Maternal and Neonatal Outcomes of COVID-19 Infection in Pregnancy.

BACKGROUND: Limited data is available on the full spectrum of maternal COVID-19 infection in terms of pregnancy outcomes. The present study aimed to compare the maternal and neonatal outcomes of COVID-19 in infected and non-infected pregnant women. METHODS: A dual-site retrospective cohort study was conducted in two tertiary hospitals in Isfahan, Iran. The sample included 104 infected and 210 non-infected hospitalized pregnant women. Odds ratios (OR) were estimated using multivariate logistic regression. RESULTS: There were significant differences between COVID-19-infected and non-infected pregnant women regarding preterm labor (PTL) (odds ratio [OR]: 11.34, 95% confidence interval [CI]: 1.19-48.54, P=0.035); hospitalization days (OR: 7.21, 95% CI: 4.05-12.85, P≤0.001); cesarean section (CS) (OR: 4.76, 95% CI: 1.78-12.45, P=0.002); neonatal admission to neonatal intensive care unit (NICU) (OR: 1.28, 95% CI: 1.12-1.67, P=0.004); and neonatal respiratory distress (OR: 2.37, 95% CI: 1.02- 5.47, P=0.044). No significant association was found between COVID-19 infection and abortion (OR: 0.06, 95% CI: 0.01-1.45, P=0.084); stillbirth (OR: 1.84, 95% CI: 0.05-39.68, P=0.743); Apgar score (1 minute) (OR: 0.91, 95% CI: 0.74-1.13, P=0.382); Apgar score (5 minutes) (OR: 0.97, 95% CI: 0.81-1.18, P=0.765); and low birth weight (LBW) (OR: 4.76, 95% CI: 1.78-12.45, P=0.002). CONCLUSION: PTL, CS, neonatal admission in NICU, neonatal respiratory distress, and hospitalization days were significantly higher in pregnant women with COVID-19 compared to those without infection.

Impact of COVID-19 Infection on Neonatal Birth Outcomes.

INTRODUCTION: There is limited data on newborns born to mothers with COVID-19 infection. This multicenter cohort study aimed to investigate the clinical characteristics and outcomes of neonates born to mothers with and without COVID-19 infection to fill a gap in the literature review. METHODS: The medical records of all neonates in Isfahan, Iran, between October 2020 and March 2021, were retrospectively reviewed. RESULTS: Among the 600 neonates in this study, 255 (42.5%) were in the infected group and 345 (57.5%) were assigned to the control group as they were born to non-infected mothers. In the infected group, sepsis, fever and pneumothorax were detected in 3 (1.2%), 3 (1.2%) and 4 (1.6%) neonates, respectively, compared with no case in the control group. In the infected group, neonatal respiratory distress (NRDS) (32, 12.5%) was significantly higher than the control group (27, 10.6%). Asphyxia in the infected group was 22(6.4%), compared with 19 (5.5%), in the control group. Preterm labor (PTL) (55, 21.65%), premature rupture of membranes (PROMs) (24, 9.4%) and intra-uterine growth retardation (IUGR) (15, 5.9%) were significantly higher in women with COVID-19 (45, 13.0%, 4, 1.2% and 7, 2.0%, respectively). Low birth weight (LBW) accounted for 42 (16.5%) neonates in the infected group and 25 (7.2%) in the control group (p < 0.05). Of the 255 neonates born to infected mothers, 38 (14.9%) were admitted to the Neonatal Intensive Care Unit (NICU), compared with 31 out of 345 (9.0%) in the control group (p < 0.05). RT-PCR test results were positive in two newborns (0.8%), one of whom died of necrotizing enterocolitis. CONCLUSION: As a result of maternal COVID-19 infections, neonates experienced higher rates of sepsis, fever, pneumothorax, asphyxia and NRDS in addition to PTL, PROMs, IUGR, and LBW.

Contradictory results have been reported on the impact of COVID-19 infection on neonatal outcomes. We conducted a review of 600 cases of neonates, with 255 (42.5%) in the COVID-19 infected and 345 (57.5%) in the control group. The results indicated that neonates born to women with COVID-19 showed higher rates of sepsis, fever, pneumothorax, asphyxia and neonatal respiratory distress in addition to preterm labor, premature rupture of membranes, intra-uterin growth retardation and low birth weight.

Comparison of serum level of some trace elements and vitamin D between patients with premenstrual syndrome and normal controls: A cross-sectional study.

BACKGROUND: Premenstrual syndrome (PMS) is a common problem among women and is identified by reversal emotional, psychological, and physical signs during the luteal phase. These signs, however, lower down in the follicular phase. The cause of PMS isn't very well-known up to nowControl group and many researchers have suggested that mineral compounds and vitamins can inhibit these symptoms. OBJECTIVE: The objective of this study is to compare the serum level of some trace elements and vitamin D between normal controls and patients with PMS. MATERIALS AND METHODS: 300 female students (19-21 yr old) from Falavarjan County were randomly selected and asked to complete a standard questionnaire on PMS during three menstruation cycles. The students were divided into two groups: healthy persons (control) and PMS persons, and PMS was determined on the basis of the answers to the questionnaire. Thereafter, the serum concentrations of zinc, iron, calcium, magnesium, potassium, sodium, and Vitamin D3 were measured and compared between the two groups. RESULTS: Our results showed that the PMS prevalence was about 41.5%. The level of vitamin D decreased in both the control and PMS groups, with a significantly lower range of vitamin D (p ≤ 0.05) in the PMS group. Other factors had no significant change between the two groups. CONCLUSION: Vitamin D deficiency was probably one of the most important causes of unpleasant symptoms of PMS between these students.

Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial.

BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the common cause of Oligo-ovulation. This syndrome causes long-term metabolic issues as well as increase the risk of diabetes type 2, hypertension, dyslipidemia, and cardiovascular disease. The current research aimed to study the effect of green tea on weight and hormonal changes of women suffering from PCOS. METHODS: This two group, double-blind, randomized clinical trial was conducted in Isfahan city. Overweight women suffering from PCOS (n = 60) were randomly divided into two groups. Green tea was prescribed to the experimental group, and placebo was prescribed to the control group. Free testosterone hormones and fasting insulin were compared in both groups at the beginning and 12 weeks after the study commencement. The weight of participants of both groups was also measured before and after the study. The statistical data were analyzed by SPSS software and paired t-test. RESULTS: The paired t-test showed that there was no significant difference in the mean weight of both groups before the intervention (P = 0.812), but the difference was significant after the intervention (P = 0.031). There was no significant difference in the mean fasting insulin of both groups before the intervention (P = 0.352), but the difference was significant after the intervention (P < 0.0001). Moreover, there was no significant difference in the mean free testosterone level of both groups before the intervention (P = 0.638), but the difference was significant after the intervention (P < 0.0001). CONCLUSION: The consumption of green tea by overweight and obese women suffering from PCOS leads to weight loss, a decrease in fasting insulin, and a decrease in the level of free testosterone.

Strategy for Mental Health Improvement of Iranian Stillborn Mothers From Their Perspective: A Qualitative Study.

BACKGROUND: Mothers got stressed when they are informed about the occurrence of stillbirth. Many researchers believe that the failure to provide the required care by health teams during this hard time is the main determinant of maternal mental health in the future. In other words, psychosocial support by medical care providers can significantly improve mental outcomes of mother after stillbirth. OBJECTIVES: This study aimed to explore stillborn mothers' suggested strategies to provide maternal mental health in the experience of stillbirth. PATIENTS AND METHODS: Twenty women who had experienced stillbirths participated in this qualitative content analysis study. They were selected through purposeful sampling method. Data were gathered by individual interviews recorded on audiotapes, transcripted and then analyzed. Then, transcriptions were coded and classified. Finally, 3 main categories and 9 subcategories were emerged. RESULTS: Analysis of participants' viewpoints and their opinions about strategies to provide maternal mental health in the experience of stillbirth lead to development of 3 main categories: "before delivery strategies" with 3 subcategories, "during labor strategies" with 3 subcategories, and "postpartum strategies" with 3 subcategories. Analyses of findings showed that, health care providers can mitigate some of the long-term negative mental outcomes of stillborn mothers by spending extra time with grieving mothers, facilitating bonding, and validating their emotional expressions. CONCLUSIONS: According to the results, revision and modification of the care plan in the experience of stillbirth seems necessary to improve mental health in these mothers. According to suggested strategies, midwives and health care providers are health professionals who can effectively and properly care for stillborn mothers.

Social support: An approach to maintaining the health of women who have experienced stillbirth.

BACKGROUND: Stillbirth is one of the deepest losses that can inflict a broad range of cognitive, mental, spiritual, and physical turmoil. Many researchers believe that the failure to provide the care required by health teams during the hard times is the main determinant of maternal mental health in the future. In other words, social support can significantly improve the mental health outcomes of mothers after stillbirth. This study aimed to explore social support to aid mothers in adaptation after the experience of stillbirth. MATERIALS AND METHODS: This was a qualitative content analysis in which 15 women who had experienced stillbirth participated. They were selected through purposeful sampling method. Data were gathered by individual interviews recorded on audiotapes, transcribed, and analyzed. Interview transcriptions were coded and then classified. Finally, two main categories and five subcategories emerged. RESULTS: Analysis of participants' viewpoints and their statements about social support led to the emergence of the two main categories of support from relatives and support from social support systems with two and three subcategories, respectively. Analysis of findings showed that mothers experiencing stillbirth need the support of their spouse and family and friends through sympathizing, in performing everyday activities and to escape loneliness. These women require support from a peer group to exchange experiences and from trauma counseling centers to meet their needs. CONCLUSIONS: It seems necessary to revise and modify the care plan in the experience of stillbirth using these results and, of course, to be considered by a panel of experts in order to provide social support to these women. Thus, midwives and healthcare provider can act, based on the development and strengthening of social protection of women experiencing stillbirth, to provide these women with effective and appropriate care.

The role of religious beliefs in pregnancy loss.

INTRODUCTION: Birth can cause and post-traumatic stresses in many women even when the occasion of birth results in alive baby. Fetal death can challenge her understanding of justice and God's love toward his creatures. Religious beliefs have a considerable effect on decreasing individuals' tendency toward bereavement; thus, it is expected to have a relationship with sorrow and mental distress ensuing fetal death. The present research has been conducted to review the existing literature on religion and fetal death and then study Iranian women and their families' response to such a tragedy. MATERIALS AND METHODS: This is a unsystematic (narrative) review. Research was conducted to study the role of mothers' religious belief in their encounter with pregnancy loss in cases belonging to a 23-year period from 1990 to 2013. PubMed and Ovid databases and Iranian religious resources such as Tebyan were utilized for these studies. Of course, several articles were also derived by means of manual search. RESULTS: Nine out of 31 papers had the searched keywords in common in the preliminary search. A review of the existing papers indicated that only 4 out of 22 papers dealt exactly with the role of religion on reaction of parents to fetal death. The four papers belonged to the years 2008, 2010, 2011, and 2012 indicating the new approach to religion in pregnancy loss cases. CONCLUSION: Religion has a significant effect on parents' acceptance of such mishaps and it may have a considerable effect on their recovery from such tragic events.