SummaryThe beginning of 2020 has seen the emergence of COVID‐19, an outbreak caused by a novel coronavirus, SARS‐CoV‐2, an important pathogen for humans. There is an urgent need to better understand this new virus and to develop ways to control its spread. In Iran, the first case of the COVID‐19 was reported after spread from China and other countries. Fever, cough, and fatigue were the most common symptoms of this virus. In worldwide, the incubation period of COVID‐19 was 3 to 7 days and approximately 80% of infections are mild or asymptomatic, 15% are severe, requiring oxygen, and 5% are critical infections, requiring ventilation. To mount an antiviral response, the innate immune system recognizes molecular structures that are produced by the invasion of the virus. COVID‐19 infection induces IgG antibodies against N protein that can be detected by serum as early as day 4 after the onset of disease and with most patients seroconverting by day 14. Laboratory evidence of clinical patients showed that a specific T‐cell response against SARS‐CoV‐2 is important for the recognition and killing of infected cells, particularly in the lungs of infected individuals. At present, there is no specific antiviral therapy for COVID‐19 and the main treatments are supportive. In this review, we investigated the innate and acquired immune responses in patients who recovered from COVID‐19, which could inform the design of prophylactic vaccines and immunotherapy for the future.

Background: Considering that the obstetricians and pediatricians need to comprehensive information about the obstetric and neonatal effect of COVID-19, this review study was conducted to investigate the impact of COVID-19 on obstetrics and neonatal outcomes. Methods: In this systematic review the international search databases following PubMed, Web of Science, Scopus, ProQuest and Embase and Google scholar were searched. All articles were reviewed by two independent researchers until 10 April 2020. After quality assessment of included studies the finding reported in 2 sections obstetrics and neonatal outcomes. Results: The sixteen studies with a sample size of 123 pregnant women with a definitive diagnosis of COVID-19 and their neonates were evaluated. The range of gestational age was 25-40 weeks. There was no death associated with COVID-19 in pregnant women. The obstetric outcomes in pregnant women with COVID-19 include decreased fetal movement, intrauterine fetal distress, anemia, PROM, preterm labor, Multiple Organ Dysfunction Syndrome (MODS) and etc. The most common delivery mode in women affect with COVID-19 was cesarean section. Expect for one case with MODS, in the majority of the studies reviewed, no severe morbidity or mortality occurred. The neonatal outcomes were stillbirth, prematurity, asphyxia, fetal distress, low birth weight, small for gestational age, large for gestational age, multiple organ dysfunction syndrome, disseminated intravascular coagulation and neonatal death. In addition, five neonates born to mothers with COVID-19 were positive for SARS-CoV-2. However, the studies report these outcomes but the exact causes of theme are not known. Conclusion: In this systematic review, we summarize the diverse results of studies about the obstetrics and neonatal outcomes following COVID-19. This infection may cause negative outcomes in both mothers and neonates. However, there were evidence about neonate infected with COVID-19, but there is controversial information about the vertical transmission of COVID-19.

Background: Polycystic ovarian syndrome is an endocrine disorder with many complications. This syndrome is a growing concern among adolescents around the world, with varying reports of its prevalence in different parts of the world. Objective: This study aimed to determine the prevalence of polycystic ovary syndrome in adolescents by a systematic review and meta-analysis. Materials and Methods: In this study, a search for published articles with an English language limitation and without a time limit was done in different databases (Scopus, PubMed, and Web of Science, Emabse and Cochrane) in January 2019. The 12 studies that met the criteria for entering a qualitative assessment scale of 5 and higher were subjected to systematic review and meta-analysis. Egger and Begg’s tests were used to check the publication bias. Data were analyzed with STATA software, version 11.1. Results: Twelve studies were included for meta-analysis. The total number of participants in the study was 149,477. The average quality score of all studies was 8.67 (range: 5–10). The prevalence of polycystic ovarian syndrome in adolescents based on the Rotterdam criteria was 11.04% (95% CI: 6.84–16.09%), based on the National Institute of Health criteria, it was 3.39% (95% CI: 0.28–9.54%), and based on Androgen Excess and Polycystic Ovary Syndrome Society, it was 8.03% (95% CI: 6.24–10.01%). Conclusion: The result of this study showed that there is a variation in the prevalence of PCOS in adolescents based on different criteria; we suggest more community-based studies among adolescences in different parts of the world.

Background: Infertile women are exposed more frequently to anxiety risk than are infertile men, thereby adversely affecting the procedures with which they are treated and the quality of their lives. Yet, this problem is often disregarded. This study accordingly determined the prevalence of anxiety symptoms among infertile women. Methods: All Persian and English studies published from the early 2000s to May 2019 were searched in international (i.e., PubMed, the Cochrane Library, Web of Science, Scopus, Embase, and PsycINFO) and national (i.e., SID, Magiran) databases as well as through Google Scholar. After the titles and abstracts of the articles were reviewed, their quality was evaluated, and relevant works for examination were selected in consideration of established inclusion and exclusion criteria. The risk of biases of individual studies according to Newcastle -Ottawa Scale was assessed. The heterogeneity of the studies was assessed using the I 2 statistic, and indicators of publication bias were ascertained using Egger's test. Stata (version 14) was employed in analyzing the findings. Results: Thirteen studies having a collective sample size of 5055 infertile women were subjected to meta-analysis, with study heterogeneity incorporated into a random effects model. The findings indicated that 36% of the infertile women involved in the evaluated studies self-reported their experience with anxiety. The pooled prevalence of the condition among the subjects was 36.17% [95% confidence interval (CI): 22.47-49.87]. The pooled prevalence levels in low-and middle-income countries and high-income countries were 54.24% (95% CI: 31.86-78.62) and 25.05% (95% CI: 15.76-34.34), respectively. The results revealed no evidence of publication bias (P Egger's test = 0.406). Conclusion: Considering the prevalence of anxiety in infertile women and its effects on health processes and quality of life, this problem requires serious consideration and planning for effective intervention, especially in lowand middle-income nations.

Background Dyspareunia is one of the most common postpartum sexual dysfunctions. Objective To estimate the prevalence of postpartum dyspareunia. Search strategy Web of Science, Scopus, PubMed, and Embase databases were searched to July 2019 using keywords including ‘perineal pain,’ ‘dyspareunia,’ and ‘sexual pain’. Selection criteria Observational studies on the prevalence of postpartum dyspareunia were included. Data collection and analysis Two authors independently reviewed articles and extracted data. Study heterogeneity was evaluated by I2 index; publication bias by Egger and Begg tests. Main results Twenty‐two studies enrolling 11 457 women were included. Based on meta‐analysis, the overall estimated prevalence of dyspareunia was 35% (95% confidence interval [CI], 29%–41%). The prevalence was 42% (95% CI, 26%–60%) at 2 months, 43% (95% CI, 36%–50%) at 2–6 months, and 22% (95% CI, 15%–29%) at 6–12 months postpartum. Begg test showed no significant bias in data related to the prevalence of postpartum dyspareunia (p = 0.466). Conclusion The prevalence of postpartum dyspareunia was 35% and decreased with increasing postpartum duration. Given the high prevalence and its impact on a woman's quality of life, special attention should be paid to this common complaint during the postpartum period.

Background:One of the important reasons behind termination of breast-feeding in the first six months after childbirth is insufficient production of breast milk.Objectives:The aim of this study was to determine the effect of herbal tea containing fenugreek seed on the signs of breast milk sufficiency in Iranian girl infants aged 0 - 4 months, at the medical health centers of Tehran university of medical sciences.Patients and Methods:This study was a clinical trial with a control group. Seventy-eight girl infants, 0 - 4 months old that were exclusively breastfed by their mothers, were randomly assigned to the intervention group (received herbal tea containing 7.5 g fenugreek seed powder in addition to 3 g of black tea, three times a day) and the control group (received herbal tea containing 3 g of black tea powder, three times a day). Before and during the four weeks of study, the signs of breast milk sufficiency were evaluated through measurement of growth parameters and use of follow-up forms for measuring the number of wet diapers in one day, frequency of defecation and infant breast-feeding times in a day.Results:Before the intervention there was no significant difference between weight, height, head circumference, the number of wet diapers and frequency of defecation between the two groups (P > 0.05), yet the number of breast feeding times of the control group was more than the Fenugreek group. At the end of the fourth week in proportion to the pre-intervention conditions, the weight of the infants in the fenugreek group increased significantly from 5282.0513 ± 1021.51121 to 6383.0769 ± 952.06190, while head circumference increased from 38.3103 ± 1.62736 to 39.9256 ± 1.50660, number of wet diapers from 5.2821 ± 0.93044 to 8.1648 ± 1.20620, frequency of defecation from 1.8846 ± 1.08495 to 2.7326 ± 0.94771 and the number of breast feeding times from 9.1795 ± 1.39778 to 15.9597 ± 1.45056 (P < 0.001). However, there was no significant effect on height variation (P = 0.078). While in the control group there was no significant difference between the mentioned variables (P > 0.05).Conclusions:Herbal tea of fenugreek seed in comparison to the control group improves the signs of breast milk sufficiency.

Introduction: Primary dysmenorrhea is considered as one of the main problems in women. This review study aimed to characterize the effect of micronutrients on primary dysmenorrhea. Methods: In this systematic and meta‐analysis study, the articles were searched at Cochrane library, PubMed, Scopus, Web of Science databases. The searching process was conducted with the key terms related to dysmenorrhea and micronutrients. Risk of bias assessment was performed, using Rev Man 5.3 software. In view of the heterogeneity of some of the studies, they were analyzed, using a qualitative method (n=10), and only 6 studies were included in Meta analyze. STATA statistical software version 11 was used for the analysis. Results: In this study, finally 16 clinical trials were investigated. Most micronutrients studied in the relevant articles had anti-inflammatory and analgesic properties with a desirable effect on dysmenorrhea pain relief. Vitamins (K, D, B1, and E) and calcium, magnesium, zinc sulfate and boron contributed effectively to dysmenorrhea pain management. Two months after the intervention, there was a significant mean decrease in the pain score for the vitamin D intervention group (SMD: -1.02, 95% CI: -1.9 to – 0.14, P =0.024) , as well as in the vitamin E intervention group compared to placebo group (SMD: - 0.47,95% CI:-0.74 to – 0.2, P = 0.001). Conclusion: Despite the paucity of related research, the studies indicated the potential effects of micronutrients on reducing the pain severity in primary dysmenorrhea. But more studies are needed to confirm the safety and effectiveness of various types of micronutrients on primary dysmenorrhea.

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