Background:Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women.Materials and Methods:In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and post hoc tests. Level of significance was set as 0.05 for all tests.Results:The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001) and 3 months after delivery (P < 0.0001) were significantly lower in the study group compared with the control group.Conclusions:Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.

Background: Breast cancer is a very common cancer in women which is diagnosable using inexpensive, accessible, and easy screening programs in the early stages of the disease. Culture, beliefs, and opinions of women affect adoption of screening techniques. Nursing professionals are supposed to be aware of such influencing factors. Therefore, this study was conducted to investigate barriers to breast self-examination (BSE) among women in Isfahan province. Materials and Methods: During a cross-sectional descriptive and correlational study in 2017, 1509 women in rural and urban areas of Isfahan province were selected using multistage sampling method. Data were collected by visiting homes, using a questionnaire, and conducting interviews and were analyzed using descriptive and analytical statistics. Results: The results showed that barriers consisted of lack of awareness about breast examination ( p = 0.006), lack of awareness about BSE techniques ( p < 0.001), and lack of training by personnel of healthcare centers ( p = 0.016), which were significantly associated with residency areas (i.e., urban and rural areas). Moreover, women's educational level was significantly associated with 5 of 10 barriers and their occupation was significantly associated with 2 of 10 barriers to BSE. Conclusions: Among the several factors that may affect BSE, a part of them in Isfahan women act as obstacle that they are moderated by some demographic factors such as residency areas, education level, and occupation. Therefore, nursing plans and interventions aimed at developing BSE should be tailored to suit the unique demographic characteristics of women.

The physiological changes during pregnancy modulate the endocrine system. Therefore, both the American and the European thyroid associations recommend the use of local trimester-specific reference intervals. The purpose of this study was to establish the first trimester reference intervals for thyroid function tests in the central area of Iran. We examined 436 pregnant women in their first trimester of pregnancy, and 444 non-pregnant women in a cross sectional study. Serum levels of thyroid stimulating hormone (TSH), free thyroxin (FT4), free triiodothyronine (FT3), thyroid peroxidase antibody, urinary iodine concentration (UIC), and thyroid volume were measured for all subjects. The first trimester-specific reference intervals (2.5th–97.5th percentile) were determined for 185 pregnant women and 256 non-pregnant women with negative TPOAb, adequate iodine level (UIC≥150 μg/l in pregnant and UIC≥100 μg/l in non-pregnant women), and normal thyroid examination. We calculated multiples of the median (MoM) for TFTs to normalize the obtained data. The first trimester-specific reference intervals of serum TSH, FT4, and FT3 for pregnant women were 0.20–4.60 mIU/l, 9.0–18.02 pmol/l, and 3.40–5.64 pmol/l, respectively, while the corresponding figures for non-pregnant women were 0.59–5.60 mIU/l, 9.52–19.30 pmol/l, and 3.70–5.55 pmol/l, respectively. The first and 99th percentile MoM of TSH in pregnant women in their first-trimester was 0.06–4.62. The local normal reference ranges for the first trimester of pregnancy in central region of Iran were different from the ranges suggested by the ATA.

Objective: Thyroid dysfunction, a common complication of pregnancy, is associated with adverse obstetric and neonatal consequences. This study aimed to determine the effect of TSH levels on early pregnancy outcome in a prospective populationbased cohort study. Design and methods:The serum TSH, free thyroxine, free triiodothyronine, thyroid peroxidase antibody levels and urinary iodine concentration of 418 pregnant women in their first trimester of pregnancy were measured. According to the American Thyroid Association (ATA) and the local reference ranges for TSH, women were divided into two groups of 0.1-2.5, >2.5 mIU/L and 0.2-4.6, >4.6 mIU/L. The risk of spontaneous abortion (SA) was calculated for each group.Results: Spontaneous abortion was detected in 7.2% (n = 30) of total 418 pregnancies. Women with TSH levels > 2.5 mIU/L had an increased risk of SA, compared to women with TSH levels of 0.1-2.5 mIU/L (relative risk [RR] 3.719, 95% confidence interval [CI]:1.713-8.074). The risk of SA was increased in women with TSH levels > 4.6 mIU/L (RR 5.939, 95% CI: 1.711-20.620). The rate of SA was increased by 78% for every unit increase in standard deviation of TSH concentration (RR 1.35, 95% CI: 1.09-1.70). The rate of miscarriages in the treated group by levothyroxine was 9.8% (n = 6) compared to 28.6% (n = 8) in the untreated group (P = 0.024). Conclusions:Our finding suggests that the upper limit for the TSH normal range should be redefined to <2.5 mIU/L during the first trimester of gestation. The local upper limit was 4.6 mIU/L, consistent with 4.0 mIU/L cut-off value recommended by the ATA. K E Y W O R D Sfirst trimester, hypothyroidism, pregnancy, pregnancy loss, pregnancy outcome, spontaneous abortion, thyroid-stimulating hormone levels

Background:Postpartum depression (PPD) is one of the most common problems in women of childbearing age. This study was conducted to evaluate the efficacy of aromatherapy on PPD.Materials and Methods:In this study, 105 pregnant women at 35–37 weeks of pregnancy were enrolled using convenient sampling and randomly assigned to three groups. The intervention group dropped 7 drops of lavender oil and 1 cc rose water at the concentration of 100%, and the placebo group dropped 7 drops of odorless sesame seed oil, with 1 cc of musk willow sweat at the concentration of 100% by dropper on a special cloth. They put the cloths on their mouths and took 10 deep breaths before sleeping and then placed them next to their pillows. The control group only received the routine care. The intervention lasted from 38th week of pregnancy until 6 weeks after delivery. Then depression level was determined before the intervention, 35–37 weeks of pregnancy, 2 and 6 weeks after delivery using Edinburgh questionnaire.Results:The mean of depression score in the intervention group decreased significantly compared to the placebo and control groups, 2 weeks (F = 9.412, p < 0.001) and 6 weeks after delivery (F = 7.813, p < 0.01).Conclusions:This study provides valid evidence for the effect of aromatherapy on PPD. Therefore, the use of aromatherapy can be recommended in high-

Background. Hypertensive disorder generally complicates 5–10 percent of all pregnancies. Angiogenic growth factors may be helpful for the diagnosis and prediction of preeclampsia. Therefore, in this study we attempted to determine the serum levels of asymmetric dimethylarginine (ADMA), vascular endothelial growth factor (VEGF), and nitric oxide (NO) metabolite (nitrite) in preeclampsia patients and compared the levels with those obtained from normal pregnant women. Methods. Ninety pregnant women (19–33 years old) in two groups of preeclampsia and normal were considered during 2012. The levels of ADMA, VEGF, and nitrite were measured in maternal serum samples using ELISA kits. Results. Significant increase of VEGF and nitrite levels was observed in preeclampsia patients when compared with other groups (P < 0.05). The serum level of ADMA demonstrated a similar increased trend in preeclampsia patients; however, the increase was not statistically significant (P = 0.08). Conclusion. The findings reveal that the elevation of serum levels of VEGF and nitrite and possibly ADMA may be involved in the pathogenesis of preeclampsia.

A concern was raised 1 regarding the number of pregnant women in the analysis of reference range for the thyroid hormones in pregnancy 2 , where we reported 185 cases and it was believed to be 145 cases.

Context Interpretation of thyroid function tests during pregnancy is limited by the generalizability of reference intervals between cohorts due to inconsistent methodology. Objective 1) To provide an overview of published reference intervals for TSH and FT4 in pregnancy, 2) to assess the consequences of common methodological between-study differences by combining raw data from different cohorts. Methods 1) Ovid MEDLINE, EMBASE and Web of Science were searched until the 12th of December 2021. Studies were assessed in duplicate. 2) The individual participant data (IPD) meta-analysis was performed in participating cohorts in the Consortium on Thyroid and Pregnancy. Results 1) Large between-study methodological differences were identified, 11 of 102 included studies were in accordance with current guidelines. 2) 22 cohorts involving 63,198 participants, were included in the meta-analysis. Not excluding TPOAb-positive participants led to a rise of the upper limits of TSH in all cohorts, especially in the first (mean: +17.4%[range +1.6 to +30.3%]) and second trimester (mean: +9.8% [range +0.6 to +32.3%]). The use of the 95th percentile led to considerable changes in upper limits, varying from -10.8% to -21.8% for TSH and -1.2% to -13.2% for FT4. All other additional exclusion criteria changed reference interval cut-offs by a maximum of 3.5%. Applying these findings to the 102 studies included in the systematic review, 48 studies could be used in a clinical setting. Conclusions We provide an overview of clinically relevant reference intervals for TSH and FT4 in pregnancy. The results of the meta-analysis indicate that future studies can adopt a simplified study setup without additional exclusion criteria.