Monitored home-based with or without face-to-face exercise for maternal mental health during the COVID-19 pandemic.

INTRODUCTION: Despite the known beneficial effects of exercise, most pregnant women do not exercise regularly. Most studies on exercise have been conducted on supervised exercise and there is limited evidence regarding the adherence and effect of other exercise programs on pregnancy outcomes. Therefore, we aimed to investigate adherence to a face-to-face plus monitored home exercise program versus a monitored home-based exercise program on its own during pregnancy. In addition, effects of these two exercise programs on women's mental health during pregnancy and postpartum (primary outcomes) and on some other maternal and neonatal outcomes (secondary outcomes) will be assessed. METHODS: In this superiority trial with three parallel arms, 150 women at 12-18 weeks of gestation will be randomised equally into three groups (face-to-face plus monitored home exercise, only monitored home-based exercise, and control). The exercise programs will be performed up to the 38th week of gestation during which participants will be assessed at specific intervals during the pregnancy, and post-partum and followed up until six months after childbirth. The exercise diary will be used to assess the adherence. The Edinburgh Depression Scale and the Positive and Negative Affect Schedule will be used to assess prenatal and postnatal depression and affect, respectively. DISCUSSION: This study reflects the feasibility and acceptance of two exercise programs for pregnant women and their effects on important outcomes. If these programs are followed properly and effectively, pregnant women's health can be improved using these methods at a lower cost compared to the conventional supervised exercise program.

Evening primrose oil for cervical ripening in term pregnancies: a systematic review and meta-analysis.

Induction of labor by using available, inexpensive and non-invasive methods with the least side effects is particularly important. A systematic review was conducted to assess the effect of evening primrose oil on cervical ripening in term pregnancies. In this systematic review and meta-analysis of clinical trials, a search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, Clinical Trials.gov, Google Scholar and Persian databases (Magiran, SID, and IRCT.ir) for published related articles without any time limit. The Cochrane handbook was used to determine the risk of bias of the included articles. The obtained data were analyzed in RevMan and reported in forest plots. The Odds Ratio (OR) was used to find the effect of the dichotomous data and the Mean Difference (MD) for the continuous data. The heterogeneity of the studies was assessed using I2, T2 and Chi2. The random effect was used instead of fixed effect if I2 >40%. A total of 28 titles and abstracts were extracted, 9 articles entered into the meta-analysis. The meta-analysis results showed significant differences between EPO and control groups in terms of bishop score (MD=1.32; 95% CI: 0.98 to 1.66), reducing caesarean section rate (OR= 0.61; 95% CI: 0.43 to 0.86), duration of first stage of labor (MD= -98.67; 95% CI: -140.98 to -56.38) and duration of second stage of labor (MD= -10.98; 95% CI: -21.86 to -0.09). There were no significant differences in terms of birth weight (MD= 100.97; 95% CI: -11.91 to 213.84) and the frequency of induction with oxytocin (OR= 0.53; 95% CI: 0.27 to 1.01). It seems evening primrose oil be effective for cervical ripening, reducing cesarean section rate and shortening the duration of labor. Due to the high heterogeneity of the studies, the researchers recommend further researches on the subject using a standard tool based on the CONSORT statement.

Effect of prenatal aerobic exercises on maternal and neonatal outcomes: A systematic review and meta-analysis.

AIM: This study aimed to evaluate the effect of prenatal aerobic exercises on maternal and neonatal outcomes. DESIGN: A systematic review and meta-analysis. METHOD: A search was carried out in databases including PubMed, ProQuest, EMBASE, Cochrane Library, Scopus, Web of Science, Magiran and SID until 30 September 2020. Two reviewers independently assessed the articles for quality and risk of bias using the Cochrane handbook. The statistical heterogeneity was determined using the Cochran's Q test and Higgins' I2 coefficient. RESULTS: Of the 2,790 extracted articles, 16 were included in this review. The results of the meta-analysis showed that prenatal exercise can increase the frequency of vaginal delivery significantly (RR: 1.24; 95% CI: 1.08-1.43), but had no statistically significant effect on other maternal and neonatal outcomes, such as first, second and third stages of labour, gestational age at birth, first and fifth-minute Apgar score, umbilical cord pH, neonatal weight, height and head circumference (p > .05). CONCLUSIONS: The meta-analysis results suggested that prenatal exercise can reduce the frequency of caesarean section.

Risk of breast cancer in relation to reproductive factors in North-West of Iran, 2013-2014.

More than one million new patients suffer from breast cancer annually in the world. In developed countries, breast cancer is the most common malignancy diagnosed among women, and in developing regions, it often ranks second to cervical cancer. This study aimed to investigate the relationship between incidence of breast cancer and reproductive factors in North-West of Iran. This retrospective analytical control-case study was conducted with 235 breast cancer patients and 235 women in the control group. Data collection tools included a set of questions with interviews and patient medical records. Data were analyzed using statistical tests: t-test, Chi-square, Fisher, and Pearson correlation coefficient. Significantly increased risks were associated between breast cancer and older age at first pregnancy, age at menopause and history of contraceptive use. A trend for decreasing risk were observed with increasing parity. Findings of this study showed no association between breast cancer and age at menarche. The study results suggested that physiological and reproductive factors may play important roles in the development breast cancer among Iranian women.