Problem: Inappropriate activation of the immune system, particularly the imbalance of T-helper type 17 (Th17)/regulatory T (Treg) cells is thought to play considerable roles in preeclampsia (PE). To investigate the probable effects of the adaptive immune system in the pathophysiology of PE, we analyzed the dynamic changes of Th17/Treg cells, cytokines profile, and transcription pattern of Th17/Treg-related genes and microRNAs (miRNAs) in 50 women suffering from PE in comparison with 50 healthy pregnant women. Methods: Expressions of cytokines, specific transcription factors, and related miRNAs were measured by real-time polymerase chain reaction (PCR). Enzyme-linked immunosorbent assay (ELISA) was used to test the interleukin (IL)-17, IL-23, IL-6, and IL-10 and transforming growth factor β in serum and supernatant of peripheral blood mononuclear cells (PBMCs). The frequency of Th17 and Treg cells were determined by flow cytometry.Results: PE patients exhibited a decreased number of Treg cells (p = 0.006), while Th17 cells were increased (p = 0.004). Forkhead box P3 and IL-10 mRNA expressions were reduced (p = 0.0001 and 0.0028, respectively), while expressions of retinoic acid receptor-related orphan nuclear receptor γt, IL-17, IL-23, and IL-6 were enhanced (p < 0.0001, 0.0018, 0.0014, and 0.027, respectively). ELISA results also showed increased levels of IL-6, IL-17, and IL-23 (p = 0.022, 0.0005, 0.0081, respectively), and decreased levels of IL-10 in the supernatant of PBMCs of PE patients compared with control group (p = 0.0011). There was significant upregulation of miR-106b and miR-326 (p = 0.0048 and 0.028, respectively) in PE patients in comparison with the control group.Conclusions: These findings suggest that imbalance of Th17/Treg cells, regulated possibly via microRNAs, may be involved in the pathogenesis of PE, emphasizing on the importance of these cells in feto-maternal immune cross-talk. K E Y W O R D S interleukin, microRNA, preeclampsia, regulatory T-cell, T-helper 17 cell J Cell Physiol. 2019;234:5106-5116. wileyonlinelibrary.com/journal/jcp 5106 |

Aim This study aimed to determine the effect of plantar reflexology on the severity of labor pain and childbirth experience (primary outcomes) and the duration of labor stages (secondary outcomes). Methods This single‐blind randomized controlled trial was performed on 90 women in Al‐Zahra and Taleghani hospitals in Tabriz‐Iran. Participants were randomly assigned into three groups; Intervention 1 (two 30‐min massages at the effective point of pain for each sole), intervention 2 (one 30‐min massage at the effective point of pain and one 30‐min massage at the heel for each sole), and control (two 30‐minute heel massages). Massage was performed once in 4‐cm dilatation and the second time in 7‐cm dilatation. The severity of pain and childbirth experience were measured by Visual Analogue Scale and Labor Agentry Scale, respectively. Partograph chart was used to measure the length of labor stages. Results The severity of pain in intervention group 1 was significantly lower than the control group (AMD: −1.7; 9% confidence interval: −2.8 to −0.6; p = 0.001), but there was no significant difference between intervention groups 1 and 2 (p = 0.066) and intervention group 2 and control (p = 0.336). A significant difference was observed between groups in terms of length of the third stage of labor (p = 0.04). There was no significant difference between groups in terms of mean childbirth experience score (p = 0.217), duration of active phase (p = 0.099), and second stage of labor (p = 0.114). Conclusion The results of the study showed that plantar reflexology can reduce the severity of labor pain and the length of third stage of labor.

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Ab s t r a c tPurpose: To assess the effects of social determinants of health on pregnancy outcome in rural and urban areas of Tabriz.Methods: A retrospective cohort study design was used to examine 600 pregnant women who attended antenatal health care services in Tabriz, Iran from August 2012 to the October 2013. They were followed up from the sixth week of gestation to three months after delivery. Socioeconomic indicators and some other measures such as body mass index, family income status, maternal education and occupation, cigarette smoking, depression, intimate partner violence based upon health ministry guidelines and pregnancy outcomes including low birth weight, small for gestational, and preterm delivery, cesarean delivery and miscarriage were assessed . Results:The mean age of women was 26.1 ± 6.6 years in rural and 27.9 ± 5.7 years in urban areas and the mean duration of pregnancy was 39.03± 1.36 weeks. There was a significant association between maternal education, cesarean section and abortion. BMI played a major role on almost all poor pregnancy outcomes (LBW, PTB, cesarean section, miscarriage) and income status was the first predictor of low birth weight. Socio demographic and behavioral factors were particularly important for predicting miscarriage, preterm labor and low birth weight. Conclusion:Although residential area (rural versus urban of Tabriz) was associated with preterm labor, low birth weight and cesarean section , only cesarean section had a significant effect after adjusting for confounding factors such as income and education level, age, parity, obstetrical complications .Disparity in distribution of resources in rural and urban area were the main factors that made the pregnancy complicated in our study.