The probiotic properties and potential of vaginal Lactobacillus spp. isolated from healthy women against some vaginal pathogens.

During the last decade, probiotic research has progressed considerably and significant advances have been made in the selection and characterization of specific probiotic strains. The most studied probiotics belong to the genus Lactobacillus. In this study, 80 Lactobacillus spp. isolated from healthy women tolerated low pH and were able to grow in the presence of bile salts. RAPD PCR technique resulted in the identification of 38 different types. These isolates were then evaluated based on adhesion capacity, antibiotic susceptibility and tolerance in simulated gastrointestinal tract. Species-specific PCR and detection of bacteriocin-related genes were also surveyed. Among the isolates, five strains-Lacticaseibacillus rhamnosus NO21, Lacticaseibacillus casei NO1, Lactiplantibacillus plantarum NO4, Lactobacillus acidophilus NO7 and Lactobacillus gasseri NO38-presented acceptable antibiotic susceptibility pattern. Further analysis showed antimicrobial activity of Lacticaseibacillus culture against various bacterial pathogens and real-time PCR showed all five strains were able to prevent the colonization of bacterial pathogens. All five selected strains produced organic acids, hydrogen peroxide and were resistant to the spermicide. In addition, they lacked haemolytic activity with the ability of hydrophobicity, auto-aggregation and co-aggregation with pathogens. These results suggest that the vaginal microbiome could be a good source for the isolation of probiotics and the strains of this study may be considered as good probiotic candidates.

Customized birthweight standard for an Iranian population.

OBJECTIVE: To produce a customized birthweight standard for Iran. METHOD: Retrospective study of a pregnancy database collected from five hospitals across Iran. The cohort consisted of 4994 consecutive term births with complete data, delivered between July 2013 and November 2014. Coefficients were derived using a backwards stepwise multiple regression technique. RESULTS: Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as significant physiological variables affecting birthweight. Paternal height and weight were also significant although weaker factors. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3390 g. Pathological factors found to affect birthweight in this cohort included village housing, anemia, preexisting and gestational diabetes and preeclampsia. CONCLUSION: The analysis confirmed the main physiological variables that affect birthweight in other countries and shows paternal factors also to be significant variables. Development of a country-specific customized birthweight standard will aid clinicians in Iran to distinguish between fetuses that are either constitutionally or pathologically small, thereby avoiding unnecessary interventions, and improving identification of at-risk pregnancies and perinatal outcome.

The effect of dietary soy intake on weight loss, glycaemic control, lipid profiles and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomised clinical trial.

BACKGROUND: The present study aimed to evaluate the effects of dietary soy intake on weight loss and metabolic status of patients with polycystic ovary syndrome (PCOS). METHODS: A randomised clinical trial was conducted among 60 women with PCOS. Participants were randomly assigned into two groups to receive either a test diet (n = 30) or a control diet (n = 30) for 8 weeks. Participants in the test group consumed a diet containing 0.8 g protein kg-1 body weight (35% animal proteins, 35% soy protein and 30% vegetable proteins) and participants in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins. RESULTS: Adherence to the test diet, compared with the control diet, resulted in significant decreases [mean (SD)] in body mass index (BMI) [-0.3 (0.6) versus +0.1 (0.5) kg m-2 , P = 0.02], fasting plasma glucose [-0.2 (0.5) versus +0.1 (0.3) mmol L-1 , P = 0.01], total testosterone [-0.3 (0.7) versus +0.3 (0.3) mmol L-1 , P < 0.001], insulin [-15.0 (18.0) versus +4.8 (18.6) pmol L-1 , P < 0.001] and insulin resistance [-0.6 (0.6) versus +0.2 (0.7), P < 0.001], as well as a significant increase in quantitative insulin sensitivity check index [+0.01 (0.01) versus -0.002 (0.02), P = 0.01]. In addition, significant decreases in triglycerides [-0.1 (0.4) versus +0.2 (0.3) mmol L-1 , P = 0.01] and malondialdehyde (MDA) [-1.2 (1.0) versus +0.2 (1.2) µmol L-1 , P < 0.001] and significant increases in nitric oxide (NO) [+13.6 (14.1) versus +0.9 (24.3) µmol L-1 , P = 0.01] and glutathione (GSH) [+170.1 (175.5) versus +24.2 (168.7) µmol L-1 , P = 0.002] were seen in the test group compared to the control. CONCLUSIONS: Adherence to test diet among subjects with PCOS significantly decreased BMI, glycaemic control, total testosterone, triglycerides and MDA, and significantly increased NO and GSH compared to the control diet.

Relationship between pre-pregnancy maternal BMI with spontaneous preterm delivery and birth weight.

The aim of the present study was to find the relationship between pre-pregnancy maternal body mass index (BMI) with spontaneous preterm delivery and birth weight. A prospective cohort study was performed on 576 pregnant women. Maternal BMI was determined at the first prenatal visit between 8-12 weeks' gestation and considered as the pre-pregnancy maternal weight. The women were then monitored up to delivery. Out of 576 women, 396 completed the study. The demographics of the women in all BMI groups did not differ with regard to age, height, history of abortion and employment. A total of 21 women (5.3%) were underweight; 198 women (50%) were normal weight; 117 women (29.5%) were overweight and 60 (15.2%) were obese. There were no cases of morbidly obese (BMI > 40 kg/m(2)) women. Obesity in women had a positive correlation with higher gestational age at the time of delivery (r = 0.213, p = 0.015) and a heavier birth weight (r = 0.361, p = 0.008). Low birth weight had a correlation with low maternal BMI (r = 0.157, p = 0.041). Macrosomia was greater in obese women (p = 0.022) and BMI had a positive correlation with macrosomia (r = 0.224, p = 0.034). Preterm delivery showed a negative correlation with maternal BMI (r = -0.124, p = 0.004) and the women with a lower BMI had a greater number of preterm deliveries (p = 0.035).

Contraceptive use in women under 20 years of age: A study in Iran.

Contraception methods are one of the most important factors in population control. A choice of the safe and effective methods available to adolescents may guarantee their safety. The purpose of the present study was to evaluate the rate and kind of contraceptive methods used by women under 20 years of age and finding the related demographic factors. A total of 500 women who finished the study were evaluated regarding the rate of contraceptive use, which method was used and the probable demographic-related factors. More than half (51.6%) of the women used contraception. The most common method was breast-feeding (27.1%), although only 2.8% had enough knowledge about breast-feeding as a contraceptive method. Other common methods used were IUD (intrauterine device) (24.8%) and the withdrawal method (24.8%). The usage of contraception was directly related to the number of pregnancies, the age of marriage and the woman's age at first pregnancy. It related indirectly to the level of education, the number of brothers and sisters and size of the family, socioeconomic status, the age of the mother when married and the age of menarche.

Comparison between nitroglycerin dermal patch and nifedipine for treatment of preterm labor: a randomized clinical trial.

OBJECTIVE: Preterm labor and delivery are of the most important complications of pregnancy and have a major role in neonatal mortality and morbidity. Management of preterm labor and prevention from preterm delivery in order to lower these risks have always been under serious concern. The purpose of this study was to compare the effect of nifedipine and nitroglycerin (NG) dermal patch for taking control of preterm labor. STUDY DESIGN: The study was performed as a randomized clinical trial on women who had been admitted in the hospital diagnosed with preterm labor. In one group, the NG dermal patch and in the other group, nifedipine was prescribed. Then the women of the two groups were followed up to delivery and were compared according to arrest of labor for 2 h, 48 h, 7 days, gestational age at the time of delivery and their adverse effects. The primary outcome was to postpone delivery for 48 h in order to have enough time for prescribing corticosteroids RESULT: The women of the two groups did not have any significant difference according to age, body mass index, primary Bishop Score, gestational age at the time of tocolytic therapy, history of abortion, vaginal or cesarean delivery and preterm labor. In more women in the NG group, delivery was postponed for 2 h (59 (98.3%) vs 48 (80%), P=0.001), for 48 h (52 women (86.7%) vs 41(68.3%), P=0.016) and also for 7 days (47 (78.3%) vs 37 (61.7%), P=0.046), than the women in the nifedipine group. Gestational age at the time of delivery was higher in the NG group (35.6±1.9 vs 34.3±2.05 weeks, P=0.155), however, it was not statistically significant. Apgar score of minute 5, (P=0.03) and neonatal weight (P=0.04), were more and cesarean deliveries, neonatal intensive care unit (NICU) admission and duration of NICU stay were less in the NG group. Adverse effects were similar, minimal and negligible in both groups. CONCLUSION: The NG patch is a more effective method for preterm labor control than nifedipine with regard to minimal side effects.

Maternal outcomes of intimate partner violence during pregnancy: study in Iran.

OBJECTIVES: To investigate the prevalence of intimate partner violence (IPV) against pregnant women and its relationship with adverse maternal outcomes, including preterm labour, abortion, caesarean section, antenatal hospitalization and vaginal bleeding, in the West Azerbaijan, Iran. STUDY DESIGN: Cross-sectional design. METHODS: In total, 1300 pregnant women, aged 18-39 years, who were referred to hospitals in the Iranian cities of Miandoab and Mahabad in the province of West Azerbaijan in 2009-2010 were recruited for this study by a convenience sampling method. Participants were asked to share their experiences of IPV during pregnancy and adverse maternal outcomes. RESULTS: Of these pregnant women, 945 (72.8%) reported that they had experienced IPV during their last pregnancy. A significant association was found between IPV and preterm labour [adjusted odds ratio (adjOR) 1.54, 95% confidence interval (CI) 1.16-2.03], caesarean section (adjOR 11.84, 95% CI 6.37-22.02), antenatal hospitalization (adjOR 6.34, 95% CI 3.82-10.52) and vaginal bleeding (adjOR 1.51, 95% CI 0.9-2.3). DISCUSSION: This study demonstrated a high prevalence of IPV during pregnancy, and found that IPV was associated with adverse maternal outcomes including preterm labour, caesarean section, antenatal hospitalization and vaginal bleeding. This adds to the existing literature and can be used to inform healthcare practices in developing countries. Medical, health and surgical services for pregnant women should consider screening for IPV, and providers should be aware that IPV victims are at increased risk for adverse outcomes. Services should also develop links with the Battered Women's Movement; such programmes now exist in many countries.

The umbilical coiling index and adverse perinatal outcome.

OBJECTIVE: Evaluation of the relationship between umbilical coiling index (UCI) and adverse perinatal outcome. METHOD: A prospective study was performed on 699 pregnant women who were 37-40 weeks. UCI was determined by dividing the total number of the complete vascular coiling by the total umbilical cord length in centimeters. Then the relationship between UCI and neonatal weight, amniotic fluid index, meconium, Apgar score, and fetal distress were evaluated. RESULTS: There was a significant difference between normo- and hypocoiled groups according to the Apgar score less than 7 in minute 5, AFI

Pregnancy outcome following a previous spontaneous abortion (miscarriage).

OBJECTIVE: To determine the pregnancy outcome following a previous spontaneous abortion (miscarriage). METHOD: A prospective cohort study was done on 300 gravida-2 patients: 200 patients (case group) whose previous pregnancy was spontaneously aborted (early abortion), and 100 patients (control group) whose previous pregnancy went to term and a live fetus was delivered. All the patients were followed until delivery, and then the pregnancy outcomes, neonatal complications and delivery routes were determined and compared between the 2 groups. Pregnancy outcomes included: maternal complications (e.g. placenta previa, placental abruption, premature rupture of the membranes, preeclampsia and eclampsia, abortion, breech presentation, preterm labor, intrauterine fetal death); neonatal complications (low birth weight, gross congenital malformations, low Apgar score at 1 min), and delivery routes (cesarean delivery or instrumental delivery, e.g. forceps or vacuum). Statistical analysis was performed using the Statistical Package for Social Science. RESULTS: Statistical analysis showed that the pregnancy complications following a previous spontaneous miscarriage were no different from those of the control group, except for abortion (16.5 vs. 11%, p < 0.003, RR = 1.15, CI 95% = 0.95-1.39), fetal deaths (1.5 vs. 0%, p < 0.004, RR = 1.51, CI 95% = 1.39-1.63), and vaginal bleeding during the first trimester (19 vs. 1%, p < 0.001, RR = 1.57, CI 95% = 1.41-1.75), which were more than those of the control group. Also, the rate of cesarean delivery (28.14 vs. 13.48%) was increased (p = 0.026, RR = 1.25, CI 95% = 1.07-1.47). Neonatal complications were not statistically significantly different in comparison with the control group. CONCLUSION: A prior spontaneous miscarriage is a risk for the next pregnancy, and the risk of abortion and intrauterine fetal death will increase. Therefore, careful prenatal care is mandatory.

Atosiban and nifedipin for the treatment of preterm labor.

OBJECTIVE: To perform a comparison between atosiban (oxytocin antagonist) and nifedipin (calcium channel blocker) for acute treatment of preterm labor and their maternal safety. METHODS: A randomized controlled trial study was performed on 80 pregnant women with preterm labor, between 26 and 34 weeks of pregnancy, in Akbar Abadi Teaching Hospital in Tehran, Iran. 40 women (the atosiban group) were compared with another 40 women (the nifedipin group) for the drugs' efficacy in delaying delivery for more than 48 h in order to undergo steroid therapy, and for more than 7 days or more, and also to assess their maternal safety. The duration between the drugs' administration and delivery were compared. The statistical analysis was performed using the Statistical Package for Social Science (SPSS). RESULTS: There was no statistically significant difference between the two groups in the treatment of preterm labor. Atosiban was effective in 82.5% of cases, and nifedipin in 75% of the cases (p=1.000), for delaying delivery for 48 h. Atosiban was effective in 75% of the cases, and nifedipin in 65% of the cases, for delaying delivery for more than 7 days. The maternal side effects in the atosiban group were 17.5%, and in the nifedipin group they were 40%, which had a statistically significant difference (p=0.027). The duration between treatment and delivery was 29.03+/-16.12 days in the atosiban group and 22.85+/-13.9 days in the nifedipin group with no statistically significant difference (p=0.79). CONCLUSION: Atosiban is an effective and safe drug for the acute treatment of preterm labor with minimal side effects, and it can be an option in the treatment of preterm labor, especially in patients with heart disease and multi-fetal pregnancies.