Vitamins B9 and B12 in children with attention deficit hyperactivity disorder (ADHD).

Background: Attention deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder that begins before age 12. Given the role of B group vitamins in cell metabolism, synthesis of nucleotides, and neurotransmitters, the present study systematically investigated the plasma levels of vitamins B9 and B12 in children with ADHD. Methods: We searched electronic databases including Web of Science, MEDLINE, EMBASE, Scopus, Iran MEDEX, Cochran database, and SID from conception to June 2023. Full-text case-control or cross-sectional studies were included in this study. Participants in the case group were children with ADHD aged 6-12 years. Review Manager Software (RevMan 5.4) was used for statistical analyses. Standardized mean differences (SMD) with 95% CIs were used to determine the differences between the two groups. Results: Six studies were included in the present meta-analysis. They included 982 children, of whom, 204 were girls and 744 were boys. The mean age of the children was 8.86±2.03 years. The level of vitamin B9 was significantly different between children with and without ADHD [SMD -0.80, 95% CI (-1.55, -0.04)]. Vitamin B12 was significantly lower in children with ADHD [SMD -0.29, 95% CI (-0.42, -0.16)]. However, due to high heterogeneity (I2 = 93%), sensitivity analysis was used, I2 fell to 21%, and significant difference was observed between the two groups [SMD -0.19, 95% CI (-0.34, -0.04)]. Conclusion: The results of this systematic review showed that the level of vitamins B9 and B12 in children with ADHD was significantly lower than that in healthy children.

The effect of a midwifery continuity of care program on clinical competence of midwifery students and delivery outcomes: a mixed-methods protocol.

BACKGROUND: The midwifery continuity of care model is one of the care models that have not been evaluated well in some countries including Iran. We aimed to assess the effect of a program based on this model on the clinical competence of midwifery students and delivery outcomes in Ahvaz, Iran. METHODS: This sequential embedded mixed-methods study will include a quantitative and a qualitative phase. In the first stage, based on the Iranian midwifery curriculum and review of seminal midwifery texts, a questionnaire will be developed to assess midwifery students' clinical competence. Then, in the second stage, the quantitative phase (randomized clinical trial) will be conducted to see the effect of continuity of care provided by students on maternal and neonatal outcomes. In the third stage, a qualitative study (conventional content analysis) will be carried out to investigate the students' and mothers' perception of continuity of care. Finally, the results of the quantitative and qualitative phases will be integrated. DISCUSSION: According to the nature of the study, the findings of this research can be effectively used in providing conventional midwifery services in public centers and in midwifery education. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1401.460). Also, the study protocol was registered in the Iranian Registry for Randomized Controlled Trials (IRCT20221227056938N1).

Effect of Companion Presence during Skin-to-Skin Contact on Maternal Anxiety: A Randomized Clinical Trial.

OBJECTIVE: To compare the effect of companion presence versus midwife presence during skin-to-skin contact (SSC) at birth on maternal anxiety and satisfaction, and neonatal physiological parameters. METHODS: A randomized controlled trial was conducted on 92 pregnant women who were randomized to provide SSC to their newly borns for one hour postpartum, in the presence of a companion (study group) or a midwife (control group). Maternal anxiety (using the Visual Analogue Scale) and the neonatal physiological parameters (including temperature, heart rate, and oxygen saturation) were assessed in four stages viz., immediately after birth, and at 30, 60 and 90 minutes after birth. Maternal satisfaction was also evaluated after transferring the mother to the postpartum ward. RESULTS: We analyzed 86 mother-infant dyads (43 per group). Having a companion significantly reduced maternal anxiety after birth as compared to having a midwife at 30, 60, and 90 minutes after birth (P = 0.04, P = 0.01, and P = 0.04, respectively). There was also a small to medium effect size of the presence of companion compared to midwife in terms of maternal anxiety at 30 minutes (Cohen's d = 0.45; 95% CI = 0.02, 0.87), 60 minutes (Cohen's d = 0.52; 95% CI = 0.08, 0.94) and 90 minutes after birth (Cohen's d = 0.45; 95% CI = 0.02, 0.88). However, there was no significant effect of the same on neonatal physiological parameters. Having a companion versus a midwife led to higher maternal satisfaction rates (P = 0.02); 65.1% of mothers in the study group and 37.2% of mothers in the control group were desirous of the same care in future (P = 0.02). CONCLUSION: Companion presence during SSC leads to a significant reduction in maternal anxiety compared to midwife presence.

Effect of a Multifaceted Approach on Perceived Support Among Mothers of Preterm Infants: A Quasi-Experimental Study.

Introduction: Mothers of preterm infants need support to deal with the issues caused by the early birth of their infants. Objective: The authors examined the impact of a multifaceted supportive approach on the mothers' perceived support levels. Methods: The present quasi-experimental study was performed on 143 mother-preterm infant pairs, in two neonatal intensive care units (NICUs) of referral and educational hospitals in Tehran, Iran. The base of developed interventions was known to support system patterns of mothers with preterm infants. Different supportive interventions (appraisal, instrumental, emotional, and informational) of mothers were implemented during three months. The Nurse Parent Support Tool was applied for assessing perceptions of perceived support by mothers. Routine care was provided for the control group. The results were analyzed by STATA software 13. Categorical variables were analyzed by chi-square test, t-test, and inverse probability treatment weights. Results: Following adjustments of mean differences of outcomes between study groups (95% confidence interval), all support scores, such as instrumental support, -1.23 (95% CI -1.04 to -1.43), total support, -1.83 (95% CI -1.6 to -2.06), appraisal support, -2.01 (95% CI -1.73 to -2.29), emotional support, -1.87 (95% CI -2.15 to 1.6), and informational support, -2.12 (95% CI -1.82 to -2.43), were significantly higher in the interventional group than in the control group (p < .001). Conclusions: Support received by mothers of preterm infants determines maternal/neonatal health. Information sharing and effective ways to support are essential elements in the mother's ability to deal with the new, stressful situation. This multifaceted supportive approach considerably improved mothers' perceived support.

Effect of maternal polycystic ovary syndrome (PCOS) on screening of aneuploidy in the first and second trimesters.

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and hormonal disorder in women. This study aimed to assess the effect of maternal PCOS on screening of aneuploidy in the first and second-trimesters. METHODS: This case-control study was conducted in Arash Hospital and Nilou Laboratory in 2017-2018. The screening test was conducted on 90 PCOS and 90 healthy mothers. Finally, the first and second-trimester screening was compared between the two groups using Chi-square, Mann-Whitney's U and students T tests and regression model by SPSS 21. P < 0.05 was considered as statistically significant. RESULTS: Free Beta-Human Chorionic Gonadotropin (Free-ß-HCG) (P = 0.04), inhibin-A (P = 0.001) and Alpha Fetoprotein (AFP) (P = 0.02) levels were higher in the PCOS women comparing to the healthy women but there was no significant difference between the mean of HCG, Plasma Protein A (PAPP-A), and Unconjugated Estriol (UE3) between the two groups. Pre-eclampsia (P < 0.001) and trisomy 18 risks in quad screening were higher in the PCOS women (P = 0.002) than the control group; however, trisomy 13, trisomy 18 and trisomy 21 risks, Smith-Lemli-Opitz Syndrome (SLOS) and Neural Tube Defect (NTD) risks were not different between the two groups. The logistic regression model showed that the first- and second-trimester screening of aneuploidywas related to PCOS. CONCLUSIONS: There was a significant difference in the mean of free-ß-HCG, inhibin-A, AFP level, and the risks of pre-eclampsia, SLOS and trisomy 18 between the two groups but no significant association was found in the mean of HCG, PAPP-A, UE3, NTD and other aneuploidies between the two groups. PCOS may affect the first- and second-trimester screening tests and pregnancy health. It may also require correction in the calculation of risks related to the first- and second-trimester screening for aneuploidy.

Preconception Obstetrics and Rheumatology Consultation: A Protective Factor Against Spontaneous Abortion in Women With Autoimmune Rheumatic Disorders.

BACKGROUND: Autoimmune rheumatic disorders are a group of illnesses that significantly affect pregnancy outcomes. AIM: The aim of this study was to evaluate the incidence and risk factors of spontaneous abortion and its association with maternal medical care in women with autoimmune rheumatic diseases. METHODS: In this medical record review study, we recruited patients who were referred to our clinic from September 2014 to September 2019. All confirmed pregnancies (based on a positive pregnancy test and sonogram) were included. Binary logistic regression was applied to construct the statistical model. FINDINGS: The present study involved 97 women (215 total confirmed pregnancies) who were diagnosed with 7 different autoimmune rheumatic disorders. The rate of spontaneous abortion was 28.8%. In the univariate analysis, the preconception obstetrics and rheumatology consultation were negatively associated with spontaneous abortion (p < 0.001; odds ratio [OR], 0.255; 95% confidence interval [CI], 0.136-0.480; and p < 0.001; OR, 0.042; 95% CI, 0.015-0.122, respectively). Perinatal obstetric care had a significant protective effect (p < 0.001; OR, 0.260; 95% CI, 0.139-0.486). The multivariate analysis showed that the preconception rheumatology consultation (p = 0.003; OR, 0.062; 95% CI, 0.010-0.393) was negatively associated with spontaneous abortions. The presence of active diseases before pregnancy (p = 0.005; OR, 9.978; 95% CI, 2.023-49.223), anti-SSA/Ro (p < 0.001; OR, 22.927; 95% CI, 4.921-106.818), and anticardiolipin IgM (p = 0.004; OR, 298.207; 95% CI, 6.209-14,323.037) were associated with a heightened risk of spontaneous abortion. CONCLUSIONS: A collaborative work carried out by maternal-fetal medicine specialists and rheumatologists could remarkably improve pregnancy outcomes.

A prospective population-based study of stroke in the Central Region of Iran: The Qom Incidence of Stroke Study.

OBJECTIVE: Based on the few population-based studies that have been conducted in the Middle East, we determined the incidence of stroke in Qom, one of the central provinces of Iran. METHODS: The Qom province includes an estimated at-risk population of about 1 million. During a 12-month period (November 2018-November 2019), all first-ever strokes occurring in the target population were registered. Hospitalized cases were ascertained by discharge codes. Out-of-hospital cases were ascertained by a prospective screening of emergency medical services, emergency departments, ambulances records, primary care clinics, rural and urban public health centers, primary care physician offices, and neurologists' offices. Crude and age-adjusted incidence rates (per 100,000 person-years) were calculated. RESULTS: During the study period, 1462 first-ever strokes occurred with a mean age of 68.1 (17-103) years; of these 45.2% were females (661 cases). The crude annual incidence rate per 100,000 at-risk populations was 145.4 (95% confidence interval, 138.1-153.0) for all types of stroke (156.5 for males and 134.3 for females), 26.4 (95% confidence interval, 23.5-29.8) for hemorrhagic stroke, and 114 (95% confidence interval, 105-121) for ischemic stroke. The incidence rate adjusted to the world population was 201.4 (95% confidence interval, 193-210) per 100,000 at-risk populations (adj incidence, 218.5 for males vs 187.4 for females). The total fatality rate during the first 28 days was 19.6%. CONCLUSION: This study states that in this region there is a high incidence of stroke, which occurs at a younger age than the global average. There was a high prevalence of underlying stroke risk factors.

Evaluation of Couple's Sexual Function after Childbirth with the Biopsychosocial Model: A Systematic Review of Systematic Reviews and Meta-Analysis.

BACKGROUND: After childbirth, sexual dysfunction refers to a chain of psychiatric, physiological, social changes and a couple's experiences. The purpose of our Systematic Review (Syst.Rev.) is to evaluate available high-quality evidence and construct a Bio Psycho Social (BPS) model of couple's sexual function after childbirth. MATERIALS AND METHODS: A systematic search was done with MeSH terms in databases, including PubMed, Web of Science, Scopus, and Science direct. A total number of 9 Syst.Rev. were evaluated from 2009 to 2019 years. The quality of extracted articles was evaluated based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist of contents using two qualified reviewers. Data synthesis was performed using the thematic analysis. RESULTS: Biopsychosocial Model of Postpartum Couple's Sexual Function (BMPCSF) is proposed as a developmental process similar to Bronfenbrenner's Bioecological Systems Model. Studies showed a significant relationship among the type of childbirth, trauma of perineum, breastfeeding, mood swings, fears, changes in the self-body image, spousal support, and Postpartum Sexual Dysfunction (PSD). Hence, the evidence about male sexuality in the postpartum period doesn't seem sufficient. CONCLUSIONS: The information from this study will help health policymakers develop the appropriate guidelines to inform couples and healthcare professionals about the BPS changes after childbirth and PSD. Besides, BMPCSF can be used in postpartum sexual counseling to improve sexual health and marital relationships. We propose comprehensive original study on couples' postpartum sexuality, especially men's conduct, emphasizing socio-cultural factors.

Serum Eicosapentaenoic and Arachidonic Acids Concentration and Cognitive Function in Patients With Coronary Artery Disease.

INTRODUCTION: Recent studies have shown that Polyunsaturated Fatty Acids (PUFAs), including Eicosapentaenoic Acid (EPA), and Arachidonic Acid (AA), are associated with cognitive functions in patients with Coronary Artery Disease (CAD). Nevertheless, controversial results have been reported, too. The current study aimed to clarify the association of serum EPA and AA levels with cognitive decline in an Iranian sample with CAD. METHODS: We evaluated cognitive function with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), in relation to serum levels of EPA and AA, in 179 CAD patients. The associations between the MMSE and MoCA scores and the other demographic parameters were evaluated. RESULTS: Patients with CAD generally had mild cognitive impairment. But we could not find any significant correlation between PUFAs and cognitive function. However, BMI was associated with EPA/MoCA; age was associated with MMSE/MoCA and BMI. Finally, the correlation between sex and MMSE/MoCA was significant. CONCLUSION: Subjects generally had mild cognitive impairment, but we could not find any significant correlation between serum EPA and AA levels with cognitive function.

The influence of mode of delivery, anthropometric indices, and infant's sex on the maternal and cord blood orexin-A levels: A cohort study.

BACKGROUND: Orexin as an adipokin hormone plays an important role in appetite regulation, energy metabolism, obesity, diabetes, and cardiovascular disease. The main source of orexin secretion in nonpregnant and pregnant women is adipose tissue and placenta, respectively. This research was conducted to evaluate the association between orexin-A level and the mode of delivery, anthropometric indices, and sex of the infant. METHODS: This prospective cohort study was conducted on 69 normal pregnant women. The samples of umbilical cord blood were obtained at the time of delivery, and maternal blood was taken within 24 h of delivery. Serum orexin-A levels were measured by using enzyme-linked immunosorbent assay. Statistical analyses were performed using SPSS and p < 0.05 was considered as significant. RESULTS: We found a significant difference between postpartum maternal and umbilical cord orexin-A level both with the mode of delivery (p < 0.001). Also, a significant positive correlation was seen between maternal and umbilical cord serum orexin-A levels (r = -0.61, p < 0.001). There was no relationship between serum orexin-A levels with anthropometric indices and the sex of the neonate (p > 0.05). CONCLUSION: Both maternal and umbilical cord serum orexin-A levels were associated with the mode of delivery. Maternal and cord blood orexin-A levels in normal vaginal delivery are higher than cesarean section.

The psychometric properties of the Bergen-Yale sex addiction scale for the Iranian population.

BACKGROUND: The assessment of sex addiction among different populations requires a valid and reliable tool. Since the Bergen-Yale Sex Addiction Scale (BYSAS) was not available in Iran, this study aimed to evaluate the validity and reliability of the Persian version of the BYSAS. METHODS: After translation/back-translation procedure, a total of 756 Iranian men and women completed the BYSAS. The structural validity of this tool was evaluated by exploratory and confirmatory factor analyses. An expert panel review also examined content validity of the items. Psychometric properties of the scale including validity, reliability (internal consistency [Cronbach's alpha]) and test-retest) and factor structure were assessed. RESULTS: Content Validity Index (CVI) and Content Validity Ratio (CVR) scores for the BYSAS were 0.75 and 0.62, respectively. In the measure's structural validity, the results of exploratory and confirmatory factor analysis supported the One-factor structure. Data analysis demonstrated satisfactory internal consistency (Cronbach's alpha ranging from 0.88 to 0.89). DISCUSSION: Study findings suggest that the BYSAS is a valid and reliable instrument for assessing sex addiction among Persian speaking adults. Replication of research findings is needed to expand the BYSAS for clinical and non-clinical Iranian populations.

Metabolic parameters in cord blood of neonate of mothers with obese and non-obese PCOS and controls: retrospective cohort study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by reproductive disorder and increased risk of metabolic syndrome. This study aimed to assess the metabolic parameters in the cord blood of neonate of mothers with obese PCOS and comparison with non-obese PCOS and controls. METHODS: This retrospective cohort study was conducted in Arash and Kamali Hospital in 2017-2018. The biochemical test was conducted on 78 neonates from obese PCOS mothers, 78 neonates from non-obese PCOS mothers, and 78 neonates from healthy mothers. Finally, cord blood lipid profile and insulin and blood sugar were determined by specific kits. Correlations between variables were compared with chi-square, Mann-Whitney's U, Kruskal-Wallis H tests and regression model by SPSS 23 and P < 0.05 was considered significant. RESULTS: Triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were higher in cord blood of newborn of obese PCOS women than non-obese PCOS and controls (P = 0.02, P < 0.001, respectively). Also, the mean insulin was higher in cord blood of neonate of non-obese PCOS women than in obese PCOS and controls (12.26 ± 12.79 vs. 11.11 ± 16.51 vs. 6.21 ± 10.66, P = 0.01). But in the study, there was no significant difference between the mean of umbilical cord low-density lipoprotein cholesterol (LDL), total cholesterol and blood sugar in three groups. The logistic regression model showed that metabolic parameters were related to PCOS. CONCLUSIONS: In the present study, there was a significant difference between the mean of umbilical cord HDL, cholesterol, and the insulin level in the three groups. But, there was no significant association between the mean of blood sugar, LDL, and TG in the groups. The metabolic disorder in PCOS might affect cord blood lipid and insulin and adulthood health.

Comparative Study of the Level of Inflammatory Factors of Erythrocyte Sedimentation Rate and Reactive Protein C in Benign and Malignant Thyroid Nodules

ABSTRACT Objective: To evaluate the level of inflammatory factors of erythrocyte sedimentation rate and reactive protein C in benign and malignant thyroid nodules. Material and Methods: In this case-control study, patients who were referred because of an enlarged thyroid gland were selected, patients who had undergone surgery for the thyroid nodule were included in the study. Erythrocyte sedimentation rate and reactive protein C were measured before surgery in patients who were candidates for thyroid surgery. The histopathological records of patients were retrospectively reviewed. Relevant cases had a cytological evaluation of thyroid nodules by fine-needle aspiration cytology (FNAC). The mean of ESR / CRP in both groups was compared using an independent t-test (p>0.05). Results: In malignant tumor type, in all patients, with Pill (PTC), analyzes in the malignant group showed a significant difference between the mean ESR / CRP in both groups with and without thyroid history. Sub-analyzes in the malignant group were significantly different between the mean ESR / CRP in both groups with and without thyroid histories (p=0.009) (40.16 ± 28.81). The association between ESR and CRP, ESR / CRP and tumor size, ESR / CRP and age in each group as well as in the whole patients were evaluated using Pearson correlation test, which showed a positive association between ESR age and ESR (p=0.024, r=0.375). In the malignant group, a negative correlation was found between the age and the CRP rate (p=0.027, r=-0.441), and in the total patients between the age and the rate (ES=0.043, r=-0.256). Conclusion: Factors such as ESR and CRP, which are considered acute phase reactors and their levels increase in acute inflammatory conditions, may not have a significant increase in chronic inflammatory conditions and malignancies.

Biological reflect of Adiponectin hormone in postpartum marital satisfaction and depression scores.

BACKGROUND: There is a growing body of evidence regarding the association between Adiponectin and mental disorders. We aim to evaluate the association between serum level of Adiponectin hormone and postpartum depression and marital satisfaction scores. METHODS: A prospective cohort study of 90 pregnant women was conducted in Mahdieh Hospital, Tehran, Iran. Blood samples were collected during the first 24 h after delivery. The serum Adiponectin concentration was measured with an Enzyme-Linked Immunosorbent Assay (ELISA) kit. The depression score was measured using a validated Iranian version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire at six weeks (6-weeks) and twelve weeks (12-weeks) after delivery. Using the Kansas questionnaire at twelve weeks (12-weeks) after delivery, the marital satisfaction score was measured. The measurements were compared between two groups, satisfied and dissatisfied mothers. P-values lower than 0.05 were considered significant. RESULTS: The mean serum level of Adiponectin was significantly higher in the dissatisfied group. It was 10.9 ± 13.4 µg/ml and 15.2 ± 17.7 µg /ml in the satisfied and dissatisfied groups, respectively (P = 0.04). The postpartum depression scores of 6- and 12-weeks after delivery were significantly higher in the dissatisfied group. At 6-weeks after delivery, the postpartum depression scores were 3.6 ± 3 and 8.7 ± 5.6 in satisfied and dissatisfied groups, respectively. Those were 2.7 ± 2.7 and 7.6 ± 5 at 12-weeks after delivery, respectively. There was a significant difference statistically (P <  0.001). CONCLUSION: Mothers in the dissatisfied group, experienced higher depression scores at 12-weeks postpartum while they had shown higher serum Adiponectin levels at the first 24 h after delivery.

Effect of short-term and long-term traffic noise exposure on the thyroid gland in adult rats: a sexual dimorphic study.

OBJECTIVES: Traffic noise, as one of the noise types, is a widespread feature of the urban environments. Traffic noise exposure can lead to hearing loss, hypertension, obesity and ischemic heart diseases. Thyroid hormones involved in the physiological and pathological conditions of the body. Therefore, this study was designed to aim the evaluation of traffic noise effects on thyroid hormones secretion and thyroid tissue structure. METHODS: Seventy two males and females wistar rats were used in this study. After one week adaptation, they divided randomly into 12 groups; the control, short term (one day) and long term (one, two, three and four weeks) groups. Traffic sound was recorded, adjusted and played (86 dB) for animals. Female rats' cycle estrus was matched. At the end of experiment, the animals were anesthetized and cardiac blood sample was drawn. Thyroid tissue was then removed. Levels of the T3, T4, TSH, corticosterone and H&E staining were measured. p<0.05 considered to be statistically significant. RESULTS: Findings showed that in the one-day group, T3 levels increased and T3 levels decreased in the long term groups (p<0.05). In the same way, concentration of TSH decreased in the one day, while they increased in the one, two, three and four weeks' groups (p<0.05). Histopathological evaluations showed that in the female and male animals, long-term traffic noise increased the full follicles and decreased empty follicles (p<0.05). CONCLUSIONS: This study revealed that traffic noise exposure led to increase of T3 plasma concentration and decrement of TSH level, although in the long term, they return to basal status. It may be due to adaptation to traffic noise.

Adiponectin levels in maternal serum and umbilical cord blood at birth by mode of delivery: relationship to anthropometric measurements and fetal sex.

BACKGROUND: The rate of cesarean section is increasing worldwide. Adiponectin is a hormone related to anti-inflammatory and anti-atherogenic effects; and it's concentrations may change in response to inflammatory situations including surgical intervention. The aim of the current study was to investigate serum adiponectin levels in maternal and umbilical cord blood according to different modes of delivery and their relationship with anthropometric measurements and fetal sex. METHODS: The study population initially comprised 90 healthy pregnant women referred to the teaching hospital. Eventually, 40 participants in the vaginal delivery group and 35 subjects in the cesarean delivery group were recruited in to the study. Umbilical cord blood and maternal serum samples were analyzed according to the standard protocol from the manufacturer. The collected data were analyzed using SPSS-16 software. P-value < 0.05 was considered as the significance level for all tests. RESULTS: Our results indicated a significant association between maternal adiponectin and the mode of delivery, with adiponectin levels significantly higher in vaginal delivery compared to cesarean section (P < 0.001). However, no difference was found in umbilical cord blood adiponectin between the two groups (P = 0.51). A significant positive correlation was found between maternal serum adiponectin in the first day after birth and umbilical cord blood adiponectin in the vaginal delivery group (P = 0.007). Nevertheless, this correlation was not statistically significant in the cesarean delivery group (P = 0.62). There was also no significant correlation between fetal sex and anthropometric measurements with maternal adiponectin (P = 0.44) and umbilical cord blood adiponectin (P = 0.86). CONCLUSIONS: The result of the current study revealed that maternal adiponectin concentration was significantly higher in vaginal delivery compared to cesarean section, which might be due to the increased levels of maternal adiponectin release during labor.

The Postpartum Marital Satisfaction, Maternal Serum Concentration of Orexin-A and Mode of Delivery.

Aims: We aimed to assess the association of postpartum maternal serum concentration of orexin-A with postpartum marital satisfaction considering the effect of mode of delivery as an influential factor. Methods: This cohort study conducted among third trimester pregnant women, who met our eligibility criteria. Postpartum maternal and cord serum concentration of orexin-A were measured and their association with postpartum marital satisfaction were assessed considering the impact of mode of delivery. Results: There was a statistically significant positive association between postpartum maternal and cord serum levels of orexin-A (r = 0.79, p < 0.001) and postpartum marital satisfaction among women with cesarean section (r = 0.31, p < 0.01). The maternal orexin-A level of women delivered with cesarean section who had post-partum marital dissatisfaction was significantly lower than those one with marital satisfaction (84.13 ± 95.88 vs. 153.08 ± 95.88 pg/ml, p = 0.04). Logistic regression model showed that the type of delivery was not related to marital satisfaction (OR = 1.7, 95%CI: 0.6, 4.8), p = 0.280). Conclusions: The postpartum maternal serum orexin-A level was associated with marital satisfaction in women delivered through cesarean section.