Evaluation of depression, stress, and anxiety among women with subfertility during the COVID-19 pandemic: A cross-sectional study in Ahvaz, Iran.

Background and Aims: Some studies have shown that the levels of stress, anxiety, and depression have increased among subfertile women during the COVID-19 pandemic. This study was designed to evaluate the levels of depression, anxiety, and stress among subfertile women during the COVID-19 pandemic in southwest Iran. Method: This cross-sectional study was conducted on 190 subfertile women from two infertility centers (Imam Khomeini and Jihad) in Ahvaz, Iran. A demographic questionnaire, and the depression, anxiety, stress scale (DASS-21) were used to assess the level of depression, anxiety, and stress of subfertile women during the COVID-19 pandemic. Data collection started in August 2021 and was completed in December 2021. Mean ± SD or N (%), and multiple linear regression were used to analyze the data. Result: Results showed that most women experienced moderate depression, anxiety, and stress. However, the percentage of women who experienced very severe anxiety was more than that for depression and stress, and 75 (39.5%) of women had all three disorders together. Anxiety was 0.176 units lower in women who were not affected by COVID-19 (95% CI: -5.781 to -0.629). The depression was 0.216 units lower in women with good and moderate economic status (95% CI: -5.603 to -1.178). Conclusion: The results of this study showed that most studied women experienced moderate depression, anxiety, and stress, but the percentages of very severe anxiety were more than that for depression and stress. Poor economic status was also a strong predictor of depression among subfertile women. Infection with COVID-19 increased the level of anxiety. Careful evaluation of subfertile women for mental health is recommended especially during crises such as the COVID-19 pandemic.

Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model.

OBJECTIVE: There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS: Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS: The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS: The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.

The Association Between Air Pollution and Low Birth Weight and Preterm Labor in Ahvaz, Iran.

PURPOSE: Pregnant women and fetuses are sensitive to air pollution due to physiological changes in pregnancy. The aim of this study was to determine the relationship between exposure to air pollution, low birth weight and preterm labor in Ahvaz. METHODS: This research was a time-series study. The research sample consisted of all data about low birth weight and preterm labor pregnant women from Imam Khomeini Hospital and Razi Hospital in Ahvaz city. Air pollutant data including O3, NO, NO2, SO2, CO, PM10 and PM2.5 and climate data were collected from the Environmental Protection Agency and the Khuzestan Province during a 10-year period from 2008 to 2018. The generalized additive models (GAMs) with different air pollutant lags up to 6 days were used. RESULTS: The results of multiple GAM model have shown that there is a direct and significant relationship between exposure to PM10 at 0-6-day lag, SO2 at 2- and 3-day lag and low birth weight. In addition, there was a direct and significant correlation between exposure to NO2, NO, CO and PM2.5 at 0-6-day lag and preterm labor. CONCLUSION: The results indicate the effect of air pollutants on low birth weight and preterm labor. Therefore, pregnant women should be informed about the negative consequences of air pollution and avoid exposure to polluted air during pregnancy.