Journal of Preventive Medicine

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Introduction: Although caesarean section as a way to save both mother and child has been accepted in an emergency state, but its harmful consequences such as infectious diseases, anesthesia complications, and postpartum depression which could be a threat to the health of the mother, child, family and the community. The aim of this study was to investigate the factors associated with cesarean delivery choice among pregnant women living in the city of Jiroft. Methods: A cross-sectional study was conducted on 145 pregnant women attending public and private medical centers in Jiroft. Data collection instrument was a questionnaire designed by the researchers. The validity of the questionnaires was confirmed and the reliability was assessed using Cronbach&rsaquos alpha coefficient which was %84. Data were analyzed by SPSS v.19 and Logistic regression test was used (p-value=0.05). Results: The mean age of the study participants’ was 34 ± 4 years and %75 of the women in the study chose cesarean delivery as the best method. Most participants in the study were pregnant for 5 - 7month (%35.25) and experienced the first pregnancy (%44.1). The majority of them (%52.4) reported friends and family as a source of information for choosing cesarean section as the delivery method. The results of logistic regression showed that the location of prenatal care, abortion, economic status, place of birth, family history of cesarean delivery, and previous cesarean were significantly related with choosing cesarean as the delivery method. Conclusion: A high percentage (%75) of participants in this study had chosen cesarean section as the delivery method. Therefore, authorities should consider it as a public health problem. A way to overcome this problem is increasing the awareness of pregnant women of normal delivery benefits through the education.

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Introduction: Anemia is one of the major causes of maternal death in developing countries and iron deficiency is the most common cause of anemia during pregnancy which can be associated with many adverse effects. Despite the implementation of programs for taking iron supplement, the statistics show that most pregnant women do not take the iron tablets correctly and regularly. This study aimed to investigate the intake of iron supplement and the factors influencing iron intake during pregnancy in women referred to Bandar Abbas Shariati Hospital in 1395. Methods: In this descriptive-analytic study 197 pregnant women who referred to Shariati Hospital in Bandar Abbas in 1395 and were in the second half of their pregnancy period were enrolled through available sampling method. To collect the data, valid and reliable questionnaire was used. Then data were entered into SPSS 19. To analyze the data, descriptive statistics indicators (mean, frequency) and chi-square test were used. A P value of <0.05 was considered as significant. Results: According to the results 61.4% of pregnant women were taking iron supplements desirably. There was significant relationship between iron supplements intake and history of anemia (P=0.002), spouse's education level (p=0.032), anemia before pregnancy (P=0.000), and mother's education level (P=0.006). However, no significant relationship was found between the intake of iron supplements and age)0.498), nationality)P=0.298(, employment status, mothers' job (p=0.622), wives' job (p=0.549),the number of pregnancies (p=0.288), Number of children(p=0.773), and the frequency of referring to health centers (p=0.481). Conclusion: According to the results of the study it can be concluded that conducting training classes for mothers and wives as well as giving sufficient information about pregnancy anemia to the community through the mass media is needed for increasing the iron intake during the pregnancy and for promoting the level of maternal health.

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Introduction: Since the maternal death affects the family and society´s health, recognizing the causes and finding the preventive measures is essential in order to reduce this type of death. The aim of this study was to determine the prevalence and causes of mortality in pregnant women in Hormozgan province.
Methods: In this descriptive cross-sectional study, the study population was all pregnant mothers who died during the years 2011-2017. Data were collected from the records available at the hospitals and the health centers, the completed maternal death forms, and the interviews on maternal death. The data collection tool was a researcher-made questionnaire and the data were analyzed using descriptive statistics with SPSS software.
Results: The rate of maternal death in Hormozgan province during the study period was 32.76 cases per 100,000 live births and the frequency of maternal death was 100. The most common cause of death was postpartum hemorrhage. The majority of deceased mothers were 18-35 years old (73%), with pregnancy interval more than three years (80%), delivery times less than 5 (87%), rural residents (57%), and wanted pregnancy (86%). The type of delivery was the cesarean section in the majority of mothers who died (60%). In addition, 75% of the mothers were died in hospitals and specialists and midwives helped them to deliver (91%). The highest mortality rate was related to post-delivery period (65%).
Conclusion: In order to reduce the maternal mortality, it is recommended to provide high quality services to the villagers, promote the referral system, reduce the unnecessary cesarean sections, provide ambulance and hospital equipments, improve the level of knowledge and skills of staff, and follow up the mothers after delivery.
 

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Introduction: The birth weight of a newborn is one of the important indicators of growth, survival, and development of the child. The aim of this study was to determine the relationship between the birth weight of the newborn and the maternal weight and maternal weight gain during pregnancy.
Methods: This descriptive-analytical and cross-sectional study was performed on 92 pregnant women in Vali-e-Asr hospital in Fasa, Iran, during the second half of the year 2016. Samples were selected by systematic random sampling. Data collection tool was a researcher-made questionnaire that its validity and reliability were checked and approved. Data were analyzed using SPSS software and independent t-test, Pearson correlation coefficient and linear regression.
Results: The mean weight of newborns at birth was 3181.20±589.29 g. The mean BMI of mothers before and at the end of pregnancy was 23.97±5.54 and 29.61±7.55 g, respectively. The findings indicated that there was a linear relationship between the weight of newborns and maternal weight at the beginning (r=0.23, P-Value<0.05) and at the end (r=0.24, P-Value<0.05) of pregnancy. There was no significant relationship between the birth weight and mother’s job, number of previous deliveries, type of delivery, pregnancy age, taking supplements, and sex of the baby (p>0.05). But a significant relationship was observed between the parental raltionship and time of the delivery (premature and timely) and weight of newborns (P-Value<0.05).
Conclusion: The findings of this study indicates the influence of pre-pregnancy weight and maternal weight gain during pregnancy on the birth weight of the newborn. Therefore, healthcare providers should pay special attention to fitting and regulating the weight of pregnant women.
 

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Introduction: The outbreak of the emerging COVID-19 virus is a public health emergency. According to the latest studies, women with gestational diabetes mellitus are at a greater risk for this virus. Due to the need for quarantine and the limitation of physical contact in the current situation and the need for women with gestational diabetes mellitus to receive repeated services, this review study aimed to assess the use of telemedicine services for women with gestational diabetes mellitus during COVID-19 pandemic.
Data sources: The PubMed, Google Scholar, Scopus, Science Direct, Wiley Online Library, and Springer databases were investigated with the keywords of COVID-19 and gestational diabetes mellitus in combination with the telemedicine and articles over the past 10 years were analyzed.
Selection methods for study: In the electronic searches, 61 articles and 5 English and Persian guidelines were retrieved. Then, older and repetitive articles were removed, and after reviewing the title and abstract of studies, 6 English articles and 3 guidelines were analyzed.
Combine content and results: According to the results of the studies, face-to-face visits should be accompanied by ultrasound appointments. Postpartum diabetes screening should be delayed for 3-6 months. Compared to routine care, telemedicine services were associated with reduced polyhydramnios, premature rupture of membranes, preterm labor, emergency cesarean section, and neonatal asphyxia in women with gestational diabetes mellitus.
Conclusion: The use of telemedicine services for women with gestational diabetes in the context of the outbreak of coronavirus is an appropriate and cost-effective way to prevent the COVID-19 and to reduce the risks of gestational diabetes; it also reduces the anxiety in the women.
 

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Objective The stress and anxiety following high-risk pregnancies can lead to adverse perinatal outcomes. Identifying effective predictors is one of the most important aspects of preventive measures. This study aims to determine the perceived stress and its predictors in pregnant women with gestational hypertension.
Methods This is a cross-sectional study that was conducted in 2021 on 100 pregnant women with gestational hypertension in Tabriz, Iran. Sampling was done by a convenience method.  Data were collected using a demographic-obstetric form, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. Data analysis was performed in SPSS v. 22 software using statistical tests such as Kruskal-Wallis test, Mann-Whitney U test, and multivariate linear regression analysis. P<0.05 was statistically significant.
Results The mean of age and number of pregnancies were 28.67±4.38 years and 2.30±0.822, respectively. Maternal education, infant gender, previous pregnancy problems (P<0.001), number of pregnancies (P= 0.037), and perceived social support (P=0.002) were the predictors of perceived stress. Among these variables, experience of problems in previous pregnancies (β=0.300) and perceived social support (β=-0.273) had the highest impact on perceived stress. Perceived social support had indirect effect on the perceived stress of women.
Conclusion Due to the high perceived stress in pregnant women with hypertension, it is necessary to pay attention to appropriate sources to provide social supports to them. In addition, it seems logical to use adaptive coping strategies against pregnancy problems to reduce their stress.

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Introduction: Pregnant women's greater vulnerability and risk of vertical transmission highlight the importance of preventing and controlling COVID-19 in this population. This study examined the conditions of mothers and newborns of pregnant women infected with COVID-19.
Methods: This cross-sectional descriptive study examined 220 pregnant mothers suspected of having the coronavirus at Quchan City Hospital over one year, starting in May 2019, and 81 mothers tested positive for the virus. Data collection employed a researcher-designed checklist, patient files, and coronavirus test results, and were analyzed using SPSS 24 software.
Results: The mean age of participants was (29.19 ± 6.14) years, the mean gestational age at the time of maternal COVID-19 infection was (36.18 ± 3.06) weeks, and hypothyroidism was the most common underlying condition in mothers (7.3%). Eight mothers (9.87%) required intensive care, and one of them died. The most frequent perinatal outcomes included fetal heart rate disorders (38.27%,) premature rupture of membranes (30.86%), premature birth (25.92%), and six cases of COVID-19 in newborns (13.6%).
Conclusion:
Given the high premature birth rate and its negative impact on infant health, resulting in hospitalization and costs, it is recommended that preventive and care measures be implemented during pregnancy.