The relationship between sexual function and mental health in Iranian pregnant women during the COVID-19 pandemic.

BACKGROUND: Sexual function, a significant contributor to quality of life, is affected by various factors, including overall mental health. COVID-19 is a current pandemic that influences the mental health of various populations, especially pregnant women. Despite the importance of sexual health, the specific nature of its relationship to overall mental health during the COVID-19 pandemic is not clearly defined. Thus, this study investigates the relationship between sexual function and mental health during the COVID-19 pandemic in Iranian pregnant women. METHODS: This descriptive-analytical, cross-sectional study was carried out among 437 pregnant women using the sociodemographic and obstetrics characteristics questionnaire, Female Sexual Function Inventory, Stress, Depression, and Anxiety Scales. Random sampling was employed to select pregnant women who had a medical record in Health Centers of Tabriz city, Iran. The questionnaires were sent to the participants' cell phones via WhatsApp or text messages, including links of questionnaires and the participants completed these questionnaires. Spearman correlation test was used to determine the relationship between sexual function and stress, anxiety, and depression. Generalized linear modeling was used to estimate each of the independent variables (sociodemographic characteristics, stress, anxiety, and depression) on the dependent variable (sexual function). RESULTS: The mean (Standard Deviation) sexual functioning (total) score was 20.0 (8.50) from the available range of 2 to 36. The mean (SD) of depression, stress, and anxiety scale was 4.81 (5.22), 5.13 (4.37), and 7.86 (4.50) (possible score ranging from 0 to 21), respectively. Based on Spearman's correlation test, there was a significant reverse correlation between the total sexual function score and stress, anxiety, and depression, indicating that all three variables negatively impacted sexual functioning. Variables such as mild stress, spouse type of job, sufficient household income, living with parents, higher marital satisfaction, and higher gestational age had a significant, positive impact on sexual function and could predict 35.8% of the variance model. CONCLUSIONS: Sexual functioning was significantly impacted by stress, anxiety, and depression - all of which are heightened during a pandemic. This topic warrants further study, and the general public should be educated on the protective influence of safe sex/intimacy on overall mental health.

Effect of Lavender cream with or without footbath on sleep quality and fatigue in pregnancy and postpartum: a randomized controlled trial.

Sleep disturbance and fatigue are frequent complaints during pregnancy and postpartum. We assessed the effectiveness of Lavender cream and footbath on sleep quality and fatigue in pregnancy and postpartum. In this trial, 141 women with sleep disturbance at 25-28 weeks gestation were recruited from public health centers in Tabriz, Iran, from May 2013 until January 2014 and randomized into one of three groups receiving: Lavender and footbath, Lavender alone, or placebo cream. Sleep quality was assessed using the Pittsburgh sleep quality index at the 4th and 8th weeks after intervention and the 6th week postpartum. Fatigue was assessed with the multidimensional assessment of fatigue scale at the 6th week after intervention and the 6th week postpartum. Repeated measures ANOVA and ANCOVA were used. Compared with the placebo group, the global sleep quality score post-intervention in pregnancy and the postpartum were significantly lower in the Lavender and footbath and the Lavender cream only groups. Fatigue in both intervention groups was significantly improved only at the 6th week postpartum. No statistically significant differences were observed between the two intervention groups. Lavender cream with or without footbath may improve sleep quality in pregnancy and postpartum.

Effects of Calcium-Vitamin D and Calcium-Alone on Pain Intensity and Menstrual Blood Loss in Women with Primary Dysmenorrhea: A Randomized Controlled Trial.

Objective: There is limited evidence on effectiveness of calcium and vitamin D on dysmenorrhea. The authors aimed to determine the effect of combined calcium-vitamin D and calcium-alone on pain intensity and menstrual blood loss in women with primary dysmenorrhea. Design: A randomized double-blind trial. Setting: Dormitories of Tabriz University of Medical Sciences. Subjects: 85 students with moderate or severe primary dysmenorrhea. Methods: Participants were randomized into three groups: receiving one tablet/day of 1000 mg calcium + 5000 IU vitamin D3, calcium-alone 1000 mg, or matched placebo, from 15th cycle day until menstrual pain disappearance in the following cycle, for three cycles. Pain intensity and menstrual blood loss were assessed one cycle before, three cycles under, and one cycle following intervention using 10-cm visual analog scale and pictorial blood loss assessment chart, respectively. The groups were compared using repeated measures ANOVA. Results: Time after intervention and interaction of time with group had no significant effects on the outcomes. Compared to the placebo group, mean pain intensity was lower in the both calcium-vitamin D (adjusted difference -0.7, 95% confidence interval -1.6 to 0.3) and calcium-alone (-1.6, -2.6 to -0.6) groups, but the difference was statistically significant only in the calcium-alone group. Menstrual blood loss was not significantly different in the either calcium-vitamin D (-4.7, -21.9 to 12.4) or calcium-alone (-0.4, -17.4 to 16.4) groups compared to placebo. Conclusions: Intake of the calcium-alone was effective in reducing menstrual pain intensity. The results could not indicate significant effects of calcium-vitamin D on the pain or any of the interventions on menstrual blood loss. Clinical trial registration: This study was approved by the Ethics committee of Tabriz University of Medical Sciences (code 92145) and registered at the Iranian Registry of Clinical Trials with IRCT201402043706N21.

Sleep quality and its relationship with quality of life in Iranian pregnant women.

Sleep disorders are a common problem during pregnancy and may affect quality of life. This study aimed to determine the status of sleep quality and its relationship with quality of life in Iranian pregnant women. This cross-sectional study was conducted on 565 women recruited using 2-stage cluster sampling methods. Data were collected using sociodemographic characteristics; quality of life; and Pittsburgh sleep quality questionnaire between March and May 2015. About 6% of the women had a sleep disorder. There were significant correlations between quality of life and total score of sleep quality, subdomains of habitual sleep efficiency, sleep disturbance, and daytime dysfunction. Paying attention to the sleep quality as an effective factor of quality of life can promote sleep quality and hence quality of life of pregnant women.

Effective factors on nutrition behaviors of pregnant women based on the beliefs, attitudes, subjective norms, and enabling factors model: A cross-sectional study.

BACKGROUND: One of the useful models in health education is the Beliefs, Attitudes, Subjective Norms, and Enabling Factors (BASNEF) model. The model is used to study behavior and to plan for change it and to determine the factors that influence people's decision-making. The aim of this study was to investigate the factors affecting the nutritional behavior of pregnant women based on BASNEF model. MATERIALS AND METHODS: This cross-sectional study was performed on 360 pregnant women referring to health centers of Tabriz-Iran by two-stage cluster sampling method from April to December 2016. Data were collected using sociodemographic, nutrition subdomain of Health Promoting Lifestyle-II (HPLP-II), and researcher-made questionnaire based on constructs of BASNEF model. Data were analyzed using the SPSS software version 21 and Pearson correlation test and General Linear Model (GLM). RESULTS: Mean ± standard deviation (SD) of nutrition subdomain of HPLP-II was 24.65 ± 4.75 within the range 9-36. Mean ± SD of BASNEF model constructs (score range) was also obtained as 45.30 ± 10.80 (0-100), 17.98 ± 2.40 (8-24), 9.30 ± 2.82 (0-20) and 2.47 ± 1.74 (0-6) for belief, attitude, subjective norms, and enabling factors, respectively. Based on the GLM, there was significant relationships between nutritional behavior and BASNEF model constructs (belief [P < 0.001], attitude [P = 0.043], enabling factors [P < 0.001], and subjective norms [P = 0.038]) as well as the variables of job, husband's education, and job and sufficiency of income for expenses. CONCLUSION: The results of the present study showed the impact of BASNEF model constructs and some sociodemographic variables on nutrition behaviors in pregnant women. Therefore, in order to improve nutrition behaviors of pregnant women, designing and implementation of interventions based on the BASNEF model are recommended.

Fatigue and sleep quality in different trimesters of pregnancy.

OBJECTIVES: Fatigue is one of the most common and persistent complaints of pregnant women. Increased severity of fatigue during pregnancy can increase the risk of preterm labor, prolonged labor, cesarean section, and postpartum depression. Therefore, this study aimed to determine the fatigue status in different trimesters of pregnancy and its relationship with sleep quality in pregnant women. MATERIAL AND METHODS: This cross-sectional study was performed by two-stage cluster sampling on pregnant women referred to Tabriz health centers. Data were collected using socio-demographic questionnaire, multidimensional assessment of fatigue and Pittsburgh sleep quality index. RESULTS: Among the 605 pregnant women studied, 94.2% of women suffered from fatigue during pregnancy. The mean (standard deviation) of fatigue score in the first, second and third trimesters of pregnancy was 23.53 (8.05), 25.78 (6.56) and 26.46 (6.72), respectively. There was also significant reverse correlation between total fatigue score with total sleep quality score (p=0.031) and with an increase in fatigue, sleep quality was reduced. DISCUSSION: The findings of this study may be used to design interventional measures for fatigue and medical care to improve quality of sleep in pregnancy.

Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19.

BACKGROUND: Pregnancy as a sensitive period of a woman's life can be affected by various psychological factors that can have adverse effects on the woman, her fetus and future baby. Since COVID-19 is a new phenomenon with limited information available, it may have adverse psychological effects on pregnant women. Therefore, this study was conducted to determine the status of depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. METHODS: This descriptive-analytical cross-sectional study was performed on 205 pregnant women covered by Tabriz health centers in Iran. The sampling method used was cluster sampling. The data collection tool was the socio-demographic characteristics questionnaire and the DASS-21 (Depression, Anxiety and Stress Scale-21), which were completed online by pregnant women. The general linear model was used to determine the predictive factors of depression, anxiety and stress. RESULTS: The mean (SD) score of depression, stress, and anxiety were 3.91 (3.9), 6.22 (4.25), and 3.79 (3.39), respectively; the score range of 0 to 21. Depression, stress, and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively, with varying degrees from mild to very severe. Based on the adjusted general linear model, variables of education level, spouse's job and marital life satisfaction were the predictors of depressive symptoms. Variables of spouse's education level, spouse's support, marital life satisfaction and the number of pregnancies were the predictive factors of anxiety symptoms and the variables of spouse's education level, household income sufficiency, spouse's support and marital life satisfaction were predictors of stress symptoms. CONCLUSIONS: Considering the role of marital life satisfaction, high level of spouse's education and income in reducing symptoms of stress, anxiety, and depression in pregnant women in critical situations such as the prevalence of COVID-19, it seems that using strategies to promote marital life satisfaction and socio-economic status can play an effective role in controlling anxiety and reducing stress and depression in pregnant women.