Iranian
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Aida Hosseini, Zahedeh Khoshnazar, Mehran Rostami, Fatemeh Ramezani, Akram Sadat Nekuee, Ali Khaledian, Parisa Hosseini Koukamri,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: One topic that has changed globally is fertility, which is influenced by factors such as the fear of childbirth, leading to the delay or avoidance of pregnancy. The global prevalence of fear of childbirth (FOC) has been reported to be 14%. The present study was designed and conducted to validate a questionnaire assessing fear of childbirth.
Methods and Materials: Psychometric properties of the Persian version of the FOC questionnaire were assessed through six stages: translation, evaluation of content validity, assessment of face validity, examination of construct validity, analysis of discriminant validity, and determination of reliability. A panel of experts (n = 10) and pregnant women (n = 10) evaluated the questionnaire items for content and face validity, respectively. The questionnaire consisted of nine elements, including fears such as the fear of losing sexual pleasure/attractiveness, fear of pain during natural childbirth, fear of embarrassment, fear of harming the baby, fear of cesarean section, fear of maternal or infant death, fear of inadequate pain relief, and fear of bodily harm, totaling 40 questions. A cross-sectional study employing a random sampling method was conducted with 300 pregnant women to establish construct validity. Internal consistency was assessed using Cronbach’s alpha and the McDonald's omega coefficients.
Results: The average age of the women in the study was 35.39 years. The content validity ratio, content validity index, and impact score for FOC were 0.98, 0.98, and 3.54, respectively, indicating strong content and face validity. Exploratory factor analysis was conducted on the 40 items to assess construct validity, revealing that nine factors accounted for 76.18% of the cumulative variance. The fit indices (CFI = 0.97, TLI = 0.95, χ2/df = 4.20, RMSEA = 0.04) supported the model's validity in confirmatory factor analysis. The average variance extracted values exceeding 0.5 indicate good convergent validity of the factors. Internal consistency was evaluated using Cronbach’s alpha and McDonald’s omega coefficients, which yielded values of 0.90 and 0.92, respectively.
Conclusion and Discussion: Addressing the FOC as a public health concern necessitates targeted education. Therefore, it is essential to recognize these fears by utilizing a standardized tool to develop effective support strategies and suitable interventions to achieve this. This questionnaire serves as a novel instrument for evaluating the complex fear of childbirth. Its reliability and validity have been confirmed among Iranian women in the community, making it a valuable resource for identifying the concerns of pregnant women and formulating educational interventions tailored to these specific fears.
Methods and Materials: Psychometric properties of the Persian version of the FOC questionnaire were assessed through six stages: translation, evaluation of content validity, assessment of face validity, examination of construct validity, analysis of discriminant validity, and determination of reliability. A panel of experts (n = 10) and pregnant women (n = 10) evaluated the questionnaire items for content and face validity, respectively. The questionnaire consisted of nine elements, including fears such as the fear of losing sexual pleasure/attractiveness, fear of pain during natural childbirth, fear of embarrassment, fear of harming the baby, fear of cesarean section, fear of maternal or infant death, fear of inadequate pain relief, and fear of bodily harm, totaling 40 questions. A cross-sectional study employing a random sampling method was conducted with 300 pregnant women to establish construct validity. Internal consistency was assessed using Cronbach’s alpha and the McDonald's omega coefficients.
Results: The average age of the women in the study was 35.39 years. The content validity ratio, content validity index, and impact score for FOC were 0.98, 0.98, and 3.54, respectively, indicating strong content and face validity. Exploratory factor analysis was conducted on the 40 items to assess construct validity, revealing that nine factors accounted for 76.18% of the cumulative variance. The fit indices (CFI = 0.97, TLI = 0.95, χ2/df = 4.20, RMSEA = 0.04) supported the model's validity in confirmatory factor analysis. The average variance extracted values exceeding 0.5 indicate good convergent validity of the factors. Internal consistency was evaluated using Cronbach’s alpha and McDonald’s omega coefficients, which yielded values of 0.90 and 0.92, respectively.
Conclusion and Discussion: Addressing the FOC as a public health concern necessitates targeted education. Therefore, it is essential to recognize these fears by utilizing a standardized tool to develop effective support strategies and suitable interventions to achieve this. This questionnaire serves as a novel instrument for evaluating the complex fear of childbirth. Its reliability and validity have been confirmed among Iranian women in the community, making it a valuable resource for identifying the concerns of pregnant women and formulating educational interventions tailored to these specific fears.
Mehran Rostami Varnosfaderani, Zahedeh Khoshnazar, Ilia Ghotb Tahriri, Zohreh Khavari, Sayna Azimiyan, Fatemeh Ebrahimipoor, Fatemeh Amirmohseni, Parisa Hosseini Koukamari,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: One of the critical global health challenges is cervical cancer. In 2020, cervical cancer ranked fourth among the most commonly diagnosed cancers in women. Standard approaches for early detection include screening women through Pap smear and human papillomavirus testing. Regular participation in screening programs is crucial, as early detection of cervical cancer through Pap smear can significantly reduce the complications and mortality associated with the disease. Approximately 50-90% of women who have developed cervical cancer or died from the disease have never been screened. Therefore, the present study aimed to identify barriers and facilitators to cervical cancer screening in the context of women's self-care.
Methods and Materials: This cross-sectional study was conducted in the spring of 2023 among 200 women attending comprehensive health centers in Saveh City. Random sampling was conducted from the health system's file and the households of the attendees. The data collection tool was a questionnaire on the determinants of cervical cancer screening based on the theoretical domains framework, consisting of dimensions such as awareness, perceived threat, priority, memory, skills, resources, feelings, perceived behavioral control, social influences, beliefs about consequences, intention, and behavioral regulation. In the original study, the questionnaire demonstrated high reliability with a Cronbach's alpha of 0.80 across all twelve dimensions. In the present study, the formal and content validity and instrument reliability were assessed, and they displayed suitable psychometric properties. The data analysis was performed using SPSS 21.
Results: The average age of participants in the study was 35 years. Among the participants, 44% reported irregular Pap smear testing, and 17.4% had never undergone the test. Also, 60% of women did not have regular gynecological examinations, with 21% citing the absence of symptoms as the reason for not seeking medical attention. The average scores of the theoretical domains framework ranged from 67.8 to 45.12. The highest averages were related to priority, memory and reminders, context, and resources. According to the logistic regression analysis, all twelve domains of the theoretical domains framework influenced the likelihood of undergoing Pap smear testing. The model was able to predict 66% of Pap smear testing behavior.
Conclusion and Discussion: The present study measured the predictors of participation in cervical cancer screening programs among women in Saveh City based on the theoretical domain framework. The theoretical domain framework is crucial for supporting the design of interventions to change behavior. It is a comprehensive framework that combines domains from 33 different behavior theories and 128 theoretical constructs. Therefore, evaluating all potential behavioral predictors increases the likelihood of effectively designing interventions to promote behavior change. By using the theoretical domains framework, this study was able to identify the key determinants
Methods and Materials: This cross-sectional study was conducted in the spring of 2023 among 200 women attending comprehensive health centers in Saveh City. Random sampling was conducted from the health system's file and the households of the attendees. The data collection tool was a questionnaire on the determinants of cervical cancer screening based on the theoretical domains framework, consisting of dimensions such as awareness, perceived threat, priority, memory, skills, resources, feelings, perceived behavioral control, social influences, beliefs about consequences, intention, and behavioral regulation. In the original study, the questionnaire demonstrated high reliability with a Cronbach's alpha of 0.80 across all twelve dimensions. In the present study, the formal and content validity and instrument reliability were assessed, and they displayed suitable psychometric properties. The data analysis was performed using SPSS 21.
Results: The average age of participants in the study was 35 years. Among the participants, 44% reported irregular Pap smear testing, and 17.4% had never undergone the test. Also, 60% of women did not have regular gynecological examinations, with 21% citing the absence of symptoms as the reason for not seeking medical attention. The average scores of the theoretical domains framework ranged from 67.8 to 45.12. The highest averages were related to priority, memory and reminders, context, and resources. According to the logistic regression analysis, all twelve domains of the theoretical domains framework influenced the likelihood of undergoing Pap smear testing. The model was able to predict 66% of Pap smear testing behavior.
Conclusion and Discussion: The present study measured the predictors of participation in cervical cancer screening programs among women in Saveh City based on the theoretical domain framework. The theoretical domain framework is crucial for supporting the design of interventions to change behavior. It is a comprehensive framework that combines domains from 33 different behavior theories and 128 theoretical constructs. Therefore, evaluating all potential behavioral predictors increases the likelihood of effectively designing interventions to promote behavior change. By using the theoretical domains framework, this study was able to identify the key determinants
Zeinab Azizian, Saba Hesami, Seyed Ali Razavi Nasab, Adele Khodabakhshi, Vahideh Aghamohammadi, Arash Rafeei Nia, Hadi Bazyar,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Breast cancer (BC) is the most common cancer and the leading cause of death in women worldwide. Among the identified risk factors, the crucial role of diet as a potential environmental factor in the incidence of BC is significant. This study was conducted to determine the relationship between the dietary acid load (DAL) index with pathobiological markers (tumor size, Ki-67 marker, histological grade, and tumor stage) and the odds of BC in Iranian women.
Methods and Materials: In this case-control study, 155 women with BC and 155 cancer-free women (18-70 years old) were recruited from Kerman City, Iran, using a convenience sampling method. DAL score was calculated based on dietary data obtained from a 168-item food frequency questionnaire. DAL included two profiles: potential renal acid load (PRAL) and net endogenous acid production (NEAP). PRAL was measured based on the dietary intake of five nutrients, including protein, potassium, phosphorus, magnesium, and calcium. NEAP was estimated based on the ratio of dietary protein to potassium. Linear regression with adjustment for confounding factors was used to determine the relationship between DAL with tumor size and the Ki-67 marker. Logistic regression, adjusted for confounding factors, was employed to investigate the odds ratio (OR) of BC according to DAL quartiles compared to the reference (OR = 1), with 95% confidence intervals (CI). The Spearman test measured the correlation between the index quartile with histological grade and tumor stage.
Results: A significant positive relationship was observed between the NEAP and PRAL with tumor stage (coefficient = 0.27; p = 0.001 and coefficient = 0.17; p = 0.02, respectively). However, there was no significant relationship between the NEAP and PRAL indices with histological grade (p ≥ 0.05). In the crude and adjusted models, no significant correlation was found between the NEAP and PRAL indices with the tumor size and Ki-67 marker (p ≥ 0.05). Also, in the crude model and the adjusted models, no significant relationship was observed between the quartiles of the NEAP and PRAL indices with the odds of BC.
Conclusion and Discussion: In this study, there was no relationship between the DAL indices (NEAP and PRAL) and the OR of BC. Future studies with prospective designs are necessary for a more detailed examination of the proposed hypothesis.
Methods and Materials: In this case-control study, 155 women with BC and 155 cancer-free women (18-70 years old) were recruited from Kerman City, Iran, using a convenience sampling method. DAL score was calculated based on dietary data obtained from a 168-item food frequency questionnaire. DAL included two profiles: potential renal acid load (PRAL) and net endogenous acid production (NEAP). PRAL was measured based on the dietary intake of five nutrients, including protein, potassium, phosphorus, magnesium, and calcium. NEAP was estimated based on the ratio of dietary protein to potassium. Linear regression with adjustment for confounding factors was used to determine the relationship between DAL with tumor size and the Ki-67 marker. Logistic regression, adjusted for confounding factors, was employed to investigate the odds ratio (OR) of BC according to DAL quartiles compared to the reference (OR = 1), with 95% confidence intervals (CI). The Spearman test measured the correlation between the index quartile with histological grade and tumor stage.
Results: A significant positive relationship was observed between the NEAP and PRAL with tumor stage (coefficient = 0.27; p = 0.001 and coefficient = 0.17; p = 0.02, respectively). However, there was no significant relationship between the NEAP and PRAL indices with histological grade (p ≥ 0.05). In the crude and adjusted models, no significant correlation was found between the NEAP and PRAL indices with the tumor size and Ki-67 marker (p ≥ 0.05). Also, in the crude model and the adjusted models, no significant relationship was observed between the quartiles of the NEAP and PRAL indices with the odds of BC.
Conclusion and Discussion: In this study, there was no relationship between the DAL indices (NEAP and PRAL) and the OR of BC. Future studies with prospective designs are necessary for a more detailed examination of the proposed hypothesis.
Fateme Shoghi, Razieh Pirouzeh, Marzieh Mahmoudimanesh, Nasim , Pirzadeh, Fateme Eidi,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: The increasing participation of both women and men in the workforce has presented a new challenge: establishing a balance between family and work roles and responsibilities. This challenge often manifests as work-family conflict, which can have detrimental effects on family life and workplace productivity. Overall, such conflict endangers the quality of life of employees. Women, in particular, are more susceptible to work-family conflict due to their multiple roles within the family. Additionally, women are more prone to experiencing depression. Given the significance of women’s roles in both family and society, as well as the impact of cultural and organizational differences on work-family conflict, this research was designed to investigate the relationship between work-family conflict and depression among women health workers in Esfarayen City.
Methods and Materials: This descriptive-analytical study was conducted cross-sectionally on women health workers in Esfarayen City in North Khorasan Province in 2024. Using a random sampling method, the study included 251 individuals. The study data were collected using Netmir's Work-Family Conflict Questionnaire and the Beck Depression Inventory. Information was entered into SPSS24 software, and descriptive and analytical tests were used to analyze the data according to its normality or non-normality.
Results: Results showed a direct (r(251) = 0.308) and significant (p = 0.001) relationship between work-family conflict and depression, as well as between work-family conflict and history of depression (t(251) = 2.28; p = 0.02), job satisfaction (t(251) = -4.31; p = 0.001), shift work (t(251) = 5.23; p = 0.001 ), and wife's work shift (t(251) = 2.26; p = 0.02). Also, there was a significant difference between work-family conflict with the place of employment (F(251) = 8.18; p = 0.001) and education (F(251) = 6.61; p = 0.002). There was also an association between depression and a history of depression (Z(251) = -3.29; p = 0.001), specific drug use (Z(251) = -2.62; p = 0.009), job satisfaction (Z(251) = -2.90; p = 0.004), work shift (Z(251) = -2.62; p = 0.009), which was statistically significant. The correlation between depression and place of employment (p = 0.01) and income (p ≤ 0.05) was found to be significant.
Conclusion and Discussion: According to the findings of this study, women with a history of depression who are dissatisfied with their jobs, work shift hours, have husbands who also work shifts, are employed in the field of therapy, and possess a bachelor's degree are more vulnerable to work-family conflict. Conversely, women experiencing work-family conflict, who have a history of depression, use certain medications, are dissatisfied with their jobs, and work shifts, and are employed in the treatment field are at a higher risk of developing depression. Therefore, it is suggested that more attention be given to these women in screening programs, population policies, and employee health interventions.
Methods and Materials: This descriptive-analytical study was conducted cross-sectionally on women health workers in Esfarayen City in North Khorasan Province in 2024. Using a random sampling method, the study included 251 individuals. The study data were collected using Netmir's Work-Family Conflict Questionnaire and the Beck Depression Inventory. Information was entered into SPSS24 software, and descriptive and analytical tests were used to analyze the data according to its normality or non-normality.
Results: Results showed a direct (r(251) = 0.308) and significant (p = 0.001) relationship between work-family conflict and depression, as well as between work-family conflict and history of depression (t(251) = 2.28; p = 0.02), job satisfaction (t(251) = -4.31; p = 0.001), shift work (t(251) = 5.23; p = 0.001 ), and wife's work shift (t(251) = 2.26; p = 0.02). Also, there was a significant difference between work-family conflict with the place of employment (F(251) = 8.18; p = 0.001) and education (F(251) = 6.61; p = 0.002). There was also an association between depression and a history of depression (Z(251) = -3.29; p = 0.001), specific drug use (Z(251) = -2.62; p = 0.009), job satisfaction (Z(251) = -2.90; p = 0.004), work shift (Z(251) = -2.62; p = 0.009), which was statistically significant. The correlation between depression and place of employment (p = 0.01) and income (p ≤ 0.05) was found to be significant.
Conclusion and Discussion: According to the findings of this study, women with a history of depression who are dissatisfied with their jobs, work shift hours, have husbands who also work shifts, are employed in the field of therapy, and possess a bachelor's degree are more vulnerable to work-family conflict. Conversely, women experiencing work-family conflict, who have a history of depression, use certain medications, are dissatisfied with their jobs, and work shifts, and are employed in the treatment field are at a higher risk of developing depression. Therefore, it is suggested that more attention be given to these women in screening programs, population policies, and employee health interventions.
Nahal Badavi, Fahimeh Yasari,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Bacterial vaginosis is caused by the imbalance of the natural bacterial flora of the vagina, which is asymptomatic in half of the cases. However, its characteristic symptoms include itching and burning, and increased vaginal secretions in gray color, which is the most common vaginitis in reproductive age. This review article was conducted to investigate pregnancy outcomes in women suffering from this disease.
Search Strategy: This systematic review involved searching the Google Scholar and Elmnet search engines, as well as Scientific information databases, such as Magiran, PubMed, Elsevier, and Science Direct, from 2000 to 2024. The keywords used in the search included “pregnancy outcome”, “bacterial vaginosis”, “Parturition”, “pregnant women”. Of all the articles identified, 31 were selected for analysis. Articles that were unavailable or irrelevant were excluded from the study, resulting in a final evaluation of 17 articles for review.
Results: According to studies, bacterial vaginosis can significantly impact pregnancy. The associated consequences include premature birth, premature rupture of fetal membranes, spontaneous abortion, low birth weight, respiratory distress syndrome, amniotic fluid infection, infections at the cesarean wound site, and an increased need for neonatal intensive care unit admission compared to healthy women.
Conclusion and Discussion: Gynecologists and midwives should educate women about the symptoms of bacterial vaginosis. By increasing awareness of this condition and encouraging necessary examinations, women can receive timely diagnosis and treatment, thereby preventing the development of adverse effects associated with the disease.
Search Strategy: This systematic review involved searching the Google Scholar and Elmnet search engines, as well as Scientific information databases, such as Magiran, PubMed, Elsevier, and Science Direct, from 2000 to 2024. The keywords used in the search included “pregnancy outcome”, “bacterial vaginosis”, “Parturition”, “pregnant women”. Of all the articles identified, 31 were selected for analysis. Articles that were unavailable or irrelevant were excluded from the study, resulting in a final evaluation of 17 articles for review.
Results: According to studies, bacterial vaginosis can significantly impact pregnancy. The associated consequences include premature birth, premature rupture of fetal membranes, spontaneous abortion, low birth weight, respiratory distress syndrome, amniotic fluid infection, infections at the cesarean wound site, and an increased need for neonatal intensive care unit admission compared to healthy women.
Conclusion and Discussion: Gynecologists and midwives should educate women about the symptoms of bacterial vaginosis. By increasing awareness of this condition and encouraging necessary examinations, women can receive timely diagnosis and treatment, thereby preventing the development of adverse effects associated with the disease.
Narjes Khazaei, Fatemeh Tanhaye Kalate Sabz, Mansoreh Nazarian,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Recurrent implantation failure (RIF) is a clinical phenomenon defined as failure to become pregnant after the transfer of at least three good-quality embryos in three cycles in women under 40 years of age. The causes for couples with RIF can be anatomical abnormalities, aneuploidy, male factors, immunology, thrombophilia, impaired endometrial receptivity, and microbiome. Impaired endometrial receptivity is estimated to account for two-thirds of implantation failures. Several studies have focused on improving endometrial receptivity for success rates in patients with RIF. This systematic study aimed to evaluate novel treatment options for RIF.
Search Strategy: The Key findings were identified by searching the PubMed, Scopus, and Web of Science databases. The terms "innovative treatment options and recurrent implant failure" were searched, and 30 papers were reviewed.
Results: According to the studies examined, various methods were used to regenerate and improve the thickness of the endometrium, including the use of growth hormone, letrozole, medroxyprogesterone acetate, granulocyte colony-stimulating factor, platelet-rich plasma (PRP), lymphocytes immunotherapy, and endometrial scratch. In addition to these methods, new promising treatment options emerged for RIF, particularly in resistant endometrium situations, including endometrial mesenchymal stem cells and their mixture with PRP. Research suggested that stem cell therapy could enhance endometrial receptivity by promoting angiogenesis and modulating the immune response. The other innovative regenerative therapy for RIF cases included the use of exosomes. These vesicles carry various bioactive molecules that can regulate gene expression and signaling pathways in recipient cells. They could also modulate the crosstalk between the embryo and the endometrium, affecting endometrial receptivity, immune response, and angiogenesis, which are critical for successful implantation.
Conclusion and Discussion: While the innovative options show potential in addressing resistant endometrium and improving outcomes in RIF patients, they are still considered experimental approaches. Further research is necessary to confirm their clinical utility. However, more research is also needed to establish the safety and efficacy of these cell-based therapies.
Masoumeh Ghavami Moshfegh, Masoumeh Seidi,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: It is projected that urban women, particularly those with higher education, will exhibit a greater tendency toward voluntary childlessness. This trend is expected to intensify as education levels and urbanization continue to rise. This study aimed to systematically review the evidence on factors affecting voluntary childlessness and solutions for childbearing in women with high education.
Search Strategy: The PRISMA statement was used to guide the conduct of this systematic review. A computerized search was performed using multiple keywords in the following databases: Medline, Cochrane, Google Scholar, and EMBASE. Without any specific criteria, the number of articles eligible for inclusion based on the following topics—childbearing, voluntary childlessness, women, and high education—reached as high as 2,000 on April 25, 2024. This count included titles and abstracts of the retrieved publications. After screening by two reviewers, studies that did not meet the above criteria (letters, viewpoints, commentaries, and editorials) were excluded. Articles were limited to English and Persian. Access was obtained to 99 complete articles, of which 19 were finally selected based on our criteria.
Results: The results were categorized into two main areas: factors affecting voluntary childlessness: (1) developmental idealism, (2) social-cultural diversification (residence, educational attainment, and job security), (3) leftover women (still unmarried, despite being highly educated and successful), (4) changes in lifestyles and fertility concepts, (5) perception of childbirth as a threat for couples, and (6) high levels of happiness (among both the men and women). Suggested solutions: (1) provide accurate information about childbearing, (2) engage with various media sources, (3) develop policies to alleviate some of the anxieties faced by women, (4) encourage active male involvement in childcare responsibilities, and (5) urge policymakers to expand multidimensional programs.
Conclusion and Discussion: The modern fertility transition seems to stem from the adoption of innovative behaviors rather than merely an adaptation to new socioeconomic conditions. The consequences of childlessness are as extensive and varied as its causes. Couples require accurate information to make informed decisions about childbearing access to this information can significantly assist them. The government should develop a reproductive policy aimed at enhancing the quality and accessibility of pregnancy and postpartum.
Search Strategy: The PRISMA statement was used to guide the conduct of this systematic review. A computerized search was performed using multiple keywords in the following databases: Medline, Cochrane, Google Scholar, and EMBASE. Without any specific criteria, the number of articles eligible for inclusion based on the following topics—childbearing, voluntary childlessness, women, and high education—reached as high as 2,000 on April 25, 2024. This count included titles and abstracts of the retrieved publications. After screening by two reviewers, studies that did not meet the above criteria (letters, viewpoints, commentaries, and editorials) were excluded. Articles were limited to English and Persian. Access was obtained to 99 complete articles, of which 19 were finally selected based on our criteria.
Results: The results were categorized into two main areas: factors affecting voluntary childlessness: (1) developmental idealism, (2) social-cultural diversification (residence, educational attainment, and job security), (3) leftover women (still unmarried, despite being highly educated and successful), (4) changes in lifestyles and fertility concepts, (5) perception of childbirth as a threat for couples, and (6) high levels of happiness (among both the men and women). Suggested solutions: (1) provide accurate information about childbearing, (2) engage with various media sources, (3) develop policies to alleviate some of the anxieties faced by women, (4) encourage active male involvement in childcare responsibilities, and (5) urge policymakers to expand multidimensional programs.
Conclusion and Discussion: The modern fertility transition seems to stem from the adoption of innovative behaviors rather than merely an adaptation to new socioeconomic conditions. The consequences of childlessness are as extensive and varied as its causes. Couples require accurate information to make informed decisions about childbearing access to this information can significantly assist them. The government should develop a reproductive policy aimed at enhancing the quality and accessibility of pregnancy and postpartum.
Fatemeh Karimi , Marzieh Mehrabinia,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Breast cancer (BC) represents the predominant malignancy among women of reproductive age, with approximately 6% of cases occurring in individuals under 40 years old. Young women diagnosed with BC often undergo aggressive therapeutic interventions, including cytotoxic chemotherapy or prolonged endocrine therapy spanning a decade, leading to transient or enduring menopausal symptoms. Consequently, survivors of BC exhibit notably reduced fertility rates post-treatment, with a 70% decrease compared to survivors of other malignancies. Hence, the discussion and implementation of fertility preservation measures emerge as pivotal considerations before initiating therapeutic regimens in young BC patients. There is a paucity of literature addressing the knowledge, practices, and attitudes of physicians in developing nations regarding these pertinent issues. Our objective was to scrutinize the landscape of fertility preservation in young women confronting BC.
Search Strategy: A comprehensive systematic quest of pertinent studies up to 2024 was undertaken by exploring databases such as PubMed, Medline, Scopus, and Google Scholar. This investigation was carried out using the principles outlined in the PRISMA.
Results: The optimal approach to fertility preservation necessitates tailored deliberations involving the patient and healthcare providers and a thorough evaluation of the advantages and drawbacks of various options. Oocyte/embryo cryopreservation emerged as the predominant modality for fertility preservation, succeeded by transient ovarian suppression utilizing gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy and a combination of GnRHa and oocyte/embryo cryopreservation. Research indicateed that younger age, higher educational attainment, employment status, possession of private health insurance, and parity status correlated with a significantly heightened propensity for fertility preservation. Primary reasons for declining fertility preservation consultations encompassed satisfaction with current offspring numbers, financial impediments, and apprehensions regarding treatment delays and cancer recurrence.
Conclusion and Discussion: A substantial proportion of young women newly diagnosed with BC harbor apprehensions concerning fertility matters, which substantially influence their therapeutic decisions. Therefore, safeguarding ovarian function and fertility emerges as paramount for young BC cohorts. Providing comprehensive counseling on fertility preservation strategies is thus imperative for these patients and should be integrally embedded within standard clinical practice.
Search Strategy: A comprehensive systematic quest of pertinent studies up to 2024 was undertaken by exploring databases such as PubMed, Medline, Scopus, and Google Scholar. This investigation was carried out using the principles outlined in the PRISMA.
Results: The optimal approach to fertility preservation necessitates tailored deliberations involving the patient and healthcare providers and a thorough evaluation of the advantages and drawbacks of various options. Oocyte/embryo cryopreservation emerged as the predominant modality for fertility preservation, succeeded by transient ovarian suppression utilizing gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy and a combination of GnRHa and oocyte/embryo cryopreservation. Research indicateed that younger age, higher educational attainment, employment status, possession of private health insurance, and parity status correlated with a significantly heightened propensity for fertility preservation. Primary reasons for declining fertility preservation consultations encompassed satisfaction with current offspring numbers, financial impediments, and apprehensions regarding treatment delays and cancer recurrence.
Conclusion and Discussion: A substantial proportion of young women newly diagnosed with BC harbor apprehensions concerning fertility matters, which substantially influence their therapeutic decisions. Therefore, safeguarding ovarian function and fertility emerges as paramount for young BC cohorts. Providing comprehensive counseling on fertility preservation strategies is thus imperative for these patients and should be integrally embedded within standard clinical practice.
Nahal Badavi, Parinaz Nadaki, Fahifeh Yasari,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Considering the proven importance of exercise in today's world, experts and researchers place more emphasis on exercise in reproductive age, especially during pregnancy for women. This systematic review was conducted to determine the benefits of exercise during pregnancy.
Search Strategy: A search was conducted in the Google Scholar, Elmnet, SID, Magiran, PubMed, Elsevier, ScienceDirect with keywords “pregnancy”, “benefits of exercise”, “Parturition”, and “Pregnant women” from 2000 to 2024. From all the articles found, 38 articles were selected and analyzed for the research. The unavailable or irrelevant articles were excluded from the study, and 27 articles were finally evaluated for review.
Results: The results showed that although pregnant women were previously advised to rest and limit physical activity, current recommendations have shifted towards encouraging increased physical activity to promote a more active and healthy pregnancy. Exercise during pregnancy can help prevent pregnancy-related disorders such as excessive maternal weight gain, high blood pressure, urinary incontinence, hip and back pain, anxiety, and depression. Additionally, engaging in regular physical activity, particularly during the second trimester is effective in reducing the risk of gestational diabetes. Standard physical exercises enhance metabolic health by increasing energy and oxygen consumption post-exercise.
Conclusion and Discussion: The amount, intensity, and type of sports activity during pregnancy should be adjusted, considering the mother's sports history and fitness level. Exercise is recommended in low-risk pregnancies.
Search Strategy: A search was conducted in the Google Scholar, Elmnet, SID, Magiran, PubMed, Elsevier, ScienceDirect with keywords “pregnancy”, “benefits of exercise”, “Parturition”, and “Pregnant women” from 2000 to 2024. From all the articles found, 38 articles were selected and analyzed for the research. The unavailable or irrelevant articles were excluded from the study, and 27 articles were finally evaluated for review.
Results: The results showed that although pregnant women were previously advised to rest and limit physical activity, current recommendations have shifted towards encouraging increased physical activity to promote a more active and healthy pregnancy. Exercise during pregnancy can help prevent pregnancy-related disorders such as excessive maternal weight gain, high blood pressure, urinary incontinence, hip and back pain, anxiety, and depression. Additionally, engaging in regular physical activity, particularly during the second trimester is effective in reducing the risk of gestational diabetes. Standard physical exercises enhance metabolic health by increasing energy and oxygen consumption post-exercise.
Conclusion and Discussion: The amount, intensity, and type of sports activity during pregnancy should be adjusted, considering the mother's sports history and fitness level. Exercise is recommended in low-risk pregnancies.
Aynaz Bagherzadi, Reza Abdollahi, Maryam Dadashi Gogje Yaran, Saeed Yavari, Ziba Dadras, Iran Khalili,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: Domestic violence against pregnant women committed by intimate partners is a worldwide concern, especially in developing countries, which constitutes a violation of human rights. Violence is defined as frightening, threatening, or annoying behaviors that are used to impose one’s power on someone else and include physical, sexual, economic, and verbal abuse and divorce. The World Health Organization has reported that more than 90% of the abused pregnant women are abused by the biological father of the child the woman is carrying. Globally, 26% of ever-married/partnered women aged 15 years and older have been subjected to physical and sexual intimate partner violence at least once in their lifetime. Gender discrimination in societies with low socioeconomic and cultural status leads to violence against pregnant mothers who are expecting a girl child. The study aimed to define the predictive factors of infant gender-based violence against women during pregnancy.
Methods and Materials: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus, Web of Science, Google Scholar, and PubMed were used for records from 2013 to 2023. Finally, 3687 studies were found, and 39 met the inclusion criteria.
Results: Analysis of the articles revealed that low educational attainment of violent men, higher alcohol consumption, substance use, history of child and family abuse, limited decision-making skills, experiencing depression, males having multiple sexual partners, and younger age were found to be individual- and family-associated factors that increase the experiences of gender-based violence. Community tolerant attitudes to violence and girl children and discriminative and patriarchal attitudes, women’s unemployment, being Muslim, lower socioeconomic class, food, and social insecurity were found to be community- and societal-associated factors of gender-based violence against pregnant women. Alcohol consumption, low educational attainment, experiencing depression, being younger, having a history of child and family abuse, tolerant attitudes to violence, and low socioeconomic status were poignant factors associated with gender-based violence amongst women.
Conclusion and Discussion: Due to individual, family, community- and societal-associated factors that cause psychological defects in women and children, it is recommended to adjust the discriminative and patriarchal attitudes with action research studies and also adjust these factors by psychological consultations before and after childbirth with the family.
Methods and Materials: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus, Web of Science, Google Scholar, and PubMed were used for records from 2013 to 2023. Finally, 3687 studies were found, and 39 met the inclusion criteria.
Results: Analysis of the articles revealed that low educational attainment of violent men, higher alcohol consumption, substance use, history of child and family abuse, limited decision-making skills, experiencing depression, males having multiple sexual partners, and younger age were found to be individual- and family-associated factors that increase the experiences of gender-based violence. Community tolerant attitudes to violence and girl children and discriminative and patriarchal attitudes, women’s unemployment, being Muslim, lower socioeconomic class, food, and social insecurity were found to be community- and societal-associated factors of gender-based violence against pregnant women. Alcohol consumption, low educational attainment, experiencing depression, being younger, having a history of child and family abuse, tolerant attitudes to violence, and low socioeconomic status were poignant factors associated with gender-based violence amongst women.
Conclusion and Discussion: Due to individual, family, community- and societal-associated factors that cause psychological defects in women and children, it is recommended to adjust the discriminative and patriarchal attitudes with action research studies and also adjust these factors by psychological consultations before and after childbirth with the family.
Nazanin Fard Moghadam, Sajad Vosough, Amirali Alizadeh,
Volume 28, Issue 0 (12-2024)
Volume 28, Issue 0 (12-2024)
Abstract
Introduction: The risk of natural and artificial disasters is continuously increasing due to urbanization, population growth, and climate change. Children and pregnant women, due to their unique conditions, are more susceptible to injury and more likely to experience complications during disasters. Research indicates that maternal exposure to disasters can have adverse effects on both the mother and the fetus, some of which may be irreversible. Therefore, this study aimed to evaluate the impact of maternal exposure to disasters on birth outcomes.
Search Strategy: This study was conducted using a systematic review method. Evidence published from 2000 to 2024 was analyzed by searching international databases (PubMed, Scopus, WOS, and Google Scholar) in English with the keywords “Disaster”, “Crisis”, “Maternal exposure”, “Prenatal exposure”, and “Birth outcome”. In this this study, search and data analysis process was based on the PRISMA guideline. From a total of 126 studies, 19 original studies were analyzed based on inclusion criteria such as exposure to natural disasters, free availability of full-text, and publication in English.
Results: Results showed a significant relationship between maternal exposure to disasters and birth outcomes. Being present in an affected area during pregnancy can have deleterious effects, including inadequate fetal development, low birth weight, preterm birth, high rates of cesarean, and a decreased immune response in infants. These adverse outcomes may be attributed to factors such as food insufficiency, poor housing conditions, limited access to healthcare facilities, and excessive stress during pregnancy, especially in developing countries. Additionally, the effects of exposure are most concentrated among infants born to women aged 15-24 years and those who experienced disasters during the first trimester. This issue suggests that exposure during the first trimester may be more strongly related to genetic disorders, while exposures later in pregnancy are likely linked to growth or labor complications.
Conclusion and Discussion: Disasters are associated with adverse birth outcomes. However, it is essential to assess the timing of exposure and the type and severity of the disasters. Improved prenatal care may mitigate the differences in birth conditions compared to those observed before exposure.
Search Strategy: This study was conducted using a systematic review method. Evidence published from 2000 to 2024 was analyzed by searching international databases (PubMed, Scopus, WOS, and Google Scholar) in English with the keywords “Disaster”, “Crisis”, “Maternal exposure”, “Prenatal exposure”, and “Birth outcome”. In this this study, search and data analysis process was based on the PRISMA guideline. From a total of 126 studies, 19 original studies were analyzed based on inclusion criteria such as exposure to natural disasters, free availability of full-text, and publication in English.
Results: Results showed a significant relationship between maternal exposure to disasters and birth outcomes. Being present in an affected area during pregnancy can have deleterious effects, including inadequate fetal development, low birth weight, preterm birth, high rates of cesarean, and a decreased immune response in infants. These adverse outcomes may be attributed to factors such as food insufficiency, poor housing conditions, limited access to healthcare facilities, and excessive stress during pregnancy, especially in developing countries. Additionally, the effects of exposure are most concentrated among infants born to women aged 15-24 years and those who experienced disasters during the first trimester. This issue suggests that exposure during the first trimester may be more strongly related to genetic disorders, while exposures later in pregnancy are likely linked to growth or labor complications.
Conclusion and Discussion: Disasters are associated with adverse birth outcomes. However, it is essential to assess the timing of exposure and the type and severity of the disasters. Improved prenatal care may mitigate the differences in birth conditions compared to those observed before exposure.
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