International Journal of Reproductive BioMedicine
Year:2017 | Volume:15 | Issue:3|Papers Count:8

Background: Infant low birth weight is one of the major problems in different societies. Different reports have provided different results regarding the relationship between maternal anemia and infant low birth weight in different months of pregnancy. Objective: The aim of this study was to determine the relationship between maternal anemia during pregnancy and infant low birth weight. Materials and Methods: This systematic review was conducted using related keywords in national (Sid, Iran. doc, Iran medex and Magiran) and international (PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar) databases. Relative risks and confidence intervals were extracted from each study. The results were combined using random-effects model for meta-analysis. The I2 index was also used to measure heterogeneity between the studies. Results: Overall, 17 studies with a total sample size of 245407 entered the final meta-analysis and demonstrated that the relative risk for maternal anemia in the first, second and third trimester of pregnancy were 1. 26 (95% CI: 1. 03-1. 55), 0. 97 (95% CI: 0. 57-1. 65), and 1. 21 (95% CI: 0. 84-1. 76), respectively. The relationship between maternal anemia and infant low birth weight in the first trimester of pregnancy was significant. Conclusion: Maternal anemia, especially during the first trimester of pregnancy, can be considered as a risk factor for pregnancy outcomes. Therefore, one needs to take the necessary steps to cure this disease in order to reduce the incidence of infant low birth weight.

Background: Fetal growth restriction (FGR) is a condition with heterogeneous pathophysiology which characterized by fetal weight less than the tenth percentile for gestational age. Several factors have impact on maternal, placental and fetal due to growth restriction. Objective: The aim of this study was to investigate the relationship between levels of leptin in the cord, and serum leptin of mothers also abnormal color Doppler indices of umbilical artery with fetal growth restriction. Materials and Methods: This is a cross sectional study conducted in Isfahan, Iran, 2015-2016. We recruited 40 women with singleton pregnancies complicated by fetal growth restriction (Group I) and 40 pregnant women with normal fetal growth (Group II) with matched age. Maternal serum and umbilical artery leptin levels were determined with Enzyme-Linked immunosorben method. Also, color Doppler ultrasound of umbilical artery was performed. Results: Mean maternal and fetal leptin levels were lower in the FGR group compared to the normal group (36. 58± (20. 99) and 7. 42 ± (4. 08)vs. 47. 32± (22. 50) and 30. 49± (14. 50) respectively). Also, mean fetal leptin level was lower in the group with abnormal color Doppler sonographic indices compared to the normal group (7. 40 ± (4. 10)vs 27. 06± (15. 80), respectively). Conclusion: This study indicated that maternal and fetal leptin levels are correlated with FGR originating from damaged placental function; also fetal leptin level can indicate changes in color Doppler sonographic indices.

Background: Testicular damage due to spermatic cord torsion may lead to infertility. It is probably because of changes in oxidative stress factors such as malondialdehyde. Objective: To investigate the protective effect of melatonin (MLT), as an antioxidant, on testicular damage induced by acute unilateral spermatic cord torsion and detorsion (T/D) in rats. Materials and Methods: In this experimental study, 48 adult male Wistar rats were randomly divided into three groups (8 rats/group): sham group underwent right scrotal surgery only., the T/D group underwent right testicular torsion (for 1 hr) and detorsion, and the melatonin group underwent right testicular torsion, received 25 μ g/kg melatonin intraperitoneally immediately after surgery of T/D. Then the histological parameters and malondialdehyde (MDA) changes were evaluated. Results: Torsion and detorsion decreased the diameter of the tubules significantly compared to controls (p=0. 003). Melatonin could increase the diameter, but it was not significant (p=0. 26). The heights of the epithelium were constant in sham, T/D, and melatonin groups without any significant difference between groups (p=0. 98). Based on Johnsen’ s score, spermatogenesis was normal in the sham group. The torsion significantly injured all lineage cells (p<0. 001). There was no any spermatid or sperm in the seminiferous tubules. Melatonin improved the spermatogenesis significantly (p=0. 02), but could not improve MDA level significantly (p=0. 99). Conclusion: Severe degenerative changes of testis were induced by acute unilateral spermatic cord torsion and detorsion in rats, but it had no effect on MDA level.

Background: Equity in distribution of resources is considered as an important priority in health care systems. Equitable distribution of obstetrics and gynecology (Ob/Gyn) services in the country level is critical in maternal and neonatal health for qualitative promotion of maternal care in pregnancy, delivery, and post-delivery periods. Objective: The present study aimed at determining regional disparity of obstetrics and gynecology services and its association with children and infants mortality rates. Materials and Methods: This was a descriptive-analytical study conducted in 2015 to investigate distribution of Ob/Gyn services using three indicators of number of nursing and midwifery personnel, total Ob/Gyn specialists, and total delivery beds among 30 provinces of the country. Equity criteria in the present study included population, normal vaginal deliveries, cesarean sections, and total deliveries. Data were gathered using a researcher-made form and Stata 12 was used to calculate Gini coefficient. The association of Ob/Gyn services with children and infant mortality rates was investigated using SPSS package and linear regression test. Results: The lowest Gini coefficient was observed in distribution of nursing and midwifery personnel in delivery wards in terms of vaginal delivery (0. 38 from 1) and the highest value was related to distribution of Ob/Gyn specialists in terms of vaginal delivery (0. 73 from 1). Infant mortality was significantly associated with number of nursing and midwifery personnel in delivery wards, and total number of Ob/Gyn specialists. Conclusion: Considering new population policies in Iran and increased fertility rate, it is recommended to facilitate accessibility of the required services for the women, particularly those of reproductive age.

Background: Elevated serum ferritin concentration is associated with insulin resistance and diabetes. Recently it has also been described in gestational diabetes mellitus (GDM). Objective: A prospective study was done to determine whether there was a relationship between serum ferritin concentration in early pregnancy and the risk of GDM. Materials and Methods: A study was performed on 1, 384 pregnant women with gestational age of 12-16 weeks. A blood sample was obtained for measurement of ferritin in the first trimester. Diagnosis of GDM was done by 75 gr oral glucose tolerance test between 24-28 wk. Results: Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (p=0. 01). A ferritin concentration of 45 ng/ml was calculated to be the 75th percentile for healthy pregnant women. Considering this level 32% in the GDM group and 25. 2%of normal subjects exhibited high ferritin levels (p=0. 01). The risk of GDM with these high levels of ferritin was 1. 4-fold higher than that for subjects with lower concentrations. The Odds Ratio was 1. 4 (95% CI= 1-1. 87) (p=0. 01). After adjusted for age Odds Ratio was 1. 38 (95% CI=1. 02-1. 86) (p=0. 03) and after adjustment for pre-pregnancy Body Mass index, the adjusted odds ratio was 1. 31 (CI= 0. 96-1. 79) (p=0. 08). After multivariable adjustment (age and body mass index), the adjusted odds ratio was 1. 3 (0. 95-1. 8) (p=0. 09). Conclusion: High serum ferritin can be regarded as a significant risk factor for the development of gestational diabetes.

Background: Methamphetamine (MA) was shown to have harmful effects on male reproductive system. Objective: To investigate probable effects of daily administration of MA on sperm parameters and chromatin/DNA integrity in mouse. Material and Methods: Thirty-five NMRI male mice were divided into five groups including low, medium, and high dosage groups which were injected intraperitoneally with 4, 8 and 15 mg/kg/day for 35 days, respectively. Normal saline was injected in sham group and no medications were used in control group. Then, the mice were killed and caudal epididymis of each animal was cut and placed in Ham’ s F10 medium for sperm retrieval. To evaluate sperm chromatin abnormalities, the aniline blue, toluidine blue and chromomycine A3 were used. For sperm DNA integrity and apoptosis, the acridine orange, sperm chromatin dispersion, and TUNEL assay were applied. For sperm morphology, Papanicolaou staining was done Results: Normal morphology and progressive motility of spermatozoa decreased in medium and high dosage groups in comparison with the control group (p=0. 035). There was a significant increase in rate of aniline blue, toluidine blue, and chromomycine A3 positive spermatozoa in high dosage group. In a similar manner, there was an increase in rates of acridine orange, TUNEL and sperm chromatin dispersion positive sperm cells in high dosage group with respect to others. Conclusion: MA abuse in a dose-dependent manner could have detrimental effects on male reproductive indices including sperm parameters and sperm chromatin/DNA integrity in mice.

Background: Preeclampsia (PE) is a serious complication of pregnancy with hallmarks of incomplete placentation, placental ischemia and endothelial dysfunction. Imbalance between vascular endothelial growth factor (VEGF), placenta growth factor (PlGF) and their receptors play important role in pathophysiology of PE. Objective: This study was aimed to asses PlGF mRNA expression in placenta of women affected with PE. Material and Methods: In this cross-sectional study, expression of PlGF mRNA was evaluated in 26 mild PE cases, 15 severe preeclamptic women and 20 normotensive controls. Patients were sub-classified as early onset PE (9) and late onset (32). After RNA extraction, PlGF expression was quantified with qRT-PCR. Results: The results of PlGF mRNA expression between mild-severe, and early-late onset PE patients showed no statistically significant difference compared with the control group (p=0. 661, p=0. 205 respectively). Conclusion: Despite we found no distinct differential expression of PlGF mRNA in placental tissue of PE patients compared with control women, but according to decreased level of this angiogenic factor in PE even before clinical onset of the disease, determining molecular mechanisms related to reduced secretion of PlGF into the maternal circulation may be useful for future therapeutics.

Background: Ambiguous genitalia is an uncommon situation that happens between 1 and 2 per every 1000 live births and falls under the umbrella diagnosis of disorders of sexual development. Case: In this article, we report a case of male pseudohermaphroditism with ambiguous genitalia. The proband was a 12 yr old girl without any uterus or ovarian tissues. Karyotype of the case is 46, XY. Genes involved in sexual differentiation such as AR, SRD5A2, LH, LHR, FSH, 17 B HSD and SRY genes were sequenced in both directions. No mutations were found in these genes either. Conclusion: It seems advisable to be cautious in similar cases, and revise protocol for tracing the genes involved in the patients.