CBT is a helpful cost-effective and non-invasive interventional therapy.
The duration of therapy required for improvement as well as its possible association with the severity of vaginismus remains unclear.
Job Adjustment and Sick Leave during Pregnancy: An Integrative Review of the Literature
Pregnant employees have special needs and most of them require sick leaves during pregnancy. Pregnancy can lead to complex work adjustments and may affect women's well-being. Therefore this integrative review of the literature aims to assess studies on job adjustment and sick leaves availed during pregnancy.
Searches were performed using Scopus PubMed ProQuest ISI Web of Science and Cochrane databases using both relevant keywords and MeSH terms including “job adjustment” “pregnancy” and “sick leave” up to August 2023 (search updated in January 2024) with no geographical restrictions. Full-text articles published in English observational studies including cross-sectional longitudinal and qualitative studies including phenomenological content analysis and grounded theory were included. Studies published in the form of conference proceedings other study designs with an interventional study method and the articles for which full texts were not available were all excluded.
Twenty-one full-text articles were considered eligible. More job adjustments lead to few sick leaves and increased presenteeism during this period. Pregnant employees implement different kinds of adjustment strategies to reach job adjustment. The manager’s efforts to facilitate job adjustment and sick leave days during pregnancy should also involve professional care or guidance adjusting job tasks and work schedules.
This integrative review of the literature shows that job adjustment during pregnancy could reduce sick leave but it needs comprehensive support from families and organizations so that pregnant women can make appropriate changes. In addition implementing adjustment strategies should be improved in pregnant women to increase job adjustment.
Welcome to the EndoHood: A Scoping Review of Social Media Spaces for those with Endometriosis
Social media has a significant capacity to influence healthcare delivery. The development of online communities is well documented for conditions including asthma and stroke. Less is known about social media use amongst those with endometriosis. This review explores internet groups as an under-recognised supplement to healthcare prompting greater clinician engagement online.
This scoping review was conducted according to the methodology developed by Arksey & O’Malley. It is the first piece of work bringing together commentary on endometriosis-related social media use and existing frameworks used to analyse other online communities. Relevant studies were identified through searches of MEDLINE and EMBASE. As an exploratory piece there were no predetermined exclusion criteria provided articles were in English or translated into English. A total of 26 articles from 2004-2024 were included.
The literature on social media posts about chronic conditions typically explores the accuracy of medical content or offers sociological commentary. Nine articles assessed the evidence base of endometriosis posts across various platforms. All raised concerns about the reliability of information shared and called for expert engagement in the dissemination of educational materials online.
Three key themes emerged from the analysis of online communities. First online groups are perceived as an antidote to unmet needs in endometriosis patients accessing traditional healthcare including problem-solving and psychosocial support. Further such groups cultivate a sense of kinship amongst affected individuals. The exchange of experiences and peer validation of symptoms contributes to a collective narrative. Finally social media can facilitate open conversation around sensitive topics through anonymity within these communities.
Endometriosis is a condition with the potential for profound psychological and psychosexual impact. Social media communities create a space in which private suffering can become public and taboo subjects explored. Clinicians have a responsibility to engage both with factual content curation and in addressing unmet care needs expressed by patients online.
Drawing and Midwife-led Counseling for Reducing Fear of Childbirth and Distress in Late Pregnancy
Pregnancy and childbirth increase maternal fear and distress. Therefore this study aimed to compare the effectiveness of drawing combined with midwife-led counseling (MLC) with that of MLC alone in reducing fear of childbirth (FOC) and distress during the third trimester of pregnancy.
This quasi-experimental study was conducted on 100 pregnant women (28–32 weeks). The drawing and MLC group painted with free themes twice a week and received MLC once a week to address maternal fears and distress over a five-week period. In the MLC group only MLC was conducted. Data were collected through demographic information the Childbirth Attitudes Questionnaire (CAQ) and the Prenatal Distress Questionnaire before and after the intervention and were analyzed using analysis of covariance chi-square tests and independent t-tests.
The mean fear and distress scores of both groups decreased significantly after the intervention (P<0.001). However the difference in the mean fear score between the intervention group (33.5 ± 7.7) and the MLC group (34 ± 8.1) and the difference in the mean distress score between the intervention group (10.2 ± 3.8) and the MLC group (11 ± 4.9) were not statistically significant. There were also no significant differences in pregnancy outcomes between the two groups.
Compared with the MLC group the drawing and MLC group experienced greater although statistically insignificant reductions in fear of childbirth and distress. However further research is necessary to draw definitive conclusions. Furthermore the interventions in our study did not affect pregnancy outcomes including delivery method hypertension preterm delivery or gestational diabetes.
Quality of Life in Subjects with Chronic Diseases and Impact of the Medication Burden
Quality of life (QoL) in patients with chronic diseases is affected by physical emotional and social aspects including medication burden. This study evaluates the impact of chronic diseases and medication on quality of life emphasizing the importance of incorporating patient perception.
A cross-sectional study conducted in Ecuador focused on the adult population treated at the Rheumatology Department of the Homero Castanier Crespo Hospital in 2023. A sample of 161 individuals was selected based on specific criteria and the COOP-WONCA questionnaire was used to assess health-related quality of life. Statistical analysis was performed using SPSS® including descriptive statistics and bivariate analysis with Chi-square and Fisher’s exact tests to explore relationships between variables.
The study population was predominantly composed of women (95.1%) adults over 70 years of age (37.8%) and individuals from urban areas (60.4%). Regarding education the majority had completed primary education (62.2%) and a significant proportion were illiterate (18.3%). Additionally 39.6% of the sample had hypertension and 14% had diabetes. Quality of life was characterized by high satisfaction with social activities (84.1%) while perceptions of physical fitness and general health were more moderate. Quality of life was influenced by osteoporosis and hypertension in the domain of physical fitness (p < 0.05) and individuals with depression reported negative effects on their emotional well-being (p < 0.05).
The predominantly female and elderly population presents differences in quality of life related to chronic diseases and depression highlighting the impact of these conditions on physical and emotional well-being.
Analysis of Mother's Intention toward Iron-deficiency Anemia Prevention Behaviour based on the Theory of Planned Behavior
Iron deficiency anemia (IDA) is prevalent among under-five and school-aged children in Indonesia often attributed to maternal knowledge gaps and unsupportive behaviors. This study grounded in the theory of planned behavior explores maternal intentions toward preventing IDA in children.
A cross-sectional descriptive survey was conducted among 226 mothers of children aged 6 months to 12 years. Data were analyzed using SPSS version 22.0 employing descriptive statistics and Likert scale scoring (Cronbach’s alpha = 0.82).
The results showed that participants were predominantly housewives (64.2%) aged 31–35 years (39.8%) with secondary education (44.2%) and monthly incomes of Rp 1–3 million (approximately 60–180 USD). Strong positive intentions were found for balanced nutrition provision (93.7%) and iron-content monitoring (89.9%). While mothers showed positive attitudes towards nutrition (95.4% agreed on providing balanced diets) and supplement monitoring (93.5%) most (63.5%) did not perceive the need for IDA screening. Knowledge of IDA causes was high (88.5%) but implementation was hindered by economic constraints (40.7%) and limited nutritional information access (38.9%).
Despite strong knowledge and positive intentions toward IDA prevention mothers showed gaps between knowledge and practice particularly in screening behaviors. Findings suggest a need for targeted interventions focusing on screening awareness and addressing economic barriers to enhance IDA prevention effectiveness.
Women’s Reproductive Health: Challenges and Advances
This commentary aimed to evaluate the impact of societal barriers technological advancements and integrated healthcare approaches on women’s reproductive health.
This commentary was written by analyzing recent peer-reviewed articles systematic reviews and credible data sources related to women’s reproductive health.
Social stigma persists around issues like infertility contraception and abortion. However advancements like telemedicine AI diagnostics and targeted supplementations with nutraceuticals including omega-3 fatty acids and probiotics have significantly improved the overall health and well-being of women.
Combining culturally sensitive engagements legal reforms and innovative healthcare technologies offers a holistic framework for advancing equitable and effective reproductive healthcare.
Correlation between Pilomatrixoma and Polycystic Ovary Syndrome (PCOS)
Pilomatrixoma a benign skin tumour originating from hair follicle matrix cells is characterized by basophilic and shadow cells with calcification and commonly presents as a firm painless subcutaneous nodule. Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting 6-12% of women globally marked by hyperandrogenism ovulatory dysfunction and polycystic ovaries. It presents with symptoms such as irregular menstrual cycles acne hirsutism insulin resistance and increased risks of diabetes cardiovascular diseases and infertility.
A 13-year-old female with upper back swelling was diagnosed with pilomatrixoma. Histopathology revealed basophilic and shadow cells and lab results indicated elevated lymphocyte counts reduced monocyte counts high RBC levels and microcytic anemia. Ultrasound showed mild polycystic ovarian changes. While pilomatrixoma and PCOS are distinct shared factors such as hormonal influences and immune dysregulation may suggest potential links. Hormonal changes in PCOS particularly hyperandrogenism may promote erythropoiesis contributing to systemic effects observed in pilomatrixoma. Genetic mutations like CTNNB1 and inflammatory states associated with pilomatrixoma may influence iron metabolism exacerbating anemia.
No direct correlation exists between pilomatrixoma and PCOS. Shared hormonal and genetic factors warrant further research but these remain distinct entities with separate clinical management.
Consequences and Functional Alterations of Endocrine Disruptors on Women's Health
Endocrine-disrupting chemicals (EDCs) are anthropogenic compounds that have garnered significant research consideration due to their harmful effects on human health. These compounds disrupt normal physiological homeostasis by interfering with processes such as hormone synthesis transport metabolism and excretion. Even at low concentrations EDCs can contribute to severe health issues including life-threatening cancers and metabolic disorders in humans and animals. Consequently monitoring EDCs in human populations is a critical area of focus. Preclinical and in vitro studies have established the impact of EDCs on hormonal pathways particularly in male and female gonadal development. Furthermore biomonitoring studies have detected EDCs in various biological matrices including those of foetuses children and pregnant women. Exposure to EDCs has been associated with complications in the female reproductive system like premature ovarian failure precocious puberty and polycystic ovary syndrome. This review provides a comprehensive summary of the associations between EDC exposure and female reproductive dysfunction emphasizing potential mechanisms underlying these effects.
Serum Cystatin C and its Correlation with Renal Function and Clinical Parameters in Vietnamese Preeclamptic Women
Preeclampsia is a significant cause of maternal and fetal morbidity highlighting the importance of early detection. While serum cystatin C is a promising biomarker for detecting renal impairment its role in Vietnamese preeclamptic women remains underexplored.
This study aimed to evaluate the applicability of serum cystatin C and other renal biomarkers in assessing preeclampsia and investigate factors influencing serum cystatin C levels with a focus on improving early detection and management in the Mekong Delta region of Vietnam.
A cross-sectional study was conducted on 50 pregnant women diagnosed with preeclampsia and 50 healthy normotensive non-proteinuric pregnant women. Data collected included age height weight body mass index systolic blood pressure (SBP) diastolic blood pressure (DBP) gestational age platelet count and various biochemical parameters such as serum uric acid urea creatinine cystatin C urine creatinine urine volume 24-hour creatinine clearance (CrCl) 24-hour urine protein serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT). These parameters were analyzed using the t-test Mann-Whitney U test and correlation and regression analyses. The area under the curve (AUC) was used to describe the relationship between sensitivity and specificity at different cut-off points.
Serum cystatin C and 24-hour urine protein levels were higher in the severe preeclampsia group while the median 24-hour urine volume was lower compared to the healthy group. Weak negative correlations were observed between serum cystatin C levels and DBP in the healthy group and 24-hour CrCl in the non-severe preeclampsia group (p<0.05). Moderate positive correlations were found between serum cystatin C levels and serum creatinine in the non-severe preeclampsia group and between pregnant women’s age and serum creatinine in the severe preeclampsia group (p<0.05). Notably serum cystatin C levels strongly correlated with gestational age in the severe preeclampsia group (p<0.05). SGOT SGPT 24-hour urine protein SBP and maternal weight were identified as significant independent predictors of serum cystatin C levels.
While serum cystatin C levels demonstrated strong predictive value for preeclampsia (AUC=0.980 p<0.001) they showed limited utility in distinguishing between severe and non-severe forms of the condition. Future studies should explore additional biomarkers to complement its predictive value. Nonetheless its correlation with key renal function markers highlights its potential role in preeclampsia management.
Effect of the Supplementation of L-Aspartic Acid, L-Ascorbic Acid, and Silver Nanoparticles (AgNPs) to the In vitro Fertilization (IVF) Media on the NMRI Mouse IVF Rates
Numerous lifestyle factors contribute to the incidence of infertility which is a major concern for couples throughout the globe. The effectiveness of in vitro fertilization (IVF) is highly dependent on the characteristics of the culture media used.
The present research study aimed to determine the effects of L-aspartic acid L-ascorbic acid and silver nanoparticles (AgNPs) on the success rate of IVF in NMRI mice.
The solutions of L-aspartic acid L-ascorbic acid and synthesized AgNPs were prepared. The 6-8 weeks-old NMRI male mice were used as sperm donors and 6-8 weeks-old NMRI mice were used for oocyte donation. In addition the IVF procedure was performed using 50 µL drops of KSOM+5%BSA in mineral oil. Seven different experimental groups were investigated in addition to the control group. Oocytes were exposed to sperm for 4-6 h in the KSOM medium as a control group.
According to the results the groups containing supplements “AgNPs” “L-aspartic acid” and “AgNPs + L-ascorbic acid” were not suitable for the 2PN stage. In contrast the group containing “L-aspartic acid + L-ascorbic acid” was the best group for the 2PN stage. In addition supplementation of the mixture of L-aspartic acid and AgNPs solution in KSOM+BSA culture medium was the most suitable group for the 2Cell stage.
In conclusion the study highlighted the varying impacts of L-aspartic acid L-ascorbic acid and AgNPs on IVF outcomes in NMRI mice. Group E combining L-aspartic acid and AgNPs emerged as effective for 2Cell development. Future research should explore the underlying biochemical mechanisms of these findings. Furthermore another study is in progress that utilizes these supplements to generate 2PN first and then the supplement-free medium as the cleavage media.
Knowledge, Attitudes, and Barriers of Physiotherapists Regarding the Assessment and Treatment of Primary Dysmenorrhea
Primary dysmenorrhea (PD) is a common menstrual disorder characterized by lower abdominal pain. Conservative strategies have been indicated to reduce symptoms of PD. This study aims to analyze the knowledge attitudes and barriers of physiotherapists regarding the assessment and treatment of PD.
This is a cross-sectional study using a semi-structured self-administered questionnaire to assess the sociodemographic academic and professional characteristics of physiotherapists as well as their attitudes perceptions and barriers related to evidence-based practice (EBP) in the assessment and treatment of PD.
Thirty Brazilian physiotherapists participated in the study 50% of whom specialized in women's health. Approximately 96.6% of women worked in healthcare. The majority (86.7%) “strongly agreed” or “agreed” that they adopt evidence-based practice (EBP) attitudes when managing patients with PD. Exercise (96.6%) manual therapy (90.0%) and thermal therapy (56.6%) were the most reported options for treating PD. Of the physiotherapists who used transcutaneous electrical nerve stimulation (TENS) approximately 23.3% reported that the most common parameter for treating PD was high frequency (HF-TENS).
Brazilian physiotherapists demonstrate knowledge and positive attitudes towards evidence-based treatment of PD. However some physiotherapeutic techniques cited for treating PD have limited supporting evidence which may be related to barriers to implementing EBP in clinical settings.
Retrospective Audit: The Irreversible Change in Ovarian Reserve After Formal Cystectomy for Ovarian Endometrioma
Ovarian cystectomy is a common treatment for endometriomas; however its long-term impact on ovarian reserve remains uncertain. This study aims to evaluate the long-term pattern of serum anti-Müllerian hormone (AMH) levels following cystectomy and to determine whether ovarian reserve recovers or continues to decline over time.
This retrospective study analysed fifty patients who underwent laparoscopic cystectomy for suspected endometriomas with a final mean follow-up of 23.3 months (95% CI 20.90–25.80). Serum AMH levels were measured preoperatively at 6 months postoperatively and at the final follow-up. Changes in AMH levels were compared between patients with unilateral and bilateral endometriomas.
A significant decline in AMH levels was observed postoperatively. Mean AMH decreased from 2.60 ± 0.87 ng/mL at baseline to 1.37 ± 0.39 ng/mL at 6 months (decline of -1.23 ng/mL P < 0.05) and further to 1.13 ± 0.43 ng/mL at final follow-up (cumulative decline of -1.47 ng/mL P < 0.05). Patients with bilateral endometriomas experienced a significantly greater reduction in AMH (-2.79 ± 1.98 ng/mL 72%) compared to those with unilateral endometriomas (-0.77 ± 0.49 ng/mL 39%) (P < 0.05).
Cystectomy for ovarian endometriomas reduces symptoms but significantly impairs ovarian reserve particularly in bilateral cases as indicated by a sustained drop in AMH levels. Fertility-preserving alternatives such as hydro-dissection and partial excision with ablation may limit ovarian damage. Complete excision is reserved for select high-risk cases. Limitations include a small sample size and the absence of a control group.
The decline in AMH following ovarian cystectomy is progressive and does not show evidence of recovery in most patients. Bilateral cystectomy has a more profound impact on ovarian reserve than unilateral surgery. Patients should be counselled about the potential long-term effects on fertility and fertility-preserving strategies should be considered when managing endometriomas in women desiring future conception.
Predictors of Intention to Receive Donated Oocytes Among Infertile People in Western Iran: The Application of the Theory of Planned Behavior
Considerable advances in the field of medical technology have provided the chance for infertile couples to have children. Using donated oocytes is one of the methods of assisted reproductive technologies. This study aimed to investigate factors affecting the intention to receive donated oocytes in infertile people based on the Theory of Planned Behavior.
This cross-sectional study was conducted among 300 infertile people referred to the Infertility Department of Fatemiyeh Hospital in Hamadan west of Iran in 2022. Participants were recruited using the convenience sampling method. The relationships between variables were determined by the Pearson correlation coefficient and linear regression using SPSS software version 24. The significance level was considered at p < 0.05.
Participants’ mean age was 34.0 (standard deviation = 6.3). Most participants were female (n = 225 75%). The intention had a significant positive correlation with attitude (r = 0.193 p < 0.01) subjective norms (r = 0.524 p < 0.01) and behavioral perceived control (r = 0.589 p < 0.01). The strongest predictor of behavioral intention to receive donated oocytes was behavioral perceived control (β = 0.422 p < 0.05) followed by subjective norms (β = 0.289 p < 0.05).
The results revealed that the intention to receive donated oocytes had a significant positive correlation with all TPB constructs. Considering the predictive power of perceived behavioral control and subjective norms in the intention to receive donated oocytes it is necessary to pay more attention to the important role of these two constructs compared to the attitude construct in designing and implementing interventions related to the acceptance of this infertility treatment.
The Relation of Age at Menarche with Reproductive Span in Women of Persian (Shahedieh) Cohort
Reproductive span is defined as the duration between menarche and menopause. This study aims to estimate natural menopause age and reproductive span and investigate their relationship with menarche age which provides important information about women's health status in an Iranian society.
This cross-sectional study was conducted on 4415 women who participated in the enrollment phase of the Shahedieh cohort study. Of 1715 subjects who experienced menopause 1276 women had natural menopause. Age at menopause and reproductive life span were estimated in 4415 women aged 35 to 70 years who were a part of the Persian cohort study by Kaplan-Meier. Crude and adjusted hazard ratios (HR) of menopause by breastfeeding duration were determined using Cox regression.
In all menarche groups the median age of menopause was estimated to be 52 years for 1276 women who had natural menopause and 3139 women who did not. The estimated median of the reproductive period was 38 which decreased with increasing age at menarche (P< 0.001) which did not change even after adjusting for breastfeeding. Women with menarche at age≤11 years had 2 years longer and women with menarche at age>14 years had 2 years shorter median reproductive period than women with menarche at age 12-13 years (median: 41 versus 37 years). According to the adjusted Cox regression model for breastfeeding duration women with early menarche had the lowest hazard rates of menopause (HR = 0.70; 95% CI: 0.56–0.87). HR for the late menarche age group had the highest hazard rates of menopause (HR = 1.41; 95% CI: 1.25-1.59).
Menarche age was not a significant determinant for menopause age while it is a strong indicator for the duration of women’s reproductive period.
Maternal Outcomes in Females with β-thalassemia
Thalassemia an inherited blood disease characterized by abnormal hemoglobin production is a global health issue. Although the effects of thalassemia on human health are well-documented less is known regarding its implications on pregnancy particularly maternal outcomes. Analyzing thalassemia during pregnancy is crucial to understanding the risks complications and results. This research is essential for clinical practice and maternity care.
The objective of this study was to determine the pregnancy outcomes in females with β-thalassemia minor visiting Jinnah Hospital and Sir Ganga Ram Hospital Lahore.
This was a case-control study. A validated questionnaire was used to assess key socio-demographic variables relevant to the study certain practices and maternal outcomes. Information was entered and results were obtained using SPSS version 24.0.
Using purposive sampling the study enrolled 92 pregnant females (46 cases 46 controls). It was observed that beta-thalassemia increases the risk of pregnancy-induced hypertension (PIH) by 3.23 times (p = 0.025 OR = 3.226 (95% CI: 1.12-9.27)). Moreover the risk of preeclampsia also increased by 5.08-fold in pregnant women (p = 0.005 OR = 5.081 (95% CI: 1.53-16.81)). Women with β-thalassemia minor had a statistically significant greater prevalence of blood transfusions before pregnancy (p < 0.001) and during pregnancy (p = 0.019) compared to women without the disease. Low birth weight infants were more likely to be born to mothers with beta-thalassemia. In healthy pregnant women a birth weight above 2500 g is more common whereas in β-thalassemia cases the opposite is true (p = 0.002 OR = 4.355 (95% CI: 1.67-11.33)).
While β-thalassemia minor is usually asymptomatic prior to pregnancy women who have it are more likely to experience adverse pregnancy outcomes than women who do not. These include a higher incidence of low birth weight babies oligohydramnios pre-eclampsia stillbirth preterm membrane rupture anemia and hypertension. Both before (p < 0.001) and during pregnancy (p = 0.019) they also show a markedly elevated need for blood transfusions. These results highlight the significance of focused prenatal treatment and monitoring in this population to reduce adverse consequences.
The Association between Maternal Lifestyle and Antenatal Anxiety among Pregnant Women: A Cross-Sectional Study
Antenatal anxiety is one of the most common problems during pregnancy. Identifying the effective factors in reducing antenatal anxiety is one of the ways to mitigate the negative consequences.
The present study aimed to determine the association between maternal lifestyle and antenatal anxiety.
This is an analytical-cross-sectional study and its study population included 201 eligible pregnant women referred to Al-Zahra Hospital in Rasht. A convenience sampling method was used. Data collection tools included the Demographic and obstetrics questionnaire The Health Promoting Lifestyle Profile (HPLP) and the standard pregnancy-related anxiety questionnaire (PRAQ). Data analysis was performed using statistical tests including the Spearman correlation coefficient Mann-Whitney test and Kruskal-Wallis in SPSS. A P<0.05 was considered significant.
Data analysis showed that the mean score of maternal lifestyle and antenatal anxiety was 67.8 ± 10.9 and 43.2 ± 20.1 respectively. There was a weak significant negative correlation between antenatal anxiety scores and the total maternal lifestyle score (r= - 0.204 P= 0.004). The results of the multiple linear regression analysis also showed that with an increase in the total score of maternal lifestyles the antenatal anxiety score decreases significantly after controlling the Demographic and obstetrics variable. That is with a unit increase in the total lifestyle score the total anxiety score decreases on average by 0.20 units (b= 0.20 P= 0.004).
A weak but significant negative correlation exists between maternal lifestyle and antenatal anxiety indicating that higher lifestyle scores are associated with lower anxiety levels. Thus healthcare providers can play an important role in alleviating antenatal anxiety through lifestyle education positively impacting maternal well-being.