Intimate partner violence during pregnancy in COVID-19 pandemic: a cross-sectional study from South-west of Iran.

BACKGROUND: Intimate partner violence (IPV) against pregnant women can cause several complications for the mother and her baby, which are life-threatening. Thus, we aimed to find the prevalence of IPV and its associated factors in pregnant women in Shiraz, Iran. METHODS: This cross-sectional study was conducted among pregnant mothers in Shiraz between July 2020 and January 2021. The questionnaire consisted of four parts: demographic data, socio-economic status (SES), obstetric and medical history, and questions about IPV. Univariate analysis was performed using Chi-square, McNemar, or Fisher's exact test, and variables with p-value < 0.20 were included in Logistic regression. The odds ratio and CI 95% for variables with p-value < 0.05 were considered statistically significant. RESULTS: The overall prevalence of IPV was 93.1% among 830 pregnant women in Shiraz. Psychological violence was the most prevalent type (92.9%), followed by sexual (11%) and physical (7.7%) violence. High SES (OR = 3.21, (CI:1.61-6.41)) was the only risk factor for overall violence, and the age group, 30-34, was a risk factor for physical violence. Mother-desired pregnancy (OR = 26 (Cl:0.09-0.79)) and father-desired pregnancy (OR = 0.91, (CI:0.22-3.80)) were protective factors against physical and sexual violence, respectively. Furthermore, Psychological violence and sexual violence increased during COVID-19 Pandemic (P.value < 0.05). CONCLUSION: According to the obtained results, the prevalence of IPV during pregnancy in Shiraz was very concerning, especially psychological violence. Improving conflict-solving skills among family members and addressing economic problems could be considered by health policymakers when designing interventional programs and policies to reduce IPV during pregnancy.

COVID-19 pneumonia and pregnancy; a systematic review and meta-analysis.

BACKGROUND: The new SARS-CoV-2 originated from Wuhan, China is spreading rapidly worldwide. A number of SARS-CoV-2 positive pregnant women have been reported. However, more information is still needed on the pregnancy outcome and the neonates regarding COVID-19 pneumonia. MATERIAL AND METHODS: A systematic search was done and nine articles on COVID-19 pneumonia and SARS-CoV-2 positive pregnant women were extracted. Some maternal-fetal characteristics were extracted to be included in the meta-analysis. RESULTS: The present meta-analysis was conducted on 87 SARS-CoV-2 positive pregnant women. Almost 65% of the patients reported a history of exposure to an infected person, 78% suffered from mild or moderate COVID-19, 99.9% had successful termination, 86% had cough, and 68% had fever (p = .022 and p < .001). The overall proportions of vertical transmission, still birth, and neonatal death were zero, 0.002, and, 0.002, respectively (p = 1, p = .86, and p = .89, respectively). The means of the first- and fifth-minute Apgar scores were 8.86 and 9, respectively (p < .001 for both). The confounding role of history of underlying diseases with an estimated overall proportion of 33% (p = .03) resulted in further investigations due to sample size limitation. A natural history of COVID-19 pneumonia in the adult population was presented, as well. CONCLUSION: Currently, no evidence of vertical transmission has been suggested at least in late pregnancy. No hazards have been detected for fetuses or neonates. Although pregnant women are at an immunosuppressive state due to the physiological changes during pregnancy, most patients suffered from mild or moderate COVID-19 pneumonia with no pregnancy loss, proposing a similar pattern of the clinical characteristics of COVID-19 pneumonia to that of other adult populations.

Knowledge and Attitude regarding COVID-19 among Pregnant Women in Southwestern Iran in the Early Period of its Outbreak: A Cross-Sectional Study.

Both knowledge and attitude can play key roles in the prevention of novel COVID-19. This cross-sectional study was conducted on a statistical sample of pregnant women in southwestern Iran between March and April 2020 to evaluate their knowledge and attitude toward this condition. So, pregnant mothers registered in antenatal clinics affiliated to Shiraz University of Medical Sciences were called and asked to fill in a three-part online questionnaire including sociodemographic characteristics, obstetric/medical history, and knowledge/attitude toward COVID-19. P-values < 0.05 were considered statistically significant. The mean score of knowledge among 540 respondents was 34 (±4.1) out of 43. Also, 44.3% answered more than 80% of the items correctly. Higher knowledge scores were accordingly associated with marriage duration, area of residence, health insurance coverage, socioeconomic status (SES), and self-rated health status. However, a strong relationship was found between knowledge, SES, and health insurance coverage with reference to multivariate analysis results. Moreover, majority of the pregnant women and their households expressed their concern about using preventive measures against COVID-19. Although most respondents were moderately worried about becoming infected with COVID-19, 264 (48.9%) cases reported that they were very much anxious about their newborns being infected with COVID-19 and 388 (71.9%) individuals asserted that they were worried about their mortality due to this infection. Besides, most mothers maintained that they had some degrees of rumination, which could interfere with their routine daily chores. Hence, health policy-makers should pay much focus on educating pregnant mothers to help them prevent mental exhaustion.

Triage by cervical length sonographic measurements for targeted therapy in threatened preterm labor: A double blind randomized clinical trial.

BACKGROUND: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. OBJECTIVE: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. MATERIALS AND METHODS: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly (n=65) or to receive tocolysis as planned (n=55). Tocolysis was prescribed when cervical length was <15 mm while those with cervical length ≥15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome. RESULTS: This RCT showed in case group, 78.9% of patient with cervical length <15 mm were delivered within 7 days and only 21.1% of them maintained their pregnancy. Of those with cervical length ≥15 mm, only 15.2% were delivered within the study period and the rest (84.8%) maintained their pregnancy (p<0.001). CONCLUSION: "Our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length ≥15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence.