JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2014 | Volume:2 | Issue:4|Papers Count:9

Background & aim: Postpartum period is accompanied by significant changes in women’s quality of life. These alterations can affect the health of mothers and children. Considering the importance of postnatal quality of life and its different contributing factors, this study aimed to compare women’s quality of life after vaginal delivery and cesarean section.Methods: This retrospective cohort study included a random sample of 2100 women, referring to Hamadan health care centers for congenital hypothyroidism screening or infant vaccination. The participants’ quality of life was examined, using Short Form-36 (SF-36) questionnaire, evaluating five periods of time including one week, two months, four months, six months, and one year after delivery (either vaginal or cesarean delivery). Data were analyzed using t-test.Results: Quality of life was significantly higher in women with vaginal delivery, compared to women with cesarean section in all periods including one week (68.77 vs. 42.44), two months (69.11 vs. 54.76), four months (78.19 vs. 53.02), six months (75.62 vs. 54.94),and one year(78.43 vs. 53.77) after delivery.Conclusion: Considering women’s higher quality of life after vaginal delivery, compared to cesarean section, it seems that vaginal delivery is a safer and less expensive option, which is recommended for all pregnant women.

 Background & aim: Physical fitness is essential for maintaining optimal health and can be achieved and improved by doing physical activities. Maximal oxygen consumption (VO2 max) has been used as a measure of physical fitness. This study aimed to determine the effect of jogging program on midwives' physical fitness.Methods: In this randomized controlled trial two large healthcare centers in Mashhad were randomly selected and each center assigned to either intervention or control group. 60 employed midwives, working at these centers, were selected via convenience sampling. The intervention group performed aerobic exercises at 30-60% VO2 max during 24 sessions. At the beginning and end of the study, participants’ physical fitness was measured by calculating VO2 max, using Bruce test. Independent t-test, paired t-test, Mann-Whitney U, Wilcoxon, and Chi-square tests were carried out using SPSS version 19 to analyse data.Results: The two groups showed no significant difference in terms of age, marital status, level of education, economic status and body mass index (P>0.05). Mean VO2 max in the intervention group (30.6±9.1) was significantly higher than that of the control group (24.3±7.3) (P=0.023). Participants' physical fitness was increased up to 30% by jogging.Conclusion: As the results indicated, jogging could improve midwives’ physical fitness. Therefore, it is essential that health system directors pay more attention to providing facilities at every workplace in order to improve employees’ physical fitness.

Background & aim: Warm water immersion during labor is associated with relaxation and pain reduction for pregnant women. This method is not extensively used in Iran, given the fear of infection and other maternal/neonatal complications. Alternative methods are required to increase the safety of normal vaginal delivery. The purpose of this study was to compare maternal and neonatal outcomes, associated with water birth and normal vaginal delivery.Methods: This analytical, cross-sectional study was performed on 43 water birth cases (study group) and 62 subjects with normal vaginal delivery (control group). Random sampling and consensus were applied for normal vaginal delivery and water birth groups, respectively. Data were collected in a data collection form, using hospital records and interviews with mothers. For data analysis, descriptive and analytical tests including t-test and Chi-square were carried out, using SPSS version 15.Results: No significant difference was observed between the two groups in terms of labor and delivery complications; although three cases of complications during the second stage of labor and four cases of hospitalizations at birth were reported in the control group. The two groups were not significantly different in terms of hospitalization for the reason of neonatal period complications. Regarding maternal complications, there was a significant difference in the rate of episiotomy between the two groups (P=0.032). Postpartum hemorrhage was mostly observed in the control group, although the difference was not significant.Conclusion: In this study, no significant difference was observed in terms of maternal or neonatal complications between the two groups. Therefore, it seems that water birth is a safe method, associated with improved pregnancy outcomes.

Background & aim: This study aimed to determine the relationship between lipid and apolipoprotein B-100 (apo B-100) levels in maternal and umbilical cord sera as well as the effects of these components on anthropometric measurements of newborn infants.Methods: This correlational study was performed on 85 appropriate for gestational age (AGA) newborns and their mothers. For analysis, 5 ml of maternal blood and 5 ml of umbilical venous cord blood were obtained during labor and immediately after delivery, respectively. Sera were separated by centrifugation and analyzed on the same day for estimation of lipid profile including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B-100. Also, anthropometric indices of newborn infants were measured and recorded. Pearson’s correlation coefficient was used to determine the relationship between variables.Results: There was a positive correlation between maternal and neonatal serum TC levels (r=0.23, P=0.042). Maternal LDL-C level was positively correlated with neonatal HDL-C (r=0.24, P=0.035), TC (r=0.29, P=0.01), and apolipoprotein B-100 levels (r=0.25, P=0.031). A significant positive correlation was observed between maternal apolipoprotein B-100 level and neonatal TC (r=0.26, P=0.019), HDL-C (r=0.23, P=0.043), and apolipoprotein B-100 levels (r=0.24, P=0.038). Maternal TG level was positively correlated with neonatal crown-heel length (r=0.27, P=0.018) and birth weight (r=0.23, P=0.039). However, maternal HDL-C level was negatively correlated with neonatal birth weight (r=-0.29, P=0.01) and chest circumference (r=-0.27, P=0.019). A significant negative correlation was found between cord blood TG level and newborn’s head circumference (r=- 0.23 P=0.046).Conclusion: Maternal lipid profile can affect neonatal lipid level and anthropometric measurements.

Background&aim: According to the previous studies, anxiety along with some other psychiatric disorders is common among mothers of children with attention deficit hyperactivity disorder (ADHD). Since maternal anxiety affects mother-child interactions, early treatment plays an important role in the prognosis of ADHD in children. This study aimed to determine the relationship between maternal anxiety and hyperactivity in children.Methods: This study was conducted on 112 mothers of ADHD children (aged 6-12 years), selected via convenience sampling from October to December 2012. The subjects lived in districts 2 and 6 of Tehran and were referred to consultation centers. Depression Anxiety Stress Scale 42 (DASS-42) and Swanson, Nolan and Pelham (SNAP-IV) questionnaires were completed by the subjects. Pearson’s correlation coefficient was used for the analysis of the relationship between variables.Results: A positive correlation was found between maternal anxiety and children’s hyperactivity (P=0.05). In fact, high levels of maternal anxiety are accounted for various child-rearing problems such as children’s hyperactivity.Conclusion: High levels of maternal anxiety lead to child rearing problems, which in turn cause various disorders such as hyperactivity in children.

Background & aim: Considering the lack of information regarding the effects of religion on young couples’ fertility preferences, this study aimed to evaluate the relationship between religious beliefs and fertility preferences among engaged couples in Mashhad, Iran, in 2013.Methods: This cross-sectional study was conducted on 450 engaged couples, referring to premarital counseling clinics at healthcare centers of Mashhad. Convenience sampling was applied and data were collected using Miller’s Fertility Preferences and Childbearing Questionnaires (1995), Khodayari's Religious Attitude Questionnaire, and a demographic questionnaire; all four questionnaires were completed by the participants. Spearman's correlation, Chisquare test, Mann-Whitney, and Kruskal-Wallis tests were used for data analysis. The significance level was considered to be 0.05.Results: Scores of religious beliefs were low, moderate, and high among 5.7%, 62.1%, and 32.2% of the couples, respectively. Childbearing desires (P£0.001), ideal number of children (P£0.001), and birth interval (P£0.001) showed significant differences in groups with low, moderate, and high scores of religious beliefs. The mean number of children desired by the groups with low, moderate, and high religious belief scores was 2.24±1.49, 2.21±0.87, and 2.69±1.37, respectively. In total, 42.2% of the participants were moderately affected by religious beliefs.Conclusion: Fertility motivations and the ideal number of children were higher among individuals with stronger religious beliefs; however, even among these religious people, fertility preferences were not favorable, compared to figures recommended by reproductive health policymakers. These findings can contribute to the improvement of reproductive indices and fertility reforms towards higher fertility rate in the country.

Background&aim: Knowledge and attitude of the nurses and midwives towards HIV/AIDS patients could affect the quality of care provision. Thus, this study aimed to determine the relationship between knowledge, attitude, and tendency of nurses and midwives towards caring for HIV/AIDS patients.Methods: This cross-sectional study was conducted on 303 nurses and midwives at healthcare centers, affiliated to Isfahan University of Medical Sciences, using stratified sampling in 2013. All participants completed a four-section questionnaire including demographic data, knowledge about HIV/AIDS, attitude towards HIV/AIDS, and tendency to care for HIV/AIDS patients. For data analysis, Pearson’s correlation coefficient, t-test, and one-way ANOVA were performed, using SPSS version 16.Results: As to the findings, 57% of the participants had insufficient knowledge, 98% had negative attitudes, and 86% had a moderate tendency to care for HIV/AIDS patients. A negative correlation was seen between HIV knowledge and attitude towards HIV patients (P=0.042, r=-0.58). Also a significant relationship was observed between attitudes towards HIV/AIDS and tendency to provide care for these patients (P=0.011, r=0.78).Conclusion: As the knowledge, attitude, and tendency to care for HIV/AIDS patients were not desirable among nurses and midwives, it is recommended that comprehensive courses be organized in order to change caregivers’ knowledge, attitudes, and tendencies towards care provision for HIV/AIDS patients.

Background & aim: Menopause is one of the most critical stages in a woman’s life. Special attention needs to be paid to the quality of life of menopausal women. Symptoms of genitourinary atrophy can affect women’s comfort and quality of life. The aim of this study was to compare two treatment methods of vitamin E suppository and conjugated estrogens vaginal cream on the quality of life of menopausal women with vaginal atrophy.Methods: This clinical trial was performed on 52 menopausal women (40-65 years old), referring to the gynecology clinic of Ghaem Hospital, Mashhad, Iran in 2013. Women were randomly assigned to two groups to use either conjugated estrogens vaginal cream or vitamin E suppository for 12 weeks. Women’s quality of life was measured in both groups before the study and 4, 8 and 12 weeks after the interventions. Data collection tools included a demographic questionnaire and Menopause-Specific Quality of Life (MENQOL) questionnaire. Fisher’s exact test, repeated measures ANOVA, Mann-Whitney and t-test were performed to analyze data, using SPSS version 11.5.Results: The mean scores of quality of life before intervention and after 4, 8 and 12 weeks of therapy were 70.03±26.34, 53.96±23.75, 43.03±20.62 and 33±18.26 in vitamin E suppository group, respectively. These values in the estrogen cream group were 64±27.83, 50.76±21.51, 37.23±20.96 and 29.53±18.65, respectively. Comparison of quality of life scores between the two groups did not show a statistically significant difference (P>0.05).Conclusion: The two groups were not significantly different in terms of the effectiveness of two methods of therapy. Therefore, it seems that vitamin E suppository could be used as an effective method for the improvement of quality of life in patients with vaginal atrophy.