JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2019 | Volume:7 | Issue:1|Papers Count:14

Background & aim: The prevalence of high-risk sexual behaviors among different social groups has been considered as a serious health-related threat in recent years. Given the importance of raising awareness and health among the youth and preventing high-risk behaviors, the present study was conducted to investigate the effect of a high-risk sexual behavior prevention program via mobile application on sexual knowledge and attitude in undergraduate female students. Methods: This quasi-experimental study was conducted among two groups of female students with a pretest-posttest design. A total number of 200 undergraduate eligible female students of Mashhad University of Medical Sciences, Mashhad, Iran were recruited in 2016. The subjects were randomly assigned to an intervention group receiving education through a mobile application (N=100) and a control group (N=100). To collect data a self-structured demographic questionnaire as well as sexual knowledge and attitude questionnaires were used. In the intervention group, the participants received a prevention program through a mobile application. Knowledge and attitude towards high-risk sexual behaviors were assessed and compared before and two weeks after the intervention. To analyze the data, paired t-test, independent t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Chi-square test were run in SPSS, version 16. Results: The mean scores of sexual knowledge and attitude after education increased compared to the pre-intervention stage (p<0. 05) in the intervention group. However, there was no significant difference in the control group in this respect (P>0. 05). Conclusion: The study results reflected the favorable effect of education via mobile application. The implementation of high-risk sexual behavior prevention programs using mobile applications could enhance sexual knowledge and attitude in students and promote community health.

Background & aim: Considering the epidemic of hookah smoking in young people, the main purpose of this study was to assess the adverse effects of hookah consumption in pregnant women and their fetus. Methods: This prospective cohort study was carried out in a a 13-month period in Isfahan, Iran, 2014. Data were collected using a questionnaire, interviewing, and examination. The study population consisted of 512 pregnant women, who were selected by convenience sampling method and assigned into two groups of smoker and non-smoker. The groups were matched considering the age, early pregnancy weight, parity, and family history of preeclampsia. Data analysis was performed using t-test and Chi-squared test in SPSS software, version 19. Results: According to the results, there was a direct relationship between preeclampsia, preterm labor, placental abruption, birth weight and APGAR score with hookah consumption during pregnancy. However, no significant correlation wa sseen between intrauterine fetal demise and hookah consumption during pregnancy (P<0. 05). Conclusion: Hookah smoking during pregnancy can make a significant difference in maternal and neonatal complications. Therefore, controlling hookah usage during pregnancy can reduce adverse pregnancy outcomes.

Background & aim: Male involvement is evidently an effective strategy for enhancing maternal health outcomes. Although childbirth has traditionally targeted women, the key roles of men in decision-making and financial support cannot be ignored. This study aimed to analyze women’ s perception of men in birth preparedness in Migori County, Kenya. Methods: This qualitative study was conducted on 32 pregnant women attending selected public health facilities in Migori County from January to March, 2016, using conventional content analysis. The study population was selected through purposive sampling technique. Data collection was performed by means of focus group discussions (FGD) organized in four high-volume health facilities. Discussions were recorded based on FGD guidelines. Subsequently, the recorded data were transcribed and reduced into themes. The thematic analysis of the results was reported in the form of narration. Results: The analysis of the data led to the identification of some important themes, including decision making for labor and delivery, financial support, birth companionship, house caretaking in the absence of women, and non-involvement of men in birth preparedness. Conclusion: Men play a key role in birth preparedness in terms of economic and emotional support. Although some cultures prohibit men from participating in the process of birth preparedness, there is a need to educate men in this regard. It is recommended to make more efforts to encourage men’ s participation through community education, which can effectively modify prohibitive cultural practices.

Background & aim: Dysmenorrhea also known as menstrual cramp or painful period is one of the most prevalent health issues among women. There are contradictory evidence regarding the impact of childbirth on the occurrence of dysmenorrhea. Also, only pain severity has been examined, as one of the clinical features of dysmenorrea in most related literature and the other characteristics of pain including duration, quality, location, as well as the associated symptoms have been overlooked. Therefore, the present study aimed to compare the patterns of primary dysmenorrhea before and after childbirth in primiparous women. Methods: In this cross-sectional study, 124 primiparous women with only one delivery were examined. The multistage sampling method was used to select the subjects who referred to the healthcare centers of Mashhad, Iran in 2010. The research tools included a demographic questionnaire, a form to record menstrual pattern, and verbal multidimensional scoring system for assessment of severity of dysmenorrhea. Data were analyzed by Wilcoxon signed-rank test and Cohen’ s kappa coefficient using SPSS. Results: The findings showed statistical significant differences in all pain characteristics before and three cycles after childbirth including pain severity (P1<0. 001, P2<0. 001, and P3<0. 001), duration (P1<0. 001, P2<0. 001, and P3<0. 001), quality (P1<0. 001, P2<0. 001, and P3<0. 001), location (P1<0. 001, P2<0. 001, and P3<0. 001), and associated symptoms (P1<0. 001, P2<0. 001, and P3<0. 001). Conclusion: According to the results of this study, childbirth could alter the pattern of primary dysmenorrhea including severity, duration, quality, and location, as well as associated symptoms. It seems that childbirth could be accepted as a factor influencing the pattern of primary dysmenorrhea.

Background & aim: Domestic violence is a socio-cultural problem. According to the literature, it has been concluded that various economic, educational, and professional issues have an impact on the severity of the violence against women. The question is whether religious tendencies can correlate with the severity and duration of violence. The present study aimed to investigate the relationship between religious attitudes and domestic violence against women. Methods: This cross-sectional study was conducted on a total of 210 women of reproductive age in Shiraz urban health centers during 2014 to 2015, who included in the study through multistage sampling. To collect data the Religious Attitude Scale developed by Khodayari-Fard as well as a self-structured questionnaire about the type and duration of violence were used in. The data were analyzed using chi-square test. Results: Based on the results of the present study it was revealed that 62. 9% (n=132), 35. 2% (n=74), and 1. 9% (n=4) of the participants had different levels of moderate, high, and low levels of religious attitudes, respectively. Also, 38. 1% (n=80) of the subjects underwent one of the different types of violence and 61. 9% (n=130) of them experienced no violence. A significant relationship was seen between religious attitudes with the type (P=0. 004) and duration of violence (P=0. 019). Conclusion: Religious attitude had a significant relationship with the type and duration of domestic violence against women. It is recommended that future studies be conducted regarding other cultural context and different religions.

Background & aim: Despite the global efforts to promote breastfeeding, women report some problems leading to stop breastfeeding in the early postpartum. Nipple soreness is considered as one of the main causes of early breastfeeding discontinuation. Treatment of this problem could keep breastfeeding for a prolonged period of time. Therefore, the present study aimed to investigate the effect of nipple pain treatment with lanolin and purslane cream on frequency and duration of breastfeeding. Methods: This double-blinded, randomized clinical trial was conducted on 86 breastfeeding women with nipple soreness who attended healthcare clinics in Mashhad, Iran, in 2016. The participants were randomly allocated to two equally sized group (43 in each), receiving purslane cream and lanolin for eight days. The correct method of breastfeeding and using the cream were trained to both groups. The nipple pain score was measured before intervention and on the third and eighth days post-intervention using a numeric pain rating scale. The subjects were also trained to record the duration and frequency of breastfeeding during the study period. Data were analyzed by SPSS version 22 using t-test, Fisher's exact test, Chi-square, and Wilcoxon tests. Results: Two study groups were identical in terms of the pain intensity before intervention. There was a significant difference concerning the pain intensity between the two groups on days 3 and 8. The pain intensity in the purslane cream group was significantly lower than the lanolin group (P<0. 001). The frequency of breastfeeding in the purslane group after the fourth day was significantly higher than the lanolin group (P=0. 017). However, there was no significant difference between the two groups regarding the duration of breastfeeding (P=0. 423). Conclusion: Improving nipple pain by purslane cream can promote the frequency of breastfeeding. As a result, it can be considered as an effective agent in treatment of nipple soreness in nursing mothers.

Background & aim: Demands for more children have substantial effects on couple’ s fertility behaviors. The ideal number of children for most Iranian’ s family is two, so that it is reasonable to study which factors determine women’ s decision to have a third child. The main aim of this study was to examine factors affecting the demand for a third child (DTC). Methods: This cross-sectional study was conducted on 6231 Iranian married women from all provinces during autumn 2014. Participants in the study were selected by multistage stratified sampling method. A structured questionnaire was employed to collect the related data. Finally, the analysis included 2272 DTC questionnaires for women with two children by applying a classification tree model. Results: In this study, 50. 7% of women with two children had no desire for having the third child, out of whom 71. 1% (79) were living in the provinces with total fertility rate (TFR) less than 2 and in urban areas, respectively. Most of them with the educational level of diploma or lower (78. 2%) had a negative opinion about having the third child (36. 1%). Based on the classification and regression tree algorithm, women who were interested in having their third child in provinces with TFR more than 2 included rural women, urban women with positive opinion toward childbearing, and those with educational level of secondary school. However, women who were keen on having their third child in provinces with TFR less than 2 consisted of urban women aged 30-49 with educational level of high school or lower, those younger than 30 years with positive opinion who married in their 20-29, rural women aged less than 30, and rural women aged 30-49 with positive opinion who married in their 20-39. Conclusion: Women’ s place of residence and opinion toward childbearing had important effects on their DTC. However, women’ s educational level as well as their age and marriage age could affect their DTC in provinces with TFR less than 2 compared to other provinces.

Background & aim: The severe reduced fertility rate and growing increase of older population in Iran have led to economic and social consequences in the country. Therefore, the purpose of this study was to investigate the fertility motivations and some of its related factors in women of reproductive age referring to urban health centers. Methods: This cross-sectional study was performed on 450 women. The population consisted of fertile women within the age range of 18-35 years referring to urban health centers of Sabzevar, Iran in 2016, who were selected by cluster sampling. Data collection tools included demographic and Miller’ s Childbearing Questionnaire. Data analysis was performed in SPSS (version 22) using descriptive statistics, Pearson correlation test, Spearman correlation test, the Kruskal Wallis, and regression test. Results: The means of positive and negative fertility motivation were 22. 64± 0. 33 and 17. 1± 3. 85, respectively. There was a significant negative correlation between positive fertility motivation with educational level (P=0. 01), as well as negative fertility motivation with income level (P=0. 001). Moreover, positive fertility motivation correlate positively with age (P=0. 01), number of pregnancies, childbirth and children (P=0. 001). There was a significant relationship among child gender, accommodation, and spouse occupation (P=0. 01). Conclusion: The results of this study showed that factors including age, educational level, number of pregnancies and children, income level, spouse occupation and accommodation can affect fertility motivation. It is suggested that population policies can increase fertility rate by enhancing fertility motivations.

Background & aim: The reduction of fertility rate in the recent years in Iran may be due to the cultural and socioeconomic development in this country. The present study was conducted to investigate the relationship of fertility rate with demographic, socioeconomic, and religious factors among childbearing women in a city in Easter Iran. Methods: This cross-sectional study was conducted on 254 childbearing women in Torbat Heydariyeh, Iran, in 2016. The data were collected using a demographic questionnaire and scale of religiosity developed by Khodayari Fard (2000). Mann-Whitney U test, Spearman correlation, and general linear model were used to assess the relationships between variables Results: The mean number of children among women was 1. 85± 0. 99. Fertility rate showed a direct relationship with age, age of spouse, and duration of marriage. There was an indirect relationship between age at marriage and fertility rate (P=0. 001). Also, fertility rate was significantly correlated with education (P=0. 001) and the mean total score of religiosity and its three dimensions (P<0. 05). Based on the general linear model, women’ s age, age of spouse, age at marriage, and level of education could predict 54% of the fertility rate variance (P<0. 05). Conclusion: According to the findings, fertility rate was significantly associated with couple’ s age, age at marriage, and educational level among the women of reproductive age in Torbat Heydariyeh. Therefore, policy makers should focus on the moderation of these variables to influence population growth.

Background & aim: Polycystic ovary syndrome (PCOS) is a metabolic disease with diverse etiologies. The prevalence of PCOS varies among different ethnicities and across various geographical and social settings. Scarce data exist on the prevalence of PCOS in Asia, especially in Malaysia. Regarding this, the present study was conducted to assess the prevalence of PCOS and its subtypes among the Malaysian University staff. Methods: This cross-sectional study was performed on females of reproductive age working at University Putra Malaysia, Selangor, Malaysia. The study population was selected through simple random sampling technique. The women with thyroid abnormalities or adrenal hyperplasia were excluded from the study. The participants were screened based on anthropometric measurements, medical history, blood pressure, and pelvic examination, as well as the presence of hirsutism, acne, and alopecia. The participants were also assessed for total and free testosterone levels and subjected to ultrasonography. The PCOS diagnosis was based on Rotterdam criteria. The data were analyzed using Mann-Whitney U test, t-test, Chi-square test, and logistic regression at the significance level of 0. 05. Results: A total of 675 females with the mean age of 26. 01± 7. 14 years participated in this study. The prevalence rate of PCOS was obtained as 12. 6%. All PCOS subjects were detected with hyperandrogenism and polycystic ovary, while anovulation was present in only one participant (1. 2%). Odds of PCOS diagnosis was significantly related to increased body mass index (OR=1. 14, 95% CI: 1. 05-1. 25), higher waist circumference (OR=1. 06, 95% CI: 1. 01-1. 11), hirsutism (OR=20. 83, 95% CI: 5. 35-81. 13), and amenorrhea (OR=0. 18, 95% CI: 0. 04-0. 69). Conclusion: This study revealed a high prevalence of PCOS and a specific phenotype of PCOS among the Malaysian employees.

Background & aim: Knowledge and attitude of healthcare providers have an important role in the success of fertility-related programs. In this regard, the present study was conducted to determine the knowledge and attitude of midwives and family healthcare providers working in community health centers of Mashhad, Iran, regarding childbearing in 2015. Methods: This cross-sectional study was conducted on 108 health staff working at 18 health and treatment centers and 23 community health centers in Mashhad. The study population was selected by multi-stage random sampling technique. The data were collected by means of the childbearing knowledge and attitude questionnaires. Data analysis was performed in SPSS software (version 16) using descriptive statistics, as well as simple and multivariate correlation tests. Results: The mean scores of knowledge and attitude toward childbearing were obtained as 12. 8± 1. 36 (out of 16) and 166. 4± 19. 9 (out of 235) i. e at good and moderate levels, among the healthcare providers, respectively. The healthcare providers' knowledge about childbearing showed a significant relationship with age (P=0. 001), duration of study (P=0. 00), duration of marriage (P=0. 00) and work experience (P=0. 001). Attitude toward childbearing was also significantly associated with all mentioned variables (P<0. 05 for all cases). However, there was no significant relationship between attitude toward childbearing and health providers’ knowledge. Conclusion: Midwifery and family healthcare providers play a critical role in the enhancement of clients' knowledge and improvement of their attitude about childbearing. As their efforts would finally result in favorable changes in the rate of childbearing in the community. Thus, it is suggested to implement educational programs to enhance knowledge and attitude of healthcare providers to be able to promote childbearing in the society.

Background & aim: Low levels of maternal haemoglobin and haematocrit in the first, second, and third trimesters are considered as possible risk factors regarding low birth weight (LBW) and preterm labour (PTL). The present study aimed to evaluate the relationship between maternal haemoglobin (Hb) and haematocrit (HCT) levels with LBW and PTL. Methods: This cross-sectional study was conducted on 383 pregnant women who were admitted in postnatal ward and gave birth to live neonates. Maternal Hb and HCT levels in the first, second, and third trimesters were obtained from medical records. The data were analysed using chi-square test by SPSS software (version 19). Results: A total of 383 pregnant women with the mean age of 25. 5 years were participated in this study. There was a significant relationship between maternal HCT in the first, second, and third trimesters with LBW (P<0. 01). Also a significant relationship was observed between maternal Hb in the first, second, and third trimesters with the LBW (P<0. 01). In addition, a significant relationship was reported between maternal HCT with the PTL (P<0. 01). There was a significant correlation between maternal Hb in the first, second, and third trimesters with the PTL (P=0. 01). Conclusion: Based on the findings of this study, it was suggested that maternal anaemia should be diagnosed and treated at any stage of pregnancy in order to reduce the risk of the LBW and PTL.

Background & aim: Child marriage, which defined as a formal marriage or informal union before the age of 18 years, occurs widely throughout the world. Child marriage directly impacts girls’ education, reproductive and sexual health, as well as psychological well-being. In this regard, the current review was conducted to examine the reproductive and sexual health consequences of child marriage. Methods: This review was conducted by searching the scientific databases including PubMed and Google Scholar as well as websites of various international organizations active in reproductive health issues between 1946 and 2018. Key words for searching included "Child marriage ", "early marriage ", "sexual health", "reproductive health", and "maternal mortality ". Published articles and also publications of International Planned Parenthood Federation (IPPF), United Nations International Children's Emergency Fund (UNICEF), World Health Organization (WHO) and Center for Reproductive Rights (CRR) were reviewed. Results: Child marriage as a result of poverty has many adverse consequences on reproductive and sexual health of girls. These include death during childbirth, physical and sexual violence, isolation, depression, cervical cancer and risk of sexually transmitted diseases (STD). Teen pregnant women are at high risk of preterm birth as well as neonatal death more than other women. Conclusion: Girls' marriage at an early age can increase the risk of sexual and reproductive complications. Therefore, training programs should be implemented to increase the awareness of society, parents, and religious leaders, to empower girls in this regard.

Background: Spontaneous bladder rupture is a rare condition, and almost all the reported cases in the world have been preceded by bladder dysfunction, radiotherapy, urinary tract obstruction, pelvic surgery, inflammation, and malignancy. Case report: In this study, we present the case of a 39-year-old woman (G: 4, P: 1, Ab: 2) who was in week 38 of pregnancy and attended our hospital with the onset of labor pain. She gave birth to a 3200 g infant through normal vaginal delivery. The patient attended with severe abdominal pain and oliguria four days after delivery. Ultrasonography showed massive abdominal fluid and bladder rupture. Conclusion: Regarding the rareness of bladder rupture during vaginal delivery, we introduced a case of bladder rupture following delivery. This case is important for midwives and gynecologists to gain more information about normal vaginal delivery complications to accelerate diagnostic and therapeutic interventions.