Quality of life questionnaire for women with gestational diabetes mellitus (GDMQ-36): development and psychometric properties.

BACKGROUND: Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers' quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. METHODS: A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. RESULTS: Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of "Diabetes Clients Quality Of Life" and the researcher-made questionnaire (r = 0.63). Cronbach's alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. CONCLUSION: Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.

The diagnostic power of cervico-vaginal fluid prolactin in the diagnosis of premature rupture of membranes.

BACKGROUND: Premature rupture of membranes (PROM) is one of the most common complications of pregnancy that has a major impact on pregnancy outcomes. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. The purpose of this study was to evaluate the diagnostic power of the vaginal washing fluid prolactin for the diagnosis of premature rupture of membranes and to determine cut-off values. METHODS: A total of 114 pregnant women were recruited in this diagnostic trial. The PROM group consisted of 54 pregnant women between 20 and 41 weeks of gestation with diagnosis of confirmed PROM [amniotic fluid pooling (+) and Nitrazine paper test (+) and fernt test (+)]. The control group consisted of 60 pregnant women between 20 and 41 weeks of gestation without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, fern test, vaginal washing fluid prolactin sampling. RESULTS: Vaginal fluid concentrations of prolactin was significantly different between the two groups (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 87.03%, 75.0%, 75.80%, 86.53% and 83.33% in detecting PROM by evaluation of vaginal fluid prolactin concentration with a cut-off value of 9.50 µIU/ml, respectively. CONCLUSIONS: The prolactin levels in the washing fluid of the posterior vaginal fornix in our experience is reliable and non-invasive diagnostic tests of PROM.

Air pollution and low birth weight: a historical cohort study from Tehran.

This historical cohort study was designed to clarify the association between air pollution and low birth weight (LBW) amongst women referred to Tehran hospitals in 2007. In total, 225 eligible pregnant women who lived within 5 km of an air pollution monitoring station during their pregnancy were selected for the study. Data were collected via interview and hospital records. Exposure to each pollutant was estimated for each woman individually throughout her pregnancy and for each trimester. Exposures were modelled as categorical variables using inter-quartile ranges in a logistic regression model. The results showed a significant association between exposure to CO and LBW (OR = 2.08, 95% Cl: 1.70-4.60), particularly during the second trimester (OR = 3.96, Cl: 1.83-12.5). We conclude that exposure to air pollution during pregnancy may be associated with LBW.

Comparison of ELISA and three rapid HCG dipsticks in diagnosis of premature rupture of membranes.

BACKGROUND: The importance of accurate diagnosis of premature rupture of membranes (PROM) is quite apparent while trying to diminish false negative or positive results as much as possible. This study compares Enzyme-Linked Immunosorbent Assay (ELISA) and three rapid human chorionic gonadothropin (HCG) dipsticks in diagnosis of premature rupture of membranes. METHODS: During 2008-2009, 181 pregnant women with single pregnancy from 14 to 41 weeks of gestation who referred to Ayatollah Taleghani Hospital in Tehran, Iran were divided into two groups, 91 patients with PROM and 90 controls with matched gestational weeks. All patients underwent speculum examination for cervicovaginal washing fluid, HCG three rapid tests and ELISA. RESULTS: The HCG concentration of vaginal fluid was significantly different between the two groups. Using receiver operating characteristic (ROC) curve and determining the threshold as 19 mIU/mL for HCG by ELISA method, the sensitivity was 94.5%; specificity, 91%; positive predictive value, 91.5%; negative predicted value, 94.2% and accuracy was 92.2%. In rapid diagnostic test, the most sensitivity was for ACON and the most specificity for DIMA. Comparing the four methods, DIMA strip showed the highest accuracy and the highest value in early diagnosis of ROM. CONCLUSION: The reliability of three rapid diagnostic tests in diagnosis of ROM in cervicovaginal discharge was acceptable.