Background:Birth injuries are defined as the impairment of neonatal body function due to adverse events that occur at birth and can be avoidable or inevitable. Despite exact prenatal care, birth trauma usually occurs, particularly in long and difficult labor or fetal malpresentations.Objectives:This study aimed to investigate the incidence of birth injuries and their related factors in Kashan, Iran, during 2012-2013.Patients and Methods:In this cross-sectional study, all live-born neonates in the hospitals of Kashan City were assessed prospectively by a checklist included demographic variables (maternal age, weight, and nationality), reproductive and labor variables (prenatal care, parity, gestational age, premature rupture of membrane (PROM), fetal heart rate (FHR) pattern, duration of PROM, induction of labor, fundal pressure, shoulder dystocia, fetal presentation, duration of second stage, type of delivery, and delivery attendance), and neonatal variables (sex, birth weight, height, head circumference, Apgar score, and neonatal trauma). Birth trauma was diagnosed based on pediatrician or resident examination and in some cases confirmed by paraclinic methods. Statistical analyses were performed by chi-square, student’s t-test, and multiple logistic regression analyses using SPSS version 17. P ≤ 0.05 was considered statistically significant.Results:In this study, the incidence of birth trauma was 2.2%. Incidence of trauma was 3.6% in vaginal deliveries and 1.2% in cesarean sections (P < 0.0001). The most common trauma was cephalohematoma (57.2%) and then asphyxia (16.8%). In multiple logistic regression analyses, decreased fetal heart rate (FHR), fundal pressure, shoulder dystocia, vaginal delivery, male sex, neonatal weight, delivery by resident, induction of labor, and delivery in a teaching hospital were predictors of birth trauma.Conclusions:Overall, incidence of birth trauma in Kashan City was lower in comparison with most studies. Considering existing risk factors, further monitoring on labor, and delivery management in teaching hospitals are recommended to prevent birth injuries. In addition, careful supervision on students and residents' training should be applied in teaching hospitals.

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Background:Postpartum depression (PPD) is a common problem after child's birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being.Objectives:The objective of this study was to assess the life quality in mothers with and without PPD.Patients and Methods:In a prospective study, women who had experienced child's birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n = 321) and fourth month (n = 300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student’s t-test, Mann–Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient.Results:Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition to physical and mental health components at two assessments. The highest correlation was found between EPDS scores and emotional well-being and total scores of SF-36 dimension at the first and the second assessments (r = -o.489, r = -0.381), respectively.Conclusions:The findings demonstrated that postpartum depression leads to a lower life quality at second and fourth months postpartum. Integration of PPD screening into routine postnatal care is recommended.

Background: Nausea and vomiting of pregnancy (NVP) is the most common medical condition of pregnancy, affecting up to 85% of expecting mothers. NVP can have serious adverse effects on the quality of a woman's life, social, and domestic functioning, and her general well-being. Therefore, it is very important to treat this condition. Objectives: The effectiveness of ginger and acupressure in the treatment of NVP was compared in the present study. Patients and Methods: 159 eligible pregnant women with symptoms of mild to moderate nausea and/or vomiting before 16 weeks gestational age participated in a 7-day clinical trial. They were divided randomly into three groups: the acupressure, ginger, and control. Participants did not receive any intervention for three days and interventions were performed for the women in acupressure and ginger groups for four days. No intervention was performed for the control group. Data was collected by self-recorded symptoms according to the Rhodes index. Data was analyzed by ANOVA, Kruskal-Wallis, Chi-square, and Fisher exact tests for quantitative and qualitative variables. Results: There were no statistical differences in the baseline demographics between the three groups. ANOVA test showed that there were significantly differences in mean difference Rhodes index scores (vomiting, nausea, retching and total score) in the three groups (P < 0.001). Conclusions: Ginger is more effective than acupressure to relieve mild to moderate nausea and vomiting in symptomatic pregnant women in less than 16 weeks of gestational age.

This article has implications for health care providers, especially midwives, for the recognition of menopausal symptoms and related factors in women. Background: Menopause is a unique event in a woman's life which has many symptoms. Frequency and severity of these symptoms vary, and they are based on the woman's epidemiological characteristics. Objectives: The aim of this study was to determine the prevalence and severity of menopausal symptoms and related factors among women, 40-60 years in Kashan, Iran. Patients and Methods: In this cross-sectional study, 700 menopausal women in Kashan City were selected using cluster sampling. Data were collected by the Menopause Quality of Life Questionnaire (MENQOL). In addition, demographic variables including; current age, age of menarche and menopause, marital status, educational level, working status and exercise activity levels, were recorded. Data were analyzed using SPSS software version 16 and socio-demographic characteristics were compared using a chi-square test. A P value < 0.05 was considered significant. Results: The most common symptoms in; vasomotor, psychosocial, physical and sexual domains were; 'night sweats', 'accomplishing less than I used to', 'feeling a lack of energy', and 'change in sexual desire', respectively. Moreover, the most severe symptoms in these domains were; 'night sweats', 'feeling anxious or nervous', 'aching muscles or joints', and 'avoiding intimacy'. There was a statistically significant difference between; the severity of menopausal symptoms and working status (P = 0.017), different educational levels (P = 0.001), exercise activity (P = 0.001), exercise frequency (P = 0.04), and duration of menopause (P = 0.03). Conclusions: The prevalence of menopausal symptoms in our population is similar to most other communities. Employment, higher educational levels, doing physical activity and duration of menopause of more than five years is associated with milder menopausal symptoms.

Background: Nausea and vomiting are common and unpleasant complications in pregnancy. Although many alternative therapists support the use of ginger for nausea and vomiting of pregnancy, there is currently insufficient clinical evidence to support its use in this condition Objectives: The present study was performed to assess the effectiveness of ginger in the treatment of nausea and vomiting in pregnancy. Patients and Methods:This seven-day clinical trial was performed on 120 eligible pregnant women with symptoms of mild to moderate nausea and vomiting before 16 weeks gestation. They were divided into; ginger, placebo and control groups, by block randomization. Women were asked to record their nausea and vomiting for three days, and then participants received either ginger capsules, or a placebo for four days. No intervention was done with the control group. Data measure was self-recorded symptoms according to the Rhodes Index. Data were analyzed by ANOVA, ANCOVA, Kruskal-Wallis, Chi-square, and Fisher's exact test, for the quantitative and qualitative variables. Results: There were no statistical differences in the baseline demographics between the three groups apart from age of marriage and wanted or unwanted pregnancy. An ANCOVA test (covariance test) showed significant differences in mean scores after the intervention in the three groups (P < 0.001). Conclusions: Ginger was effective for the relief of mild to moderate nausea and vomiting in pregnant women at less than 16 weeks gestation.

Objective: To determine the maternal and neonatal outcomes of pregnant women with COVID-19 infection.Methods: A cohort study was conducted on 56 pregnant women with COVID-19 and 94 healthy pregnant women during the COVID-19 epidemic in Iran. Two groups were followed until childbirth. Demographic and obstetric information, clinical symptoms, laboratory and radiographic findings of the patients, and maternal and neonatal outcomes of the two groups were gathered by a checklist. Data were analyzed using SPSS version 16. A P value < 0.05 was considered significant. Results:The two groups were similar in terms of maternal age, gravida, parity, and comorbidities (P > 0.05). The rate of cesarean delivery in the exposed group was higher than that in the control group (P = 0.027; relative risk [RR] =2.23). Pre-eclampsia was seen in 19.8% of the exposed group and 7.4% of the control group (P = 0.037; RR = 2.68). The rate of preterm labor in the exposed group was higher than that in the control group (P = 0.003; RR = 2.70). Fetal distress was seen in 16.1% of the exposed group and 4.3% of the control group (P = 0.016; RR = 3.84). Conclusion:Pregnant women with COVID-19 had an increased risk of pre-eclampsia, preterm labor, and cesarean delivery. Their fetal and neonatal outcomes were fetal distress, newborn prematurity, and low Apgar score.

Preeclampsia is a major cause of maternal death and morbidity. Body mass index (BMI) predicts an increased risk of developing hypertensive disorders and preeclampsia. However, waist-to-hip ratio (WHR), as a central obesity index, has not been assessed in predicting this disorder in pregnancy. We assumed that WHR might be more sensitive in predicting the risk of preeclampsia, compared with BMI. The aim of this cohort study was to investigate the relationships of BMI and WHR with preeclampsia. This was a prospective cohort study of 1200 pregnant women with singleton pregnancies. Anthropometric indices included WHR and BMI, which were measured at the first antenatal visit (⩽ 12 weeks of gestational age). The incidence of preeclampsia was assessed after 20 weeks of gestation. Maternal demographic data and obstetric outcomes were also recorded for each subject. All of the statistical tests were performed using SPSS software, version 16. The overall incidence of preeclampsia in the study population was 4.2%. The maternal WHR and BMI at the beginning of pregnancy were significantly associated with the occurrence of preeclampsia (P = 0.006 and P = 0.001, respectively). WHR ⩾ 0.85 and BMI ⩾ 25 kg m(-2) in the first 12 weeks of pregnancy had relative risks of 2.317 (confidence interval (CI): 1.26-4.27) and 3.317 (CI: 1.6-6.86) for preeclampsia. BMI and WHR were anthropometric indicators that presented correlations with preeclampsia. Of these anthropometric indices, BMI had greater predictive value in preeclampsia.