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Introduction: Pelvic floor disorders are one of the most common morbidities in women, which have negative consequences on women's daily life. Since the total prevalence of this disorder among Iranian′s women has not been reported by appropriate tools, this study was conducted with aim to determine the prevalence of pelvic floor disorder and its risk factors. Methods: This cross-sectional study was conducted in 2021-2022 on 400 non-pregnant women of reproductive age referring to Tabriz health centers. Data related to pelvic floor disorders were collected through the Australian Pelvic Floor Questionnaire and the Sociodemographic and Obstetric Characteristics Questionnaire. Data were analyzed using SPSS software (version 26) and Chi-square test and multivariate logistic regression. P

Introduction: Prolonged labor stages can have serious consequences for both mother and infant. Positive effects and encouraging results of nipple stimulation on the duration of labor have been observed in some studies. This study was performed with aim to determine the effects of breast stimulation on the duration of labor (primary outcome) and Apgar score and method of delivery (secondary outcomes). Methods: This systematic review and meta-analysis was conducted according to the PRISMA guidelines. A search of published Persian and English texts without time restrictions up to July 2023 was performed in reputable databases including Scopus, Web of Science, Google Scholar, PubMed, and the SID Persian database with English keywords of Stimulation, Physical stimulation, Labor progress, Labor stage, Duration of labor, Breast, Nipple, and Labor, as well as their equivalent Persian keywords. Two authors independently assessed the quality of the articles using the Cochrane Risk of Bias tool and ROBINS-I tool, and the meta-analysis was conducted using RevMan software (version 5.3). Results: Out of 307 identified studies, 10 articles met the inclusion criteria. According to the subgroup analysis based on the control group, nipple stimulation compared to no intervention significantly reduced the duration of the first stage of labor (4 studies, mean difference: -2.66; 95% confidence interval: -1.70 to -3.61; p

Background & aim: Like becoming a mother, becoming a father is a new and important role that entails several responsibilities and expectations for men. This study aimed to investigate the relationship between psychological status and perceived social support in men during their wives’ pregnancy.Methods: This cross-sectional study investigated 372 Iranian men in the third trimester of their wives' pregnancy using multistage cluster sampling from May 2014 to February 2015 in Tabriz, Iran. The self-administered questionnaires used included demographic questionnaire, Personal Resource Questionnaire (PRQ-85-part2), and short form of depression, anxiety, and stress (DASS-21). The statistical tests including Spearman correlation, Mann-Whitney, Kruskal Wallis and linear regression model were used for data through SPSS v. 21.Results: Perceived social support was negatively correlated with anxiety (r=-0.390, P

Background & aim: Amniocentesis is the most common invasive method used for diagnosis of genetic disorders. Studies showed that women with insufficient information about amniocentesis have high level of anxiety. The present study was performed to evaluate the impact of education on perceived stress of women referring for amniocentesis.Methods: This quasi-experimental study was conducted on 62 pregnant women referring to Alzahra hospital, Tabriz, Iran for amniocentesis from March 2019 to January 2020. Using block randomization, the subjects were assigned to two groups of 31 women for each group. The intervention group received an oral and face-to-face individual training session. Perceived Stress Scale and Spielberger State-Trait Anxiety Inventory were completed before and 2 to 3 weeks after amniocentesis (before receiving results). ANCOVA and repeated measures ANOVA were used for data analysis.Results: The mean score of perceived stress before, after the intervention and 2 to 3 weeks after amniocentesis was 25.25±7.49, 23.87±7.40 and 24.45±7.09, respectively. The mean score of state anxiety were 43.84±10.03, 42.35±11.13 and 41.67±11.24, and trait anxiety were 42.53±10.56, 39.19±9.35 and 41.29±10.40, respectively. After the intervention, with adjusting the baseline scores, significant difference was found between two groups regarding stress (P=0.020), state anxiety (P=0.029) and trait anxiety (P=0.002), but 2 to 3 weeks after amniocentesis, no difference was observed in terms of perceived stress (P =0.198), state anxiety (P =0.394) and trait anxiety (P =0.516).Conclusion: Positive short-term effect of education was seen on perceived stress and anxiety of women referring for amniocentesis. It is recommended to perform more trials to assess its long-term effects.

Introduction: Vitamin D deficiency in women may play a role in the pathogenesis of infertility and menstrual dysfunction. Due to the high percentage of insufficient vitamin D serum levels in women of reproductive age, recently the role of vitamin D in reproductive physiology has also been considered. The present study was performed with aim to determine the relationship between vitamin D serum level and pregnancy success rate in a cycle of in vitro fertilization (IVF). Methods: In this prospective cohort study conducted in 2022, 116 reproductive-aged women diagnosed with both primary or secondary infertility in their first IVF cycle were studied. Based on the serum level of vitamin D in the blood sample measured by the Elisa method 7 days before embryo transfer, the participants were divided into two groups: deficiency or insufficient and sufficient and were evaluated at the gestational age of 7 weeks in terms of the presence of intrauterine gestational sac and the presence of heartbeat. Data collection tools included socio-demographic, infertility, and nutrition questionnaires, and checklists for recording test results and pregnancy outcomes. Data were analyzed by SPSS statistical software (version 24) and chi-square, independent t-test, and multivariate logistic regression. P

Background: A high-quality Ph.D. course requires frequent assessment and identification of deficiencies and limitations. The midwifery Ph.D. course started in 2016 in Iran and since no evaluation has been performed on this program, the present study aimed to evaluate the Iranian midwifery Ph.D. course based on the CIPP model.Method: This descriptive-evaluative research was conducted based on the CIPP model in 2021 in the schools of nursing and midwifery of Tabriz and Ahvaz Universities of medical sciences, Iran. The statistical population included the faculty members of the midwifery Ph.D. program (9 individuals) and midwifery Ph.D. graduates and students (21 individuals). The data collection tools comprised CIPP-based questionnaires exclusively for faculty members and students. Descriptive statistics were employed for data analysis.Results: Most students (81%) and faculty members (77.8%) reported an appropriate general evaluation of the midwifery Ph.D. curriculum. Most faculty members (77.8%) and students (90.8%) reported the indicators of the midwifery Ph.D. curriculum as appropriate in terms of context. More than three forth of faculty members (77.8%) and more than half of the students (57.1%) reported this curriculum as appropriate regarding input. This program was also reported to be appropriate according to 52.4% of students and 66.7% of faculty members in terms of process. Furthermore, a total of 66.7% of participants in both groups reported an appropriate status in terms of output.Conclusion: Midwifery Ph.D. curriculum was reported as an appropriate program. Also, students of this discipline requested greater stress on clinical upskilling for midwifery Ph.D.

Background & aim: The prevalence of anxiety and fear of childbirth (FOC) during pregnancy is high. This study aimed to measure the effect of group counseling with Beck′s cognitive therapy on anxiety and FOC in primiparous women.Methods: This randomized controlled trial was conducted on 68 primiparous women who referred to the health centers of Ardabil, Iran. The participants were randomly assigned to the counseling and control groups. The intervention group participated in six, 60-minute weekly sessions of cognitive group counseling. All women completed the Spielberger State-Trait Anxiety Inventory (STAI) before the intervention and during the active phase of labor. A questionnaire for the measurement of fear of childbirth (W-DEQ version A) was completed before the intervention, at the 36th week, and also two hours after delivery (W-DEQ version B). Mackey Childbirth Satisfaction Rating (MCSR) and childbirth experience questionnaire were completed 12 to 24 hours after delivery. Data were analyzed using Chi-square, independent t-test, ANCOVA, and repeated measures ANOVA.Results: There was no statistically significant difference between the two groups in terms of mean scores of state (P=0.842) and trait (P=0.859) anxiety during labor, FOC after the intervention (P=0.566), childbirth experience (P=0.400), and childbirth satisfaction (P=0.828). Also, there was no statistically significant difference in the frequency of vaginal delivery between the two groups (P=0.856).Conclusion: The findings of the present study showed that Beck′s group cognitive therapy was not effective in reduction of anxiety and FOC. Therefore, it is recommended to do more research in this regard in the future.

Background & aim: Exclusive breastfeeding for the first 6 months of life is recommended for all infants. Therefore, this study was performed to determine the predictors of exclusive breastfeeding in mothers.Methods: This cross-sectional study was conducted on 183 lactating mothers with infant aged 4 months referring to Tabriz health centers and health bases in July to October 2017. Sampling was done by a two-stage cluster random sampling method. Data were collected using the infant feeding checklist, the Iowa Infant Feeding Attitude Scale (IIFAS), and the Self-efficacy Scale. Independent t-test was used to determine the relationship between feeding attitude and breastfeeding self -efficacy. Logistic regression was used to determine the predictors of exclusive breastfeeding.Results: Mean of attitude toward breastfeeding was 55.13±5.5 (ranging 17 to 85). Mean of breastfeeding self-efficacy was 131.8±15.5 (ranging 33 to 165). From 183 mothers who participated in the study, 72.0% reported exclusive breastfeeding. The results showed a statistically significant correlation between exclusive breastfeeding with feeding attitude (P = 0.005) and breastfeeding self-efficacy (P = 0.004). According to the logistic regression model, there was a statistically significant relationship between neutral breastfeeding attitude with positive attitude toward formula feeding (OR=16.6; P

Background: Jaundice is one of the most common neonatal complications. Therefore, promptly diagnosing and treating it is vital. This study aimed to determine the effect of Fenofibrate and phototherapy compared to the phototherapy alone on total serum bilirubin (TSB) at 24 and 48 h (primary outcome) and side effects (secondary outcome). Methods: English (Cochrane Library, Web of Science, Medline, CINAHL, PsycINFO, PubMed, and Google Scholar) and Persian (SID and Magiran) databases were searched using verified keywords (MeSH library) without time constraint. The risk of bias was assessed using the Cochrane Handbook. RevMan software (version 5.3) was used for meta-analysis and the mean difference was calculated as effect size. In heterogeneous cases, the random effect was reported instead of the fixed one. Results: The total number of studies found in all databases was 5482. Six articles were included in the present study. The results of the meta-analysis showed no statistically significant difference in TSB levels within 24 (Mean difference: -5.56; 95% Confidence Interval (95% CI): 4.53 to -16.05; P = 0.27) and 48 h (-4.77; 2.57 to -12.10; P= 0.20) between Fenofibrate with phototherapy group and the phototherapy alone group. No side effects have been reported in included studies. Conclusion: Although the results of the five studies showed the significant effect of Fenofibrate as adjuvant therapy on reducing TSB level, the meta-analysis failed to show the same result in the study groups. It is recommended to perform more trials following all principles of randomized controlled trials to find an effective treatment for hyperbilirubinemia.

Introduction: Spontaneous abortion is one of the common complications of pregnancy that its etiology is unknown. Since vitamin D deficiency may be one of its causes, this systematic review was performed with aim to evaluate the relationship between vitamin D and abortion. Methods: In this systematic review and meta-analysis, the literature published from 1990 until the end of 2019 were searched in databases of PubMed, Embase, Cochrane Library, Scopus, Web of Science, SID, Magiran, IranMedex with the keywords of Vitamin D, 25-hydroxyvitamin, 25-Dihydroxyvitamin D3, Pregnancy loss, fetal loss, miscarriage and abortion and the equivalent Persian keywords. The quality of the papers was examined using Ottawa checklist, and STATA software was used for the meta-analysis. Results: Among 311 papers found in the first stage, finally 5 papers (5203 individuals) met the study criteria. In terms of methodological quality, all of the included articles were of average level. The findings of the studies included in the meta-analysis showed that there is a relationship between low levels of vitamin D and abortion (Effect size: 0.02; 95% Confidence Interval: -0.02 to 0.06). Conclusion: The results of the meta-analysis suggested a relationship between serum level of vitamin D and abortion; thus, it can be concluded that low levels of vitamin D are considered as a risk factor for abortion.

Background: Premature birth and subsequent admission to the neonatal intensive care unit (NICU) may impair the neurodevelopment of neonates. The present study aimed to determine the effect of developmental care on neurodevelopmental outcomes of newborns.Methods: This quasi-experimental study was conducted on 105 premature neonates (in three groups of 35 newborns). The control group received conventional care, and the intervention group 1 received developmental care beginning since admission to NICU stay. In addition, the intervention group 2 received developmental care since entering the delivery or operating room. The developmental outcomes were evaluated based on the Ages and Stages Questionnaire (ASQ) and Bayley-III Scales of Infant and Toddler Development. Moreover, magnetic resonance imaging was performed to evaluate the brain myelination at the adjusted age of 12 months.Results: The obtained findings showed that the frequency rates of communication and language impairment were significantly lower in the intervention group 2, compared to those reported for the control group and intervention group 1, based on the ASQ. The comparison of the scores of the Bayley subscales (i.e., cognition, language, and motor) showed that the frequency of language impairment was significantly higher in the control group, compared to those reported for the intervention group 1 (P=0.012) and intervention group 2 (P=0.024). No significant difference was observed in terms of the neonates’ brain myelination (P>0.05).Conclusion: The obtained results showed that developmental care, especially when initiated since birth, may improve some aspects of developmental outcomes in preterm newborns.

Background: Self-efficacy and infant-care behavior are the most important indicators of the successful transition of a woman into the maternal role. This study aimed to determine the effect of counseling with the skills training approach on maternal self-efficacy and infant-care behavior.Methods: The present randomized controlled trial was conducted on 68 women visiting health centers in 2019 in Tabriz, Iran. Participants were divided into intervention and control groups through block randomization based on the number of parities (one or two parities) and type of delivery (Cesarean section or normal vaginal delivery). The intervention group received 4 counseling sessions. The maternal self-efficacy and infant-care behavior questionnaires were completed before and two weeks after the intervention.Results: There was no significant difference between the groups in terms of socio-demographic characteristics (P>0.05). After the intervention, the mean±SD values of total maternal self-efficacy score were 35.6±5.7 and 30.9±1.9 in the intervention and control groups, respectively. Based on the ANCOVA test with baseline control, the mean was significantly higher in the intervention group than the control group (mean difference (MD): 2.9; 95% Confidence Interval (CI): 0.8-5.1; P=0.08). After the intervention, the mean±SD scores of infant-care behavior in the intervention and control groups were 78.9±3.8 and 76.2±3.6, respectively. Moreover, based on the ANCOVA test with baseline control, the mean value was significantly higher in the intervention group than the control group (MD: 2.8; 95% CI: 1.6-4.1; PConclusion: Counseling was effective in maternal self-efficacy and postpartum infant-care behavior. Therefore, it is recommended to use this method for the promotion of the health of mothers and their neonates.

Objective: Chronic constipation is frequently observed in postmenopausal women. An herbal combination including clover plants, Roman anis or Anisone, green anis or fennel, green raisins, Alhagi maurorum, violets, Terminalia chebula, senna and golqand has been introduced in traditional books as an effective laxative. Thus, the present study aimed to assess the effectiveness of the combined herbal capsule on chronic constipation in postmenopausal women. Materials and Methods: This triple blinded, randomized placebo-controlled trial was conducted on 64 postmenopausal women. Individuals were randomly assigned to combined the herbal capsule and placebo groups. The herbal capsule included cloves (4 units), Anise and Anison (6 units each), violet flowers (12 units), Terminalia Chebula and fresh green raisins (25 units each), senna leaves, Alhagi maurorum, and Golqand (50 units each). Constipation questionnaire and the individual’s assessment of constipation symptoms scale were used for data collection. Results: The mean frequency of bowel movements in the herbal capsule group was significantly higher than the placebo group (mean difference=4.2; 95% confidence interval: 0.3 to 4.5; p Conclusion: Consumption of herbal capsules improved chronic constipation in postmenopausal women.

Background: Neonatal jaundice is the most common cause of newborns' hospitalization. This study aimed to examine various maternal, childbirth, and neonatal factors affecting the neonatal skin bilirubin level and severe jaundice. Methods: This cross-sectional study was conducted on 1066 healthy neonates with a gestational age of 35 weeks or over and birth weight of ≥2000 g at teaching hospitals of Alzahra and Taleghani in Tabriz, Iran, during 2016-2017. The participants were selected using convenience sampling. Data were collected using a three-part researcher-made questionnaire assessing maternal, childbirth, and neonatal characteristics based on the medical histories of mothers and newborns as well as interviews with mothers. Neonatal jaundice was measured utilizing the Kj-8000 device on days 3-6 after birth by measuring the skin bilirubin level. Moreover, the need to phototherapy (severe jaundice) was determined based on the American Academy of Pediatrics guideline. The generalized linear model and multivariate logistic regression were employed for data analysis. Results: Out of the followed-up neonates, 94 (9.96%) cases developed severe jaundice and 850 (90.04%) newborns did not show any symptoms of this complication. The results of the adjusted generalized linear model showed that infant’s bilirubin level correlated significantly with a history of jaundice in previous children, infant’s age at first meconium excretion, frequency of feeding, gestational age, mother’s blood type, and a number of maternal ultrasound during pregnancy. Moreover, the results of adjusted logistic regression revealed an association between severe jaundice and variables, such as the place of residence, history of jaundice in previous children, feeding the infant with water or sugar water during breastfeeding intervals, frequency of feeding the infant, gestational age, mother’s blood type, time of discharge from the hospital, and number of pregnancies. Conclusion: Some factors related to neonatal jaundice were identified to raise the awareness of healthcare personnel for the early identification and treatment of neonatal jaundice in order to prevent its complications.

This study aimed to determine sleep quality and its socio-demographic predictors regarding three trimesters of pregnancy. This cross-sectional study was conducted on 605 pregnant women referred to health centers in Tabriz, Iran, using a two-stage cluster sampling method. Data were collected using socio-demographic characteristics questionnaire and the Pittsburgh Sleep Quality Index. The mean±SD of the total sleep quality scores were estimated at 5.22±2.52, 5.82±3.07, 8.60±3.03, and 6.56±3.24 in the first, second, and third trimester, and during the whole pregnancy, respectively. Moreover, the study results showed that 81 (40.1%), 105 (53.0%), 172 (83.9%), and 358 (59.2%) mothers experienced sleep disorder in the first, second, and third trimester, and during the whole pregnancy, respectively. According to the results of this study, sleep quality predictors may help health providers identify high-risk pregnant women in terms of sleep disorder to provide them with appropriate interventional programs.

Preparation for pregnancy and management of modifiable risk factors result in favorable pregnancy and childbirth outcomes. Regarding this, the present study aimed to determine preconception lifestyle status and its predictors among women contemplating pregnancy. This cross-sectional study was conducted on 201 women aged 18-35 years contemplating pregnancy for the coming year. The data were collected using sociodemographic characteristic form, preconception lifestyle questionnaire, preconception lifestyle awareness questionnaire, and perceived stress scale. Data analysis was performed using Pearson correlation, independent t-test, one-way ANOVA, and multivariate linear regression. The mean preconception lifestyle score was 2.7±0.3 (range: 1-4). According to the results, knowledge about preconception lifestyle, maternal age, receipt of routine preconception care, and marital satisfaction were the predictors of preconception lifestyle. Based on the findings, it is necessary that the health care providers take some measures to improve the preconception lifestyle in women contemplating pregnancy by considering its predictors.

Background & aim: To have successful pregnancy, it is necessary to focus on the mother’s quality of life during pregnancy. This study was conducted to determine the predictors of quality of life among Iranian pregnant women. Methods: This cross-sectional study was conducted on 565 pregnant women visiting health centers of Tabriz, Iran, 2015. The participants were selected using the cluster sampling method. Data were collected using socio-demographic and obstetrics characteristics questionnaire, Edinburgh Postnatal Depression Scale, and a specific questionnaire for quality of life in pregnancy. Data were analyzed by SPSS, version 16. General linear model was used to estimate the effects of the independent variables (depressive symptoms and socio-demographic and obstetrics characteristics) on the dependent variable (quality of life). Results: The mean of the total score of quality of life was 2.9±0.3 from the achievable score range of 0-4. There was a significant negative correlation between depressive symptoms and quality of life (r=-0.53, P

Introduction: Postpartum is a vulnerable period in terms of mental problems. Herbal medicine may be an effective intervention for improving the mothers’ mental health.This study was performed with aim to determine the effect of Lavender cream with or without footbath on anxiety, stress and depression. Methods: This randomized clinical controlled trial was conducted on 141 women aged 18-40 years with first to three pregnancies at 25-28 weeks of pregnancy in Tabriz-Iran during 2013-2014. The subjects were placed in three groups; receiving Lavender cream and footbath, Lavender cream, and placebo. Immediately after delivery, women applied locally 2 gr (two segments of hand finger) cream (Lavender or placebo) to the legs, 1.5 hours before sleep, for 6 weeks. The group of footbath immersed their legs in warm water. Depression, anxiety and stress were assessed at baseline and 6 weeks after delivery using DASS-21 (Depression, Anxiety, stress scales-21). Data were analyzed by SPSS software (version 14) and One-way ANOVA, Kruskal-Wallis and Mann-Whitney U tests. P0.05). Conclusion: Lavender cream with or without footbath can decrease stress, anxiety and depression of women at postpartum period.

Introduction: Childbirth causes increasing weight between 0.4 to 1.8 kg according woman's age. Changes in life as a result of pregnancy and childbirth result in shifting in mothers operations and some can't handle taking care of their infant even in third month and don’t start housework and social activities. According to the results of researches about activity subtraction of fat people, aim of this study is to consider weight retentionand its relation with mothers' functional state in 6 months after childbirth. Methods: This cross sectional research has been done 6 months after delivery on 307 in Ardabil, 2016. Weight retention was measured by minus weight in 10th-12th week of pregnancy and weight in 6 month after childbirth. Weighting process was done by a similar person in each time. Data gathering tools in this research were included socio demographic and functional status questionnaire. Results: three hundred seven women participated in this study from May to August 2016. The mean (SD) Body Mass Index was 25.58(4.47). The mean (SD) weight retention 6 months after delivery was 0.5(9.99) kg. Out of job subdomain of functional status, others, including household activities (p=0.05), social and community activities (p=0.042), infant care activities (p= 0.009) and self-care activities (p

Introduction: The general experience of women from childbirth process is an important outcome. The quality of these experiences affect the mother and her babies’ health and their relationship, sexual activity and desire to having next child in future. Hot shower and intravenous injection of hyoscine are utilized to promote childbirth experience and increased satisfaction of childbirth; however, their effects are not thoroughly investigated. This study was performed with aim to assess the effects of hot shower and intravenous injection of hyoscine on childbirth experience in nulliparous women. Methods: This randomized controlled clinical trial was conducted on 162 nulliparous women who were hospitalized in 29-Bahman hospital of Tabriz in 2015. The participants were assigned into 3 groups of 54 cases (intravenous hyoscine, hot shower, and control) by block randomization. In the intervention groups, hyoscine and hot shower were applied at dilatation of 4 cm and 7 cm. The control group received routine cares. Childbirth experience questionnaire was completed by the participants 12 to 24 hours after childbirth; the higher score showed better experience. Data were analyzed by SPSS software (version 20) and One-way ANOVA and Chi-square, Fisher-Exact, and Kruskal-Wallis tests. P0.05). Conclusion: Using of non-pharmacological method of hot shower can improve childbirth experience similar to hyoscine group; therefore, using of this non-pharmacological supportive method is recommended to the mothers.