Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis.

BACKGROUND: Sexual problems and diminished sexual quality of life can adversely affect the physical, psychological, and emotional health of women. The present study was done to determine the social intermediate factors of health associated with sexual quality of life in women of reproductive age. DESIGN: Systematic review and Meta-analysis. DATA SOURCES: Embase, Web of Science, PubMed/Medline (NLM), ProQuest, and CENTRAL. ELIGIBILITY CRITERIA: Observational studies (cross-sectional, case-control, cohort) from 2010 to 2022 with no language constraints were included. The sexual quality of life, as the main variable of the study, has been evaluated using Symonds women's sexual quality of life scale (SQOL-F). The health social determinants intermediate factors based on WHO model were considered as exposure variables. DATA EXTRACTION AND SYNTHESIS: The data of included studies were extracted by two independent persons through a researcher-made checklist according to the study aims. Quality assessment of studies was done using Newcastle-Ottawa instrument. R software (Version R-4.2.1) were used for meta-analysis. Publication bias was evaluated by Egger & Begg tests. Sensitivity analysis was done through one-out remove approach. RESULTS: Eventually, 15 studies were eligible to be included in this systematic review and meta-analysis. Variables of depression, quality of marital relation, body image, self-esteem, physical activity, and sexual function were among the health social intermediate factors associated with sexual quality of life. Publication bias had no effect on the obtained results; no study affecting the results was found through sensitivity analysis. CONCLUSION: Considering the relationship between modifiable factors and sexual quality of life, it seems that identification of these factors can be an important step towards designing interventional studies to help women experience enhanced sexual quality of life.

Designing and validation of a reproductive health need assessment tool for women experienced domestic violence.

BACKGROUND: Violence as a serious health problem and one of the main manifestations of gender inequality brings about adverse health effects for women. Therefore, it is of utmost importance to recognize the reproductive health status of women subjected to violence in order to provide the health services they need. Considering that one of the ways to determine reproductive health status is the use of valid questionnaires in this field, this study aimed to determine the components of reproductive health in domestic violated women and design a valid and reliable assessment tool. METHODS: The present study was conducted based on a mixed-method design. The first part of the study (qualitative section) was conducted based on conventional content analysis. In this part, unstructured in-depth interviews were conducted with 18 violated women and 9 experts. In the next stage, the item pool was formed and the Reproductive Health Needs of Violated Women Scale was designed based on the review of the literature and the results of the qualitative section with 39 items using the Waltz approach. For psychometric assessment of the above instrument, face and content validity, item analysis, and construct validity were examined using exploratory factor analysis. RESULTS: Based on the results of factor analysis, the four following factors were extracted with a total variance of 47.62: "men's participation", "self-care", "support and health services", as well as "sexual and marital relationships. The internal consistency of the instrument was calculated at α = 0.70-0.89 and α = 0.94 for different constructs and the whole instrument, respectively. Moreover, intra-cluster correlation coefficients were obtained at ICC = 0.96-0.99 and ICC = 0.98 for constructs and the whole instruments, respectively. CONCLUSIONS: Based on the results of the current study, the present scale is a tool that specifically assesses the reproductive health needs of violated women and has appropriate validity and reliability. The results of the assessment using the aforementioned instruments can be of great help in promoting the reproductive health of women subjected to violence.

Violence against women is a significant public health problem, as well as is a fundamental violation of women's human rights. Violence can negatively affect women's physical, mental, sexual and reproductive health. So there is obviously a need to measure this issue to provide necessary services for women experiencing violence. In current work an appropriate instrument was developed on the basis of the qualitative findings and a literature review. For this purpose, the inductive-deductive method was used to design the expressions and items of the tool. Both qualitative and quantitative methods were used to determine face and content validity. The construct validity was investigated by exploratory factor analysis; in this part of study the sample included three hundred and fifty violated women. The final version of the scale have four factors with total variance of 47.62 and 39 items which are evaluated by Likert scale. The current tool was valid and reliable to measure the reproductive health needs in domestic violated women.

Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making.

BACKGROUND: Women's empowerment is a process wherein females are afforded power over their own lives as well as their participation in the communities and larger societies to which they belong. An important aspect of such empowerment is the right to make decisions regarding fertility-an entitlement affected by the social health determinants that contribute to the social conditions under which humans live and work throughout their lives. As one such determinant, psychosocial factors play an essential role in the development of women's empowerment. Correspondingly, this study conducted a structural equation modeling of these determinants to examine the empowerment of Iranian women in reproductive decision making. METHODS: This cross-sectional study involved 400 women who were referred to clinical centers of the Shahid Beheshti University of Medical Sciences in Tehran, Iran. Data were collected using six questionnaires, namely, demographic, socioeconomic, and social support questionnaires, the Rosenberg self-esteem scale, a marital satisfaction questionnaire, and an empowerment survey. The data were analyzed using SPSS software version 17, and the structural equation modeling was carried out using EQS software version 6.1. RESULTS: The Iranian women had an average level of empowerment with respect to reproductive decision making, and such empowerment was related to all the psychosocial factors examined (p = 0.001). The final model appropriately fit the data (comparative fit index = 0.92, root mean square error of approximation = 0.06). The psychosocial factors served as intermediate social determinants of the women's empowerment in reproductive decision making (ß = 0.78, p = 0.001). This empowerment was indirectly affected by socioeconomic situation as a structural factor (ß = 0.44, p = 0.001). CONCLUSIONS: Socioeconomic factors, through the mechanism of psychosocial determinants, may significantly affect women's empowerment in making decisions regarding reproductive health. Conditions associated with these factors should be improved to ensure that women claim and exercise their right to have mastery over their reproductive health.

The Structural Model of Spirituality and Psychological Well-Being for Pregnancy-Specific Stress.

Women experience different types of stress in their lifetime. The present study was conducted to examine the structural model of spirituality and psychological well-being for pregnancy-specific stress. The present descriptive correlational study was conducted on 450 pregnant Iranian women (150 women from each trimester) in Dehdasht city in 2015. Data were collected using the personal-social questionnaire, the pregnancy-specific stress questionnaire, the spirituality questionnaire and the psychological well-being questionnaire and were then analyzed in SPSS-16 and Lisrel-8.8 for carrying out a path analysis. The fit indices of the model indicate the good fit and high compatibility of the model and rational relationships between the variables (GFI = 0.94, NFI = 0.85, CFI = 0.94 and RMSEA = 0.048). Of the variables that affected pregnancy-specific stress through both paths, spirituality had a positive effect (B = 0.11) and the personal-social variable a negative effect (B = -0.37). Psychological well-being affected pregnancy-specific stress negatively and directly and through one path only (B = -0.59). The results obtained through the model confirm the effect of spirituality and psychological well-being in reducing pregnancy-specific stress. Given that handling stress has a major role in the quality of daily life in pregnant women, stress management skills are recommended to be promoted among pregnant women so as to mitigate stress and its negative consequences.

Psychosocial factors in pregnancy and birthweight: Path analysis.

AIM: Birthweight is known to be affected by several factors. In the present study a relationship model of psychological and economic determinants of birthweight was designed and tested. METHODS: This prospective study involved 400 pregnant women in four districts of Tehran, Iran. The subjects were selected through a multistage sampling method. Seven questionnaires (socioeconomic status; Holmes and Rahe Stress Scale; Perceived Stress Scale; 21-item Depression, Anxiety, and Stress Scale [DASS-21]; perceived social support; pregnancy-related anxiety scale; and domestic violence questionnaire) were used to assess participant psychosocial and economic conditions. In order to collect post-partum information about the mother and the infant, the women were followed up until delivery. Data were analyzed using SPSS-16 and Lisrel-8.8. RESULTS: Based on the obtained path diagram, the greatest adverse effects on birthweight were exerted directly by DASS-21 score (B = -0.14) and indirectly by stressful life events (B = -0.037). Among variables that affected birthweight in both paths, socioeconomic status and perceived stress had the strongest overall effects on birthweight (B = 0.203 and -0.1024, respectively). CONCLUSION: According to the path analysis model, psychosocial and economic factors can directly/indirectly affect birthweight.

Assessment of quality of prenatal care in Shahid Beheshti Medical Science University centers.

PURPOSE: Improving hospital service access and mothers' care are said to be the best approaches for decreasing maternal mortality. This study aims to evaluate prenatal care (PNC) and suggest ways to improve hospital and health center maternity services. DESIGN/METHODOLOGY/APPROACH: This was a cross-sectional descriptive study to evaluate prenatal care services in three domains: service structure; care process; and outcomes. Using non-randomized quota sampling, 600 PNC clients were assessed in 12 pre-natal clinics. Two checklists were used to assess facilities and care process and a questionnaire to assess client satisfaction. Validity and reliability were assessed and confirmed. FINDINGS: Six hundred subjects, averaging 29.3 (+/- 9.4) weeks pregnancy, were included. Assessing different care processes demonstrated the following compliance to standards: counseling process 55.5 per cent (+/- 21.2); history-taking 48.71 per cent (+/- 11.4); vital signs assessment 53.4 per cent (+/- 10.6); general examination 30.2 per cent (+/- 13.3); obstetrical examination 91.8 per cent (+/- 27); blood tests 93.8 per cent (+/- 21.9); urinary tests 86.9 per cent (+/- 26.3); clients' education about peri-natal-risk 39.7 per cent (+/- 27.1). Results showed that 0.54 per cent (+/- 13.1) of clients were satisfied with care processes. RESEARCH LIMITATIONS/IMPLICATIONS: Clients and providers were informed about the study's evaluation processes, which may have affected the results. PRACTICAL IMPLICATIONS: Study method and results can be used to improve PNC services. ORIGINALITY/VALUE: This is the first time a study has focused on Iranian PNC structures, processes and outcomes.

The relationship between social determinants of health and girls' age at menarche based on the world health organization model: path analysis.

Objectives: Given the descending trend of menarche age and the effect of social determinants of health on menarche, the present study was conducted to examine the relationship model of social determinants of health with menarche age of girls. Materials and methods: The present cross-sectional study enrolled 840 mothers and their 6-17 year-old daughters in the city of Kashan, Iran (2020). Questionnaires used included: demographic-family questionnaire for mothers and daughters, question about age at menarche, Perceived Social Support, Physical Activity, Socioeconomic Status, Spiritual Health, General Health Questionnaire, the quality of couple's relationship and the family communication pattern. The statistical analysis was performed in SPSS-16, and the relationship model was examined using path analysis method in LISREL-8.8. Results: The girls' menarche age was directly affected by sister's (b = 0.83) and mother's menarche age (b = 0.05), BMI (b = 0.01), physical activity (b = -0.06), conversation orientation (b = -0.002), socioeconomic status (b = -0.01) and maternal general health (b = 0.009). It was also indirectly affected by mother's menarche age, social support, socioeconomic status, and maternal spiritual health and parents relationships. Conclusions: The results showed that the numerous factors affect the girls' age at menarche directly and indirectly. Considering mutual interaction of factors revealed in the proposed model, it is recommended this model be used as an appropriate framework in research, design and implementation of programs relating to adolescent girls.

Sexual dysfunction among women of reproductive age: A systematic review and meta-analysis.

BACKGROUND: Available statistics show a high prevalence of sexual dysfunction (SD) among women worldwide. Various factors affect SD among women of reproductive age. OBJECTIVE: To evaluate studies on the prevalence and determinants of SD in different parts of the world. MATERIALS AND METHODS: MEDLINE, EMBASE, Web of Science, Scopus and ProQuest databases were systematically reviewed during 2000-2019. All original articles were reviewed. The STROBE checklist was used to evaluate the quality of the papers. I 2 was calculated to determine heterogeneity. Fixed effects and/or random-effects models were applied to estimate the pooled prevalence. Meta-regression analysis was also performed to identify the sources of heterogeneity. RESULTS: Based on the results of the meta-analysis (21 eligible studies), the pooled prevalence with 95% confidence interval of SD was estimated at 50.75% (41.73-59.78). The prevalence of pain and disorders in arousal, sexual desire, lubrication, orgasm, and sexual satisfaction were calculated (39.08%, 48.21%, 50.70%, 37.60%, 40.16%, and 35.02%, respectively). Also, age, depression, low education level, increased duration of the marriage, and the presence of chronic diseases were the highest risk factors for SD. CONCLUSION: The prevalence of SD in women of reproductive age varies in different countries. Considering the importance of female SD, further studies are needed to facilitate the development of relevant educational interventions.

Comparison of health-promoting lifestyle and irrational health beliefs in healthy pregnant women and gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. The goal of this study was to compare health-promoting lifestyles and irrational health beliefs in pregnant women with GDM and healthy pregnant women. MATERIALS AND METHODS: The present study was a descriptive causal-comparative study in which 100 eligible GDM women and 100 eligible healthy women were selected through available sampling in three referral hospitals in Tehran In 2020. In this study, the Health Promoting Lifestyle Profile (HPLP) and the Irrational Health Beliefs Scale (IHBS) were used. Data were analyzed using independent t-test and logistic regression by SPSS 16 software. RESULTS: Findings showed that there is a significant relationship between the variables of IHBS and HPLP. For every one unit increase in an IHBS score, the chance of having diabetes increases by 2.8%. In the case of HPLP, women who exercised well were 7.5% less likely to develop diabetes, and those who took good responsibility were 7.8% less likely to develop diabetes. Furthermore, in independent t-test, the HPLP variable showed a significant difference between the two groups with diabetes and healthy individuals (P < 0.001). Furthermore, in comparing the subscales of this variable, physical activity (P < 0.0001), self-fulfillment (P < 0.004), responsibility (P < 0.003), and stress control (P < 0.001), a significant difference was observed. The results of IHBS research showed a significant difference between the two groups of gestational diabetes and healthy individuals (P < 0.004). CONCLUSION: The results of the present study show the need to identify and focus on irrational health beliefs and health-promoting lifestyles. Modification of these psychological structures can be useful in the prevention and management of this chronic disease.

Effect of omega-3 and vitamin D co-supplementation on psychological distress in reproductive-aged women with pre-diabetes and hypovitaminosis D: A randomized controlled trial.

PURPOSE: Psychological distresses and pre-diabetes are among the risk factors of developing type-II diabetes. The present study was conducted to determine the effectiveness of omega-3 and vitamin D co-supplementation on psychological distresses in women of reproductive age with pre-diabetes and hypovitaminosis D. METHODS: The present factorial clinical trial was conducted on 168 women of reproductive age with pre-diabetes and hypovitaminosis D. These participants were selected by stratified random sampling and were assigned to four groups for 8 weeks: group 1 (placebo group), group 2 (omega-3 group), group 3 (vitamin D group), and group 4 (co-supplement group). The medication and placebo doses being two 1000-mg tablets each day for omega-3 and 50,000-IU pearls every 2 weeks for vitamin D. Fasting blood glucose and vitamin D were measured at the beginning of the study. The Depression Anxiety Stress Scale-21 and the Pittsburgh Sleep Quality Index were completed by the participants at the start and end of the intervention. RESULTS: A significant difference was observed in terms of reduction in anxiety and improvement in sleep quality in the co-supplementation compared to the other three groups (p < .05). There was also a significant difference between the group receiving both supplements and the group receiving only placebos in terms of reduction in depression and stress (p < .05). CONCLUSION: Vitamin D and omega-3 co-supplementation improved depression, anxiety, and sleep quality in women of reproductive age with pre-diabetes and hypovitaminosis D. Therefore, these two supplements can be recommended for improving the mental health of this group of women. CLINICAL TRIAL REGISTRY: Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on February 9, 2019.

The effect of omega-3 and vitamin D co-supplementation on glycemic control and lipid profiles in reproductive-aged women with pre-diabetes and hypovitaminosis D: a randomized controlled trial.

BACKGROUND: Prediabetes can predispose the individual to type 2 diabetes in the long-term. The present study was conducted to determine the effectiveness of vitamin D and omega-3 co-supplementation on glycemic control and serum lipid profiles in women of reproductive age with prediabetes and hypovitaminosis D. METHODS: The present factorial, triple-blind, clinical trial was conducted on 168 women of reproductive age with prediabetes and hypovitaminosis D. The participants were assigned to four groups based on block randomization method: the placebo group received omega-3 and vitamin D placebos; the omega-3 group took omega-3 supplements and vitamin D placebos; the vitamin D group received omega-3 placebos and vitamin D supplements and the co-supplementation group. The groups received every 2 weeks 50,000 IU pearls of vitamin D and twice-daily doses of 1000-mg omega-3 tablets or placebos for 8 weeks. Dietary intake, physical activity, anthropometric indices and blood biochemical tests were measured at the beginning and end of the study. Analysis was performed using two-way mixed ANOVA. RESULTS: A significant reduction was observed in fasting glucose, insulin, homeostasis model assessment-beta cell function, weight and waist circumference in the co-supplementation group compared to the other three groups (P < 0.05). Moreover, high-density lipoprotein-cholesterol levels increased significantly in the co-supplementation group compared to the other three groups (P < 0.05). Despite the fact that homeostasis model assessment-insulin resistance, total cholesterol, triglyceride and low-density lipoprotein-cholesterol levels decreased after intervention in the co-supplementation group, there was no significant difference between the groups in these outcomes. CONCLUSION: Vitamin D and omega-3 co-supplementation improved fasting serum glucose, insulin, high-density lipoprotein-cholesterol level, homeostasis model assessment-beta cell function, weight and waist circumference in women of reproductive age with prediabetes and hypovitaminosis D. This co-supplementation can therefore be recommended for glycemic control in these women.Trial registration Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on 9 Feb. 2019.

Weight gain during pregnancy and its associated factors: A Path analysis.

Aim: Weight gain during pregnancy is an important indicator in the prediction of morbidity and mortality in infants and mothers. This study aimed to determine the association factors for weight gain during pregnancy. Design: A longitudinal study. Methods: A total of 734 women were selected using multistage cluster sampling. Data were collected using demographic and midwifery questionnaires, economic and social status, psychological factors, domestic violence, perceived social support and food insecurity. Results: Of participants 28.7%, 49.6% and 21.7%, respectively, received insufficient, adequate and excessive weight gain in pregnancy respectively. Among health determinants entered in the model, mother's age, prepartum body mass index and direct and indirect prenatal care, size of households, food insecurity, stress, anxiety, stress and pregnancy-specific stress as well as violence had a positive and increasing effect on weight gain during pregnancy. Conclusion: Considering the effect of inappropriate weight gain during pregnancy on undesirable pregnancy outcomes, related factors such as nutritional status, stress and depression in prenatal care should be assessed. Healthcare providers should consult, educate pregnant women.

The effect of co supplementation of omega-3 and vitamin D on cardio metabolic risk factors and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D: a study protocol for a randomized controlled trial.

BACKGROUND: A prediabetic state is a risk factor for type 2 diabetes. There are no approved drugs to manage prediabetes. Among the supplements routinely used by individuals, vitamin D and omega-3 have been studied to reduce fasting blood sugar. However, their co-supplementation has not been studied in individuals with prediabetes. This randomized controlled trial is designed to determine the effects of these two supplements on fasting blood sugar, other cardio metabolic risk factors, and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D. METHODS/DESIGN: This 2 × 2 factorial, triple-blind, randomized, placebo-controlled, clinical trial will be done on 168 women of reproductive age diagnosed with prediabetes and hypovitaminosis D. Participants will be randomly assigned equally to four groups: (1) 1000 mg omega-3 fatty acid twice a day + vitamin D placebo every two weeks; (2) omega-3 fatty acid placebo twice a day + 50,000 IU vitamin D every two weeks; (3) 1000 mg omega-3 fatty acid twice a day + 50,000 IU vitamin D every two weeks; (4) omega-3 fatty acid placebo twice a day + vitamin D placebo every two weeks for eight weeks. At the beginning, participants will provide a self-reported questionnaire on the sociodemographic characteristics. At baseline and post-intervention visits, physical activity, Depression Anxiety Stress Scale 21 and Pittsburgh Sleep Quality Index, and a three-day food record will be collected for each individual. Blood pressure, weight, height, and waist circumference will also be measured. At the beginning and at the end, a blood sample will be used for estimating serum glucose indices (fasting blood sugar and insulin, homeostasis model assessment-insulin resistance, homeostasis model assessment-beta cell function), lipids (triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol), and vitamin D status. Data analysis using Kolmogorov-Smirnov test, paired t-test, one-way analysis of variance, and repeated measures analysis of variance will be conducted through SPSS-24 software. DISCUSSION: The primary aim of the present trial is to determine the effect of vitamin D and/or omega-3 on glycemic indices, lipid profiles, psychological distress, blood pressure, and anthropometric indices in prediabetic women with hypovitaminosis D. The results from this trial will provide evidence on the efficacy of these two supplements for preventing or delaying the onset of type 2 diabetes in high-risk individuals. TRIAL REGISTRATION: Iran Clinical Trials Registry, IRCT20100130003226N17. Registered on 9 February 2019.

Urogenital chlamydia trachomatis treatment failure with azithromycin: A meta-analysis.

BACKGROUND: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection. OBJECTIVE: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin. MATERIALS AND METHODS: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables. RESULTS: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient's age contributes significantly to the heterogeneity for azithromycin treatment failure rate (ß░=░0.826; p░=░0.017). CONCLUSION: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections.

The effect of Cinnamon on primary dysmenorrhea: A randomized, double-blind clinical trial.

BACKGROUND: Primary dysmenorrhea is a cyclic cramp in pelvic which interferes with daily activity. This study determined the effect of Cinnamon on relieving dysmenorrhea. METHODS: This is a randomized, double-blind clinical trial. The intervention group received Cinnamon (capsules contained 1000 mg cinnamon) and the control group received placebo (capsules contained 1000 mg starch) during the first 72 h of menstruation for two cycles continuously. The Visual Analogue Scale was used to determine the severity of pain. The subjects were followed up for two cycles. Descriptive statistics, Independent T test, analysis of variance (ANOVA) with repeated measures were used for continuous quantitative variables. Mann-Whitney and Chi-square tests were used for nominal and ordinal qualitative variables. RESULTS: The results showed the mean intensity of dysmenorrhea significantly decreased over time in both groups (time: P < 0.001) and this reduction was significantly different over time between two groups (time*group: P = 0.02). There is significantly more reduction in the intervention group. Also the pain reduction in the intervention group was significantly lower than the placebo group after the first treatment (P = 0.001) and the second treatment (P = 0.002) compared to before treatment. CONCLUSIONS: Cinnamon can reduce the intensity of primary dysmenorrhea. This aromatic spice for relive of primary dysmenorrhea is recommended.

Relationship of socioeconomic status, psychosocial factors, and food insecurity with preterm labor: A longitudinal study.

BACKGROUND: Premature birth is the main cause of neonatal mortality and long-term complications, which imposes heavy financial and psychological burdens on the family and society; therefore, it is important to recognize the factors affecting it. OBJECTIVE: The aim of this study was to determine the relationship between socioeconomic status, psychosocial factors, and food insecurity with preterm delivery. MATERIALS AND METHODS: This longitudinal study was conducted on 674 pregnant women at 24-28 wk of gestation who met the inclusion criteria. The subjects were selected using cluster sampling. The pregnant women filled out total questionnaires of study and they followed up until delivery and the data about the newborn was collected after delivery. The data collection tools included questionnaires for evaluating socioeconomic status, psychosocial factors, and food insecurity. RESULTS: The prevalence of preterm delivery was 7.7%, and socioeconomic factors were not associated with preterm labor. Among the intermediary factors, social health, food insecurity, stress, and prenatal care had a significant relationship with preterm labor. The prevalence rates of preterm delivery in cases with food insecurity, stress, and inadequate prenatal care were 2, 9.1 and 13.2 times higher than those who had food security, did not experience stress, and received adequate care during pregnancy. CONCLUSION: Preterm labor is a relatively common problem in which intermediary social determinants of health can play an important role. Considering the limited studies on this issue, the results of this study can lay the foundation for future studies.

The Correlation between Islamic Lifestyle and Pregnancy-Specific Stress: A Cross-Sectional, Correlational Study.

BACKGROUND: Pregnancy is associated with great psychological, emotional and physical stress. In addition to undergoing hormonal changes, pregnant women experience a change in their attitude toward life and learn to re-assess their skills and lifestyle. Lifestyle, in general, and Islamic lifestyle, in particular, is concerned with the different psychological, social and physical aspects of the individual's life. AIM: This study was conducted to evaluate the correlation between Islamic lifestyle and pregnancy-specific stress in pregnant women. MATERIAL AND METHODS: This cross-sectional, correlational study was conducted on 300 pregnant women presenting to prenatal care clinics. Data were collected using a demographic, the Islamic lifestyle and the pregnancy-related stress questionnaires. RESULTS: The results showed a statistically significant negative correlation (r = -0.284) between Islamic lifestyle and pregnancy-specific stress (P < 0.01). The stepwise regression showed that the mean score obtained in the pregnancy-related stress questionnaire decreased by 0.75 per year of marriage and by 0.14 per point in the Islamic lifestyle questionnaire. CONCLUSION: There was a significant negative correlation between Islamic lifestyle and pregnancy-specific stress. Training mothers, raising their awareness and encouraging them to adopt an Islamic lifestyle may play a significant role in controlling pregnancy-specific stress.

A comparison of physical activity and nutrition in young women with and without primary dysmenorrhea.

Background: Dysmenorrhea is the most common gynecological disorder in young women and is seen in almost 50% of women. The present study was conducted to investigate the relationship between physical activity and nutrition with primary dysmenorrhea in students at Mazandaran University of Medical Sciences (Sari, Iran) in 2015. Methods: This comparative descriptive study was conducted on 250 students with and without primary dysmenorrhea. Data were collected using personal-demographic, nutrition and physical activity questionnaires. The output was then analyzed in SPSS-18 using independent t-test, Chi-square test and logistic regression analysis. Results: The results showed significant differences between the two groups in terms of nutrition and physical activity, as the mean score of nutrition was 57.91 in the group with dysmenorrhea and 61.68 in the group without, while the mean intensity of physical activity was 5518.75 metric in the group with dysmenorrhea and 4666.42 metric in the group without. Physical activity was calculated by MET scale (minutes/week). This index measured the amount of consumed energy at the time of activity relative to that consumed at resting time. Conclusions: A healthier and more favorable nutrition style and more regular physical activity reduces the severity of dysmenorrhea in girls. Therefore, educational measures are required to raise awareness among young women about the effects of proper nutrition and physical activity on the prevention and reduction of dysmenorrhea complications.

The Effect of Prangos Ferulacea Vaginal Cream on Accelerating the Recovery of Bacterial Vaginosis: A Randomized Controlled Clinical Trial.

BACKGROUND: The present study was conducted on the effect of prangos ferulacea vaginal cream on accelerating the recovery of bacterial vaginosis. METHODS: This randomized controlled clinical trial was conducted on 100 non-pregnant women referring to health centers affiliated to Lorestan University of Medical Sciences in 2016 with the diagnosis of bacterial vaginosis based on the patient's complaints, Amsel's clinical criteria, and the Nugent microscopic criteria. The women were randomly divided into two groups of 50. One group was treated with oral metronidazole plus Prangos ferulacea vaginal cream and the other with oral metronidazole plus a placebo vaginal cream for seven days. The patient's complaints, Amsel's clinical criteria and the Nugent microscopic criteria were assessed seven days after treatment. The data were analyzed using SPSS, version 20, with a significance level of 0.05. RESULTS: The response to oral metronidazole plus Prangos ferulacea vaginal cream treatment was 94% according to Amsel's clinical criteria and 88% according to the Nugent microscopic criteria. The response to oral metronidazole plus placebo vaginal cream treatment was 94% according to Amsel's criteria and 86% according to the Nugent criteria. The analysis of the patients' complaints, Amsel's clinical criteria and the Nugent microscopic criteria showed significant differences in each group before and after the treatment. CONCLUSION: This trial showed that Prangos ferulacea vaginal cream accelerated the recovery of bacterial vaginosis of patients with bacterial vaginosis. It can be used effectively as a complementary treatment with oral metronidazole in cases of medication resistance and also in people wishing to use herbal remedies Trial Registration Number: IRCT2016042327534N1.

The relationship between psychological factors and maternal social support to breastfeeding process.

INTRODUCTION: Childbirth is a stressful factor that can trigger disorders such as depression in women. The various problems characteristic to the puerperal period make mothers more prone than ever to stress, anxiety and depression. The aim of this study was to determine relationship between psychological factors and social support and breastfeeding process in mothers presenting to healthcare centers in Shahrood, Iran. METHODS: The present cross-sectional study was conducted on 465 mothers with infants aged one to six months, presenting to Shahrood healthcare centers in 2015-16. Data were obtained using a researcher-designed demographic and breastfeeding questionnaire, the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, Cohen's Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Data were analyzed in SPSS-18 using measures of central tendency, the Chi-square test, the t-test, Mann-Whitney's test and Fisher's exact test and Logistic Regression Model. The level of statistical significance was set at p<0.05. RESULTS: The prevalence of exclusive breastfeeding was 68.4% in the study population. The results revealed a significant relationship between state and trait anxiety and exclusive breastfeeding (p=0.004 and p=0.006, respectively). According to the results of the logistic regression, each unit of increase in the mother's mean state of anxiety protects the chances of non-exclusive breastfeeding up to about 54% (OR=0.462). CONCLUSION: The findings suggest that maternal anxiety can reduce the chances of exclusive breastfeeding. It is therefore recommended to actively monitor and manage maternal anxiety in the postpartum period so as to support exclusive breastfeeding.