Journal of Midwifery & Reproductive health
Volume:12 Issue: 1, Jan 2024

At least 50% of infertile couples' problems are related to the male factor infertility. There is widespread use of herbal medicine among men for infertility problems. This study was conducted to determine the effect of Ceratonia siliqua L. (Carob) on semen parameters in idiopathic male infertility.

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were searched without time restrictions till December 2023 through searching English databases including PubMed, Scopus, Web of Science, Cochrane Library, EMBASE and ProQuest using MeSH terms of male infertility, RCT, herbal medicine, idiopathic male infertility, Ceratonia siliqua L, Carob, semen parameters and their equivalent words in Persian, which were searched individually or in combination. Two reviewers independently assessed eligibility and quality of included articles and any disagreements were resolved by consensus with a third party.

Out of 140 articles, 97 documents were removed due to duplication. After screening 43 remaining articles, 30 articles were excluded based on the title and abstract, and eight articles due to being conducted on animals. One article was the study protocol, which was also excluded. Finally, four articles were included in systematic review. All studies reported Carob is effective in improving some or all parameters of semen including count, motility, and morphology.

Considering small number of human studies related to the effect of Carob on semen parameters, conducting more robust clinical trials are recommended.

 COVID-19 infection may adversely affect pregnancy outcomes. We aimed to assess the incidence rate of the COVID-19 virus and its effect on maternaland neonatal outcomes.

 This was a cohort study in which a number of health-care centers in Tehran province were randomly selected, and all pregnant women referring to these centers were screened for COVID-19 from April 2020 to July 2020. Out of 15520 pregnant women, 263 individuals infected with COVID-19, who were followed until delivery. To collect the data, a demographic and obstetric characteristics questionnaire and a maternal and neonatal outcome checklist were used. Data analysis was done by SPSS version 22 using the Chi-square test, independent t-test, and logistic regression model.

 The incidence of COVID-19 among participants was 17 per 1000 (95% CI: 15-19). Women with a higher BMI (OR = 1.198, CI =1.003-1.431, P = 0.047) and lower blood oxygen level (OR= 0.886, CI: 0.808-.970, P=.009) were more likely to have adverse pregnancy outcomes. Preterm labor (18.3%) was the most common outcome of pregnancy, followed by stillbirth (0.8%), ICU admission (3.0%), maternal mortality (1.1%), need to mechanical ventilation (1.5%) and preeclampsia 1(0.38). Regarding neonatal outcomes, neonatal COVID-19 was seen in 1.9% of cases, NICU admission in 15.2%. Neonatal mortality without COVID-19 in 2.3%.  The majority of neonates with complications were male (29.1% vs. 21.5%, (P= 0.002).

 Pregnant women had a lower COVID-19 incidence rate than the general population, but when infected, they were at risk for poor maternal and neonatal outcomes.

Cupping therapy is a long-standing traditional therapy that its application has re-emerged, recently. Due to the lack of a review on the applications of this method specifically in obstetrics and gynecology, the present study was performed to evaluate and summarize data from clinical trials on dry and wet cupping applications in obstetrics and gynecology.

In this narrative review, Web of Science, PubMed, Scopus, Science Direct, ProQuest, databases and Google Scholar search engine, as well as Persian databases including SID, Magiran, and Iranmedex were searched without time limit until the end of November 2022. Keywords included cupping, women, pregnancy, obstetrics, gynecology, treatment, dry and wet cupping, clinical trial and their persian equivalents. All clinical trials that examined the effect of different cupping therapy applications for obstetric and gynecological conditions were evaluated by two independent reviewers using the Jadad scale and studies with the scores of 3 or more were included in the review. Nine eligible clinical trials were included in this review.

Cupping therapy was identified as an effective method for improving primary dysmenorrhea, chronic pelvic pain, hypercholesterolemia in menopausal women, oligomenorrhea, idiopathic menorrhagia, low back pain due to pregnancy and delivery, perineal pain due to the childbirth and postpartum anxiety.

The widespread use of cupping in obstetrics and gynecology has had a positive effect on mitigating a wide range of conditions. Knowledge of the various applications of this method could help specialists to employ this branch of complementary medicine along with other conventional medicine methods of treatment.

 Limited studies have been conducted on the effectiveness, applicability, and satisfaction of mind-body interventions as short-term methods that affect body conditions like Polycystic Ovary Syndrome (PCOS). Therefore, this study aimed to compare the efficacy of online mind-body interventions versus face-to-face counseling on the quality of life (QOL) of women with PCOS.

 This parallel randomized clinical trial was implemented in Yazd in 2020.  Sixty eligible women with PCOS were randomly allocated to the online group (n=30) and face-to-face counseling (n=30) groups. Eight 120-minute sessions of mind-body interventions were held for both groups, either as online or face-to face. Data was collected using the PCOS Health-Related Quality of Life (HRQOL) questionnaire (at baseline, week 8 and 12), counseling satisfaction scale (at week 8 and 12), and FBS (at baseline and week 8) in both groups. Data were analyzed by SPSS (version22) using T-test, and repeated measures ANOVA.

  HRQOL was 94.87±11.75 in online and 90.50±9.76 in face-to-face group at baseline, which increased significantly to 108.53±4.5 in the online and face-to-face groups at week 12, with a greater increase in the online group (P<0.001). Satisfaction with counseling increased at week 12 compared to week 8 in both groups, which was not significantly different (P=0.31). FBS decreased at week 8 compared to baseline in both groups without a significant difference (P=0.26).

 The greater effectiveness of online mind-body interventions on HRQOL in women with PCOS highlights their potential value as telehealth interventions.

Pender's model promotes healthy behaviours by changing one's lifestyle. There have been few studies on using this model to improve the health of women with stress urinary incontinence. This study aimed to determine the effect of group counseling based on the Pender’s model on the health promotion of women with stress urinary incontinence.

This randomized clinical trial comprised two groups, with a total of 70 women, who were selected through convenient sampling and then were randomly allocated into either the control or intervention group using permutation block randomization. The intervention group received a structured program of six group counseling sessions based on Pender's model. Data collection instruments included demographic characteristics questionnaire; the Questionnaire for Urinary Incontinence Diagnosis (QUID); Depression, Anxiety and Stress Scales-21 (DASS-21) and a researcher-developed questionnaire aligned with the constructs of Pender's model. Both groups completed the questionnaires before, immediately following the intervention, and again two months later. Data analyzed by independent t-test, Mann-Whitney, and repeated measure regression using SPSS version 25.

  Prior to the intervention, there was no statistically significant difference in the average total scores of the health promotion between the two groups (P=0.561). However, following the intervention and at the two-month follow-up, the intervention group exhibited a significant increase in their total scores on the health promotion compared to the control group (P<0.001).

Group counseling based on the Pender’s model is an effective counselling approach enhancing the health promotion of women suffering from stress urinary incontinence. Therefore, its utilization is recommended in the clinical settings.

Periodontal diseases cause adverse obstetric outcomes in pregnancy. However, pregnant women generally avoid going to the dentist. This study was conducted to assess the reliability and validity of Periodontal Diseases Assessment Index (PEDIAP) in Pregnancy for Midwives in Turkish society.

This is a validation study consisted of 111 pregnant women referred to antenatal clinic of a training hospital in western Turkey in 2017. Construct validity of the index was calculated by exploratory and confirmatory factor analyses (EFA, CFA), reliability by Cronbach's alpha coefficient, inter-applicant agreement with Kendal W coefficient and intraclass correlation coefficient (ICC) and factor structure with principal components analysis and Varimax rotation using SPSS for Windows 20.0 software.

Results showed that the index explained 33.94% of the total variance, and the factor loading values were between 0.47 and 0.68. Based on the CFA, fit indices were found to be χ2/sd = 1.6384, RMSEA = 0.0762, and CFI = 0.9795. The regression coefficients and t values were significant (t > 1.96). The index was found to have a positive correlation with (CPITN) scores (p < .001). The Cronbach alpha coefficient was calculated to be 0.774. It was found that the Kendal W coefficient ranged from 0.550-1 for each item, the ICC coefficient was 0.869, and correlation was significant (p < 0.001). The cut-off value of the index was specified as 3.5

The results of this study show that the PEDIAP is a valid and reliable index for use in research and midwifery care.

The fear of being affected by COVID-19 has significantly reduced perinatal care. The current study aimed to evaluate the impact of smartphone-based self-care education on awareness, perceived severity, and self-care of pregnant women at risk of preterm birth during a covid-19 pandemic.

This quasi-experimental study was conducted on 115 pregnant women at risk of preterm birth that was assigned into intervention (N=58) and control (N=57) groups. The research tools included the demographic and preterm delivery screening checklist, awareness, perceived severity, and self-care questionnaires. The intervention group received training files using WhatsApp software within two weeks. The control group received no intervention. The questionnaires were completed before (T1), 8 (T2) and 12 (T3) weeks after the implementation of the intervention in two groups. ANOVA, ANCOVA, independent t-test, chi-square, and Fisher's exact test were used to analyze the data using SPSS software (version 24)  

No significant difference was found between baseline data (T1) before the intervention in two groups (p>0.05); while after the intervention, a significant increase was observed in the mean score of awareness at T2 and T3 compared to T1 (P<0.001) as well as self-care at T2 and T3 compared to T1 (P<0.001). Also, a significant decrease was observed in the mean score of perceived severity (P<0.001) in the intervention and control group over time. 

It appears that distance learning to provide care for pregnant women and informing healthcare providers about their condition can be useful, especially for those who are at risk during pandemics.

Increased paternal engagement in antenatal care and birth positively influences pregnancy outcomes. There is very little research that describes the men's value of the reproductive health of their partner and its impact on paternal engagement in preconception, antenatal, and postpartum care. The purpose of this study was to examine the potential associations of paternal values towards women’s empowerment (PVWE) with maternal and paternal antenatal care (ANC) attendance.

Secondary analysis of a men’s survey conducted by the Demographic and Health Surveys (2010-2014) (n=26892). A retrospective analysis of observational data collected as part of a prospective census survey was performed. An empowerment instrument was created ad hoc using four available variables. Nine sub-Saharan countries were included. Surveys obtained via stratified sampling with varying probability using weight distributions. Data were pooled into an aggregate dataset and examined through various regression methods. 

PVWE was positively associated with maternal antenatal care. Lower PVWE was associated with lower likelihood that women attend ANC. PVWE was also positively associated with paternal antenatal care attendance. Lower versus higher PVWE was associated with lower likelihood that fathers attended ANC.

PVWE is positively associated with maternal and paternal antenatal care attendance. Men’s values of the reproductive rights of their partner may contribute to antenatal care attendance or antenatal care may shape men’s values of women.  Further research can build upon this study to provide more insight as to how masculinity shapes men’s values of the respective rights of women.

 During the waiting period for breast biopsy results, women experience sleep disorders. This study conducted to determine the effect of implementing Peplau’s model on sleep quality of women waiting for the results of breast biopsy.

This randomized clinical trial was conducted in 2019 at two educational hospitals in Mashhad, Iran. Women who were eligible to enter the study were randomly assigned to the intervention (n=34) and control groups (n=34) by lottery method. The intervention group received a program based on the Peplau's model, included a face-to-face communication and three telephone follow-ups. The control group received conventional care. Data were collected using Pittsburgh Sleep Quality Index, in three stages of before sampling, before and two weeks after receiving the results. Data were analyzed using Chi-square, t-test and the analysis of variance with repeated measures.

 The mean score of sleep quality of women was 9.1 ± 3.2 in the intervention and 8.4 ± 2.6 in the control group before sampling. It was 8.2 ± 0.3 in the intervention and 8.3 ± 2.4 in the control group before receiving the result. However, two weeks after receiving result. It was 7.4 ± 2.7 in the intervention and 7.6 ± 2.8 in the control group. The analysis showed statistically significant difference between two groups in terms of sleep quality in different time periods (P=0.01).

 Considering the positive effect of the Peplau’s model application on improving the sleep quality, it is recommended to use this model especially in outpatient care settings.

Psychological and behavioral factors caused by COVID-19 adversely affect physical and mental well-being, especially in pregnant women. The current study was performed to evaluate the correlation between knowledge, preventive behaviors, and COVID-19 anxiety with perceived stress among pregnant women.

This cross-sectional study was conducted among 290 pregnant women referring to two hospitals in Tabriz, Iran in the second six months of 2021. All participants were selected through convenient sampling. Data were collected using demographic-obstetric questionnaire, knowledge of COVID-19 questionnaire, preventive behaviors scale against COVID-19, the Corona Disease Anxiety Scale (CDAS), and the Cohen Perceived Stress Scale (PSS). Data were analyzed by SPSS software version 24 and descriptive and interpretive statistics.

Based on the results, 23.8% and 38.6% of participants had severe anxiety and stress, respectively. There was a direct and significant correlation between knowledge and preventive behaviors (r=0426, P<0.001). The results of univariate regression showed that the preventive behaviors and COVID-19 anxiety explain 1.7% (β=0.130, SE=0.123, P=0.027) and 5.51% (β=0.742, SE=0.034, P<0.001) of stress changes, respectively. In univariate linear regression, a moderate correlation was observed between the three variables including employment status, preventive behaviors, and anxiety with perceived stress (R=0.557), and anxiety had the highest regression coefficient (β=-0.665).

The current study highlighted the importance of measuring knowledge, preventive behaviors, COVID- 19 anxiety and perceived stress in pregnant women during COVID-19 pandemic. This assessment will assist healthcare providers in delivering appropriate services during the future pandemics.

Gestational diabetes is is associated with some degree of sexual dysfunction in women. Therefore, this study aimed to explore the perceptions and experiences of women with gestational diabetes regarding their sexual function.

This study was a qualitative research using the conventional content analysis approach and was conducted from April to December 2020 in Mazandaran Province, Iran. The participants included 15 women with gestational diabetes, six key individuals, and two husbands of women with gestational diabetes who were selected using a purposive sampling. The data were collected through in-depth semi-structured interviews. The content analysis approach was used based on the Graneheim and Lundman (2004) method. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness. MAXQDA10 software was used for data management.

Data analysis illustrated four themes: "sexual problems in women with gestational diabetes", "worries and problems caused by gestational diabetes", "non-comprehensive services", and " need to empower the individuals and significant others ". 

Worries and problems caused by gestational diabetes that develop in women who receive inappropriate and non-comprehensive services can affect their sexual function. Therefore the supportive role of health care providers and significant others are necessary to empower the patients to overcome their sexual problems.

As one of the most influential factors of marital life, sexual satisfaction can significantly lead to peace and compatibility of couples. The present study investigated the effect of Guided Imagery and Music (GIM) on the level of sexual satisfaction in women of reproductive age.

In this parallel cluster-randomized trial which was conducted from Feb. 2019 to Apr. 2020, 72 women of reproductive age (two groups of 36 subjects) who had moderate or undesirable sexual satisfaction were sampled. The guided imagery music was presented for the intervention group for 6 weeks as twice a week. No intervention was performed for the control group.  The data collection tool included fertility characteristics and Larson questionnaires, which was completed before, immediately and one month after the intervention. Data were analyzed by SPSS software (version 20) using independent t-test, chi-square, Mann-Whitney and variance analysis with repeated measurements.

 There was no statistically significant difference between the two groups in the sexual satisfaction score before the intervention. The mean sexual satisfaction score in the intervention group had a statistically significant difference between the baseline (91.1±9.1), immediately after intervention (112±4.46) and one month later (102±9.24) (P< 0.001). However, there was no significant difference between the changes in the sexual satisfaction of women in the control group between three times.

GIM technique improves women's sexual satisfaction. It is recommended to health care providers to use this behavioral technique to enhance the level of sexual satisfaction in women of reproductive age.

Preeclampsia is a hypertensive disorder that affects 2–7% of pregnancies, remaining a major contributor to maternal and fetal mortality and morbidity with uncertain pathogenesis.  Some evidence suggests the role of infectious agents in development of preeclampsia. This study assessed the potential relationship between H. Pylori infection and development of preeclampsia. This case-control study was conducted in one educational hospital in Mashhad, Iran, in 2021. Study participants were selected through convenience sampling. A total number of 34 normotensive and 34 women with preeclampsia in their third trimester enrolled in the study. We assessed serum levels of hemoglobin, hematocrit, platelets, creatinine, and serum levels of H. pylori (IgG and IgA) in all participants, comparing the infection rates between the study groups. There were no significant difference in age, BMI, number of previous pregnancies, hemoglobin, hematocrit, platelet count and creatinine levels among different study groups (P>0.05). The H. Pylori test was positive in 30 (88.2%) pregnant women in preeclampsia group and 23 (67.6%) in the control group (P=0.041). H. Pylori infection was significantly more prevalent in women with preeclampsia compered to healthy pregnant women in third trimester. This suggests a potential association between H. Pylori infection and the development of preeclampsia.