Association of insulin resistance with polycystic ovary syndrome phenotypes and patients' characteristics: a cross-sectional study in Iran.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. This disorder affects 6-15% of women of childbearing age worldwide. It is diagnosed with hyperandrogenism, polycystic ovaries, and chronic anovulation with insulin resistance. This study aimed to assess the prevalence of insulin resistance (IR) in 4 phenotypes of PCOS, and its relationship with demographic, clinical, and paraclinical individual characteristics in a sample of Iranian PCOS patients. METHODS: This particular cross-sectional investigation involved 160 female participants, aged between 18 and 45 years, who were receiving care at gynecology clinics in Urmia, northwestern Iran. All the participants had been diagnosed with PCOS and were categorized into one of four phenotypes. All the participants underwent clinical evaluations, paraclinical assessments, and ultrasound scans. IR was defined as HOMA-IR > 2.5. The statistical significance level was 0.05. RESULTS: Among the 160 participants, the prevalences of the 4 phenotypes were: A: 83 (51.9%), B: 37 (23.1%), C: 21 (13.1%), and D: 19 (11.9%). IR was detected in 119 participants (74.4%); its rate was significantly different between the 4 phenotypes (p-value: 0.008) as A: 62 (74.7%), B: 34 (91.9%), C: 12 (57.1%), D: 11 (57.9%). Linear and logistic regression analyses were performed to control confounding factors. In linear regression, PCOS phenotype, classic phenotype (A&B), economic status, and Hb levels were significantly related to HOMA-IR; in logistic regression Hb levels, exercise, economic status, and PCOS phenotypes were significantly associated with insulin resistance. CONCLUSIONS: The most prevalent PCOS phenotype in this study was A. PCOS phenotypes were significantly related to insulin resistance and HOMA-IR, with the highest levels of insulin resistance and HOMA-IR observed in phenotype B. Determining the phenotype of PCOS may be helpful for better management of PCOS and its associated complications. However, further investigations are recommended in this regard.

Genital warts and women's sexual challenges: is sexual compatibility possible? A qualitative study.

BACKGROUND: Genital warts, besides their importance as symptoms of sexually transmitted infections, can also threaten the sexual health of couples. The purpose of this study was to explore the sexual compatibility in women with active genital warts. METHODS: A qualitative study with a conventional content analysis approach in Tehran, Iran, from January 2019 to February 2020 was conducted on a purposeful sample of data saturation achieved after interviewing 14 women with genital warts, 2 couples and 3 dermatologists, 1 sexologist and 1 infectious disease specialist. Data were collected through unstructured interviews and analyzed using conventional content analysis approach. RESULTS: After data analysis 224 initial codes, 5 main categories "change in the frequency of sexual activity", "changing types of sexual intercourse", "protected sexual intercourse", "concealment of lesions", "focusing on personal hygiene by couples after sexual activity" and finally a central theme of "adaptation to challenges of sexual intercourse" were extracted. CONCLUSIONS: This study revealed the perceptions and experiences of women with active genital warts about the process of their sexual adaptation. The main concepts found in this study focus on challenges related to sexual intercourse. It seems that recognizing women's sexual adaptation challenges after getting genital warts may help them take effective and practical measures to improve their sexual compatibility and health.

Prediction of adverse pregnancy outcomes by first-trimester components of metabolic syndrome: a prospective longitudinal study.

PURPOSE: This study aimed to identify the optimal cutoff values of each component of metabolic syndrome (MetS) in the first trimester of pregnancy for predicting adverse pregnancy outcomes. METHODS: A total of 1076 pregnant women in the first trimester of gestation were recruited in this prospective longitudinal cohort study. Specifically, 993 pregnant women at 11-13 weeks of gestation who were followed up until the end of pregnancy were included in the final analysis. The cutoff values of each component of MetS in the occurrence of adverse pregnancy outcomes including gestational diabetes (GDM), gestational hypertensive disorders, and preterm birth were obtained via receiver operating characteristic (ROC) curve analysis using the Youden's index. RESULTS: Among the 993 pregnant women studied, the significant associations between the first trimester MetS components and adverse pregnancy outcomes were as follows: triglyceride (TG) and body mass index (BMI) with preterm birth; mean arterial pressure (MAP), TG, and high-density lipoprotein cholesterol (HDL-C) with gestational hypertensive disorders; BMI, fasting plasma glucose (FPG), and TG with GDM (all p values < 0.05). The cutoff point values for the above-mentioned MetS components were: TG > 138 mg/dl and BMI < 21 kg/m2 for the occurrence of preterm birth; TG > 148 mg/dL, MAP > 84, and HDL-C < 84 mg/dl for gestational hypertensive disorders; BMI > 25 kg/m2, FPG > 84 mg/dl, and TG > 161 mg/dl for GDM. CONCLUSION: The study findings imply the importance of early management of metabolic syndrome in pregnancy to improve maternal-fetal outcomes.

Sexual dysfunction in women with genital warts: a systematic review.

PURPOSE: To provide an understanding of the changes in sexual function in women with genital warts. METHODS: In this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included. RESULTS: 19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts. CONCLUSION: This study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future. SYSTEMATIC REVIEW REGISTRATION: (PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584 ).

Development and validation of a guideline on sexual and reproductive health services for polycystic ovary syndrome in Iran: a mixed-methods study protocol.

BACKGROUND: Sexual and reproductive health (SRH) is an important aspect of women's health. Polycystic ovary syndrome is a common disease among women and has long-term negative effects on women's health. Evidence shows that polycystic ovary syndrome has different impacts on SRH needs among women. The aim of this study is to design and validate an SRH services guideline for healthcare providers in treating women with polycystic ovary syndrome. METHODS: The guideline will be developed and validated using an exploratory sequential mixed-methods approach in three phases based on the National Institute for Health and Care Excellence (NICE) model: (1) scoping phase (describing the SRH needs of women with polycystic ovary syndrome from the results of both review and qualitative studies); (2) development phase (developing a primary guideline for SRH services); (3) validation phase (validation of the guideline will be performed by a panel of experts and stakeholders using the AGREE [Appraisal of Guidelines for Research and Evaluation] tool). DISCUSSION: A specific and practical guideline on the SRH of Iranian women with polycystic ovary syndrome will be developed, which will be compatible with their specific needs and culture, considering the limited resources available. It will help service providers identify and address the specific needs of women with polycystic ovary syndrome.

Are maternal metabolic syndrome and lipid profile associated with preterm delivery and preterm premature rupture of membranes?

AIM: We aimed to evaluate the association of metabolic syndrome (MetS), its components and lipid profile in mid-pregnancy with preterm delivery and preterm premature rupture of membranes (PPROM). METHODS: This prospective cohort study was conducted on 203 pregnant women between 24 and 28 weeks of gestation, undergoing gestational diabetes screening test with 50 g glucose challenge test (GCT). Fasting serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were measured during the week after GCT assessment. Information on the participants' pre-pregnancy weight, demographic/reproductive characteristics, and height and blood pressure (BP) measurements were documented at baseline entry into the study. Metabolic syndrome was defined as the co-existence of 3 or more of the following criteria: Body mass index (BMI) before pregnancy ≥ 30 kg/m2, BP ≥ 130/85 mmHg, GCT ≥ 140 mg/dl, TG ≥ 150 mg/dl, and HDL-C ≤ 50 mg/dl. All participants were followed through routine prenatal care, up to delivery. Any deliveries or rupture of membranes of less than 37 weeks of pregnancy were considered preterm delivery and PPROM, respectively. Statistical analysis was performed by SPSS V.20, and p value of less than 0.05 was considered significant. FINDINGS: MetS was detected in 10 (4.9%) of participants. Logistic regression analysis showed HDL-C levels, and hypertension were associated with spontaneous preterm delivery [(OR 0.952, 95% CI 0.910-0.995), (OR 1.629, 95% CI 1.554-1.709) respectively], but no statistically significant results were found for PPROM. CONCLUSIONS: Low HDL-C levels and hypertension in mid-pregnancy are associated with the occurrence of spontaneous preterm deliveries, indicating that MetS and its components should be monitored more closely in pregnancy.

Effect of intrauterine device insertion on Candida species in cervicovaginal specimen identified by polymerase chain reaction technic: A longitudinal study on Iranian women.

AIM: To assess the effects of copper T-380-A intrauterine device (IUD) insertion on Candida species in cervicovaginal specimen by a molecular method, polymerase chain reaction. METHODS: This is a longitudinal prospective study performed on 95 women attending Health Centers of Tehran, Iran in 2012, who selected copper T-380-A IUD for contraception and had no history of local or systemic antibiotics or antifungals use during the previous 2 weeks. Cervicovaginal specimens were twice collected and cultured on Sabouraud dextrose agar and CHROMagar Candida, before and 3 months after IUD insertion. Finally, a molecular method, PCR-RFLP was performed for identification of Candida species. P-values <0.05 were considered significant. RESULTS: The mean age of participants was 28 ± 7.44 years. Positive Candida cultures were significantly increased 3 months after IUD insertion (25.3% vs 11.6%, P = 0.007). The most common identified species before and after IUD insertion, were Albicans, Glabrata and then both 'Albicans & Glabrata', respectively. The prevalence of Albicans and Glabrata decreased, while both 'Albicans & Glabrata' increased insignificantly. CONCLUSION: There was more than about fourfold increase in positive Candida cultures after IUD insertion. As the prevalence of simultaneous infection with both 'Albicans & Glabrata' species which are resistant to usual treatment, increased, it seems necessary to provide more intensive follow-up care for IUD users.

Inverse relation between fruit and vegetable intake and the risk of gestational diabetes mellitus.

Background: The aim of this study was to investigate the association of intakes of fruit, vegetable and dairy with gestational diabetes mellitus (GDM). Methods: This prospective study was conducted over a 17 month period, on a random sample of pregnant women (n = 1026), aged 18-45 y, in their first half of pregnancy, attending prenatal clinics in five hospitals' affiliated to universities of medical sciences in different districts of Tehran, Iran. Dietary intakes were assessed during gestational age ≤ 6 weeks using a 168-item validated semi-quantitative food frequency questionnaire. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3-h oral glucose tolerance test. Diagnosis of GDM was based on criteria set by the American Diabetes Association. Results: Of 1026 study participants, 71 had GDM, with a mean age and pre-pregnancy BMI of 26.7 ± 4.3 y and 25.4 ± 4.5 Kg/m2, respectively. High fruit and vegetable intakes were negatively associated with GDM risk. Compared with women who consumed < 2.1 servings/day, odds ratio (ORs) for those who consumed ≥ 4.9 servings/day was 0.44 (95% CI: 0.20-0.93), after adjustment for confounding factors. Fruit and vegetable intakes were significantly and inversely associated with the GDM; ORs (95% CIs) for GDM among participants with the highest, compared to the lowest quartiles were 0.48 (0.18-0.89) for fruit and 0.46 (0.22-0.99) for vegetables intake. No association was found between dairy products and GDM. Conclusions: Fruit and vegetable consumption in women of reproductive age have beneficial effects in the prevention of GDM.

The effect of metabolic syndrome and its components in midpregnancy on neonatal outcomes.

Background: The prevalence of metabolic syndrome has been rising worldwide in recent decades. Determining the associations between metabolic syndrome and its components in midpregnancy with neonatal anthropometric indices and outcomes is a major challenge in both public health and clinical care. Methods: This prospective cohort study was performed on 238 pregnant women at 24-28 weeks of gestation. Metabolic syndrome was recognized with 3 or more of the following criteria: triglyceride ≥ 247 mg/dL; HDL < 61 mg/dL; GCT ≥ 140 mg/dL; prepregnancy body mass index ≥ 30 kg/m2; and blood pressure ≥ 130/85 mmHg. Statistical analysis was performed through descriptive statistics, including mean, standard deviation, frequency, and percentage, Mann-Whitney test, Chi-square test, Fisher's exact test, linear and logistic regression in SPSS 21.0. P values < 0.05 were considered significant. Results: There was a significant association between blood hypertriglyceridemia in weeks 24-28 and anthropometric indices, including weight, height, and jaundice, in the first 24 hours of birth. Metabolic syndrome also had a significant relationship with jaundice (P=0.002). The results of linear regression analysis revealed that metabolic syndrome was positively associated with birth weight (B=0.18, P=0.003) and height (B=0.18, P=0.009). Among the components of metabolic syndrome, the results showed a direct relationship between increased blood triglyceride of the mother and newborn's weight (B=0.11, P=0.011) and height (B=0.14, P=0.007). Also, increased BMI had a significant direct relationship with the newborn's weight (B=0.11, P=0.023) and height (B=0.12, P=0.023). Moreover, decreased HDL had a significant reverse relationship with the newborn's weight (B=0.09, P=0.042). Conclusion: Presence of metabolic syndrome and its components in midpregnancy may influence neonatal outcomes, especially anthropometric indices. However, more studies should be conducted to further investigate these relationships.

Women's sexual and reproductive health care needs assessment: an Iranian perspective.

BACKGROUND: Reproductive health problems are a leading cause of women's ill health and mortality worldwide. There is a need to investigate sexual and reproductive health care needs in different societies and cultural contexts. Despite the success in health care promotion in the Iranian health care system, women still need to receive sexual health care and appropriate HIV/AIDS services. However, studies on the sexual and reproductive health care needs of Iranian women are lacking. AIMS: This study aimed to investigate the sexual and reproductive health care needs of women referred to health care centres in an urban area of the Islamic Republic of Iran. METHODS: We carried out a cross-sectional study in 2013 on 514 women living in an urban area in the north of the Islamic Republic of Iran. Taking into consideration ethical principles, data were collected using the Sexual and Reproductive Health Care Needs Assessment Questionnaire. RESULTS: The findings showed a greater need for the provision of care by practitioners in the sexual history and activities domain (73%) compared with other domains. Also, the woman's age and the location where she sought treatment and care for sexually transmitted infections were predictors of sexual activities needs. CONCLUSIONS: Owing to the high prevalence of women's referral to health care centres seeking treatment of sexual disorders, there is a need for the provision of sexual counseling centres and services promoting women's reproductive health care.

Effect of zinc sulfate supplementation on premenstrual syndrome and health-related quality of life: Clinical randomized controlled trial.

AIM: The purpose of study was to assess the effect of zinc sulfate (ZS) supplementation on premenstrual syndrome (PMS) and health-related quality of life (QoL). METHODS: This was a double-blind randomized and placebo-controlled trial using the parallel technique conducted between June 2013 and May 2014. A total of 142 women (age, 20-35 years) with PMS were allocated to either the ZS or placebo group. The women in the intervention group received ZS 220-mg capsules (containing 50 mg elemental zinc) from the 16th day of the menstrual cycle to the second day of the next cycle. Data were collected using the Premenstrual Symptoms Screening Tool (PSST) and 12-item Short-Form Health Survey Questionnaire. RESULT: The prevalence of moderate to severe PMS in the ZS group significantly decreased throughout the study period (9.5% in the first, 6% in the second and 2.6% in the third month of the study, P < 0.001), but in the control placebo group this reduction was seen only in the first month of the study (14.2% in the first, 13.7% in the second and 13.5% in the third month, P = 0.08). Also, ZS improved the PSST component scores throughout the study period. The mean scores of QoL in physical and mental components were significantly improved in the ZS intervention group. However, the differences were statistically significant only 3 months after the intervention. CONCLUSION: Zinc sulfate, as a simple and inexpensive treatment, was associated with improvement of PMS symptoms and health-related QoL. Additional studies are warranted to confirm these findings.

Maternal rare inherited bleeding disorders and neonatal complications.

AIM: The aim of this study was to examine the association between maternal inherited bleeding disorders and neonatal complications. MATERIAL AND METHODS: This was a historical cohort study. The rare inherited bleeding disorders (RIBD) group consisted of a total of 100 women suffering from inherited bleeding disorders, aged 20-45 years who experienced pregnancy. In the healthy control group, 200 age- and body mass index-matched women were selected. Details of demographic and obstetric characteristics of the samples in both groups were collected using their medical records. RESULTS: The mean ages of the women in the RIBD and healthy control groups were 32.6 (7.07) and 32.4 (7.3) years, respectively. No statistically significant differences were found in terms of age and other demographic characteristics of the women between the groups. The mean neonatal birthweight in the RIBD group was statistically lower than that in the healthy control group, 3018.2 (546.9) g vs. 3299.4 (456.8) g, respectively (P = 0.021). The prevalence of low birthweight in the RIBD group was statistically higher in comparison to that in the healthy control group (P = 0.041). After adjustment for potential confounders, it was found that maternal bleeding disorder had significant negative effects on birthweight in newborns (odds ratio, 1.05; 95% confidence interval, 1.01-3.43, P = 0.001). Those infants were statistically more likely to experience head bleeding, early hyperbilirubinemia and hospitalization than the healthy group (P = 0.001). CONCLUSIONS: Maternal rare inherited bleeding disorders may have a devastating consequence for neonates.

Changes in copper and zinc serum levels in women wearing a copper TCu-380A intrauterine device.

OBJECTIVE To assess the effects of the copper intrauterine device (IUD) TCu-380A, on copper and zinc serum levels. MATERIAL AND METHODS This longitudinal study enrolled 121 women attending Health Centres in Tehran between November 2011 and August 2012. A blood sample was obtained before use and three months after insertion of a TCu-380A IUD. Serum levels of copper and zinc were measured for the 101 women who had completed three months with the device in situ. Analyses of change included paired t-tests, McNemar tests and linear regression. RESULTS Significant elevations in mean serum levels were found for both copper (170.22 µg/dl at three months vs.160.40 µg/dl at baseline, p = 0.034) and zinc (107.67 µg/dl at three months vs. 94.61 µg/dl at baseline, p < 0.001) three months after IUD insertion. CONCLUSIONS A slight, but significant increase in copper serum levels, not reaching toxic levels, was observed three months after TCu-380A IUD insertion. Zinc levels too had risen significantly, which was quite unexpected, and warrants further investigation.

The Iranian version of the Premenstrual Symptoms Screening Tool (PSST): a validation study.

The objective of the current study was to translate and test psychometric properties of the Premenstrual Symptoms Screening Tool (PSST) in Iran. Using a standard "forward-backward" procedure, the English version of PSST was translated into Persian. A random sample of university students aged 18 years and over completed the questionnaire in Tehran, Iran. Psychometric properties of the Iranian version of PSST were assessed by performing reliability (internal consistency) and validity analyses [Content Validity Ratio (CVR) and Content Validity Index (CVI)]. In all, 925 female students took part in the study. Of these, 284 (30.7 %) had premenstrual syndrome (PMS) and 119 (12.9 %) had premenstrual dysphoric disorder (PMDD). Reliability of the PSST as measured by internal consistency was found to be satisfactory (Cronbach's alpha coefficient, 0.93). The content validity as assessed by CVR and CVI were desirable (0.7 and 0.8, respectively). The Iranian version of PSST seems to be a reliable and valid measure of detecting PMS and PMDD in Iranian young female populations.

The Impact of Maternal Predisposing Factors on Level of Maternal Serum Pregnancy-Associated Plasma Protein A and Free Subunit Human Chorionic Gonadotropin and Nuchal Translucency.

Background: This study aimed to investigate the relationship between maternal predisposing factors with the level of maternal serum pregnancy-associated plasma protein A and free subunit human chorionic gonadotropin and nuchal translucency. Materials and Methods: We performed a cross-sectional-analytical study on 762 pregnant women who referred to the Gene Azma Medical Genetics Laboratory in Isfahan for amniocentesis. All pregnant women at high risk of screening in the first trimester of pregnancy for trisomy 21 and other aneuploidy were referred to a gynecologist for amniotic fluid sampling (amniocentesis). Multiple of the means (MoM) of PAPPA ≤0.5, 0.5 ≥ MoM free ß-hCG >2.5, and NT ≥3.5 mm were considered abnormal. We used Chi-square method and Mann-Whitney U-test to compare data qualitative and quantitative, respectively. Results: In individuals with less pregnancies and deliveries, the value of abnormal NT was higher (P < 0.01, P < 0.001, respectively). On the other hand, the highest abnormal rate of NT was observed in pregnant women under 35 years (21, 84%, P < 0.012). In addition, abnormal levels of free ß-hCG are more common in women < 35 years of age (186, 66.9%, P < 0.02) and female fetuses (171, 58.8%) (P < 0.006). Conclusion: According to the results of this study, it can be said that considering the underlying factors of pregnant mothers in performing tests related to screening in the first trimester of pregnancy can lead to a reduction in false positive rates.

Free androgen index (FAI)'s relations with oxidative stress and insulin resistance in polycystic ovary syndrome.

This study aimed to determine the levels of the free androgen index (FAI) and its association with oxidative stress and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS). This cross-sectional study was performed on 160 women aged 18-45 years, visiting gynecology clinics of Urmia in northwestern Iran during 2020-2021 who were diagnosed with PCOS and exhibited one of the four phenotypes of PCOS. All the participants underwent clinical examinations, paraclinical tests, and ultrasounds. FAI cut-off point was considered to be 5%. The significance level was set at < 0.05. Among the 160 participants, the prevalence of the four phenotypes was as follows: phenotype A: 51.9%, phenotype B: 23.1%, phenotype C: 13.1%, and phenotype D: 11.9%. High FAI was detected in 30 participants (18.75%). Additionally, It was found that phenotype C had the highest FAI levels among the PCOS phenotypes, with a significant difference between phenotypes A and C (p value = 0.03). IR was observed in 119 (74.4%) of the participants, and the median (interquartile range: IQR) of malondialdehyde (MDA) levels among the participants was 0.64 (0.86) µM/L. In linear regression, the PCOS phenotype (standard beta = 0.198, p-value = 0.008), follicle-stimulating hormone (FSH) levels (standard beta = 0.213, p-value = 0.004), and MDA levels (standard beta = 0.266, p-value < 0.001) were significantly related to the FAI level, but the homeostatic model assessment for insulin resistance (HOMA-IR) was not statistically associated with FAI. Thus, in this study, PCOS phenotypes and MDA levels (an indicator of stress oxidative) were significantly related to FAI, but HOMA-IR (the indicator of IR) was not associated with it.

Humoral immunogenicity assessment after receiving three types of SARS-CoV-2 vaccine.

Several vaccines have been developed against SARS-CoV-2 and subsequently approved by national/international regulators. Detecting specific antibodies after vaccination enables us to evaluate the vaccine's effectiveness. We conducted a prospective longitudinal study among members of Tarbiat Modares University of Tehran, Iran, from 4 September 2021 until 29 December 2021. We aimed to compare the humoral immunogenicity of 3 vaccine types. Participants consisted of 462 adults. Anti-SARS-CoV-2 receptor-binding domain [RBD] IgG titer was compared in 3 groups, each vaccinated by available vaccines in Iran at the time: Oxford/AstraZeneca, COVIran Barekat, and Sinopharm. The median IgG titer was: 91.2, 105.6, 224.0 BAU/ml for Sinopharm, COVIran Barekat and Oxford/AstraZeneca respectively after the first dose; 195.2, 192.0, 337.6 BAU/ml after the second one. We also analyzed the frequency of antibody presence in each vaccine group, in the same order the results were 59.0%, 62.6% and 89.4% after the first dose and 92.1%,89.5% and 98.9% after the second. The comparison of results demonstrated that AstraZeneca vaccine is a superior candidate vaccine for COVID-19 vaccination out of the three. Our data also demonstrated statistically significant higher antibody titer among recipients with an infection history.

Maternal serum C-reactive protein in early pregnancy and occurrence of preterm premature rupture of membranes and preterm birth.

AIM: The aim of this study was to determine the relationship between maternal serum C-reactive protein (CRP) levels in the first 20 weeks of pregnancy and later occurrence of preterm premature rupture of membranes and preterm birth. MATERIAL AND METHODS: A prospective cohort study that measured maternal serum CRP levels in 778 pregnant women in the first half of pregnancy was performed in the city of Noor (north Iran), and included follow-up of patients up to time of delivery. Preterm premature rupture of membranes and preterm birth were defined as the occurrence of membranes rupture and birth, respectively before 37 weeks of gestation. RESULTS: Of the 778 pregnancies studied, 19 (2.41%) preterm premature rupture of membranes and 58 (7.3%) preterm births were seen. Median CRP levels in preterm premature rupture of membranes and preterm birth cases were much higher than in term deliveries (7 and 6.8 respectively vs 2.4 mg/L; 66.67 and 64.76, respectively vs 24.38 nmol/L). CRP levels >4 mg/L had statistically significant relationships with preterm premature rupture of membranes (OR 5.91, 95% CI 2.07-16.89) and preterm birth (OR 8.95, 95% CI 4.60-17.43). With a cut-off level of 4 mg/L of CRP, sensitivity, specificity, and likelihood ratios (LR(+) and LR(-) ) for preterm birth were 81, 70, 2.70, 0.28%, respectively, and for preterm premature rupture of membranes they were 79, 67, 2.41 and 0.31%, respectively. CONCLUSION: It seems that the inflammatory marker, CRP, can be used in the early stages of pregnancy to identify women at risk of experiencing preterm premature rupture of membranes and preterm birth.

The Relationship between Screening Markers in the First Trimester of Pregnancy and Chromosome Aberrations.

Background: This study was designed and performed to investigate the relationship between fetal chromosome aberrations and screening markers in the first trimester of pregnancy in order to prevent the birth of infants with chromosome aberrations with early prenatal diagnosis. Methods: We conducted an analytic cross-sectional study on result of chromosomal culture of 762 pregnant women with high-risk combined screening test from December 2018 to June 2020 and analyzed by SPSS program. Results: There was a significant relationship between chromosome structural abnormalities with free beta-human chorionic gonadotropin (free ß-hCG) values equal to and higher than 1.5 multiples of the median (MoM) (P: 0.05). The highest incidence of disorder in number of chromosomes with abnormal nuchal translucency (NT) percentiles (≥99%) was seen (P < 0.001). It also shows that the cumulative number of chromosome aberrations of 25 (78.12%) occurred in individuals with a NT less than 99th percentile and at the same time a risk of 1/50≤ risk <1/10. Discussion: According to the results, Comparative Genomic Hybridization (CGH) array method is recommended to detect structural abnormalities in chromosomes in samples with NT ≥3.5. In addition, it is noteworthy that chromosomal structural abnormalities occur in free ß-hCG ≥1.5 MoM. Conclusion: Due to the frequency of chromosomal structural disorders and its effect on the incidence of fetal abnormalities, the study of chromosomal structural disorders is recommended.

Sexual and reproductive health aspects in women with polycystic ovary syndrome: An integrative review.

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women worldwide, affecting their sexual and reproductive health (SRH). Objective: This integrative review aimed to identify SRH aspects in women with PCOS by consolidating the findings from previous studies. Materials and Methods: The present integrative review was conducted through an electronic systematic review search of 1052 manuscripts published from April 2000 to March 2020 using PubMed, SCOPUS, Web of Science, Embase, Google Scholar, MEDLINE, Science Direct, Ovid, and the Cochrane Library. After at least 2 researchers evaluated the articles based on the inclusion and exclusion criteria, 27 papers were accepted. The data were analyzed by thematic analysis. Results: 9 main themes of SRH were obtained: 1) the impact of PCOS-related complications on reproductive health; 2) the lifelong effect of PCOS on reproductive patterns; 3) PCOS and adverse reproductive and pregnancy outcomes; 4) women's need for understanding complications; 5) the financial burden of the disease; 6) women's life experiences and quality of life; 7) sexual disorders; 8) psychological concerns and issues; and 9) femininity feelings and roles. Conclusion: We were able to identify and categorize various aspects of SRH needs for women with PCOS. These categories can facilitate a more comprehensive assessment of SRH, including previously neglected areas. We suggest that these aspects should be considered in the health plans of women with PCOS.