مقالات رزومه فاطمه بیات

Postponed childbearing is a social phenomenon in Iranian families. There is a controversy about its effect on mental health. Therefore, this study was conducted aimed to determine the role of childbearing in the rate of depression, stress, and anxiety in Iranian women of childbearing age.

This cross-sectional study was performed in 2021 on 581 eligible non-pregnant married women from 31 provinces of Iran. Non-random available sampling was performed as electronic form in virtual space. Data were analyzed by Demographic and Medical History Questionnaire, Sleep Quality (adapted from LSQ), Marital Satisfaction (EMS), Perceived Social Support (MSMPSS), Socioeconomic Status (Ghodratnama Questionnaire), and Stress-Anxiety-Depression (DASS-21). Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, and binary logistic regression. P<0.05 was considered statistically significant.

Female and spouse education (P <0.001), female employment (P = 0.004), and higher socioeconomic status (P = 0.04) were significantly higher in women without children. The marital satisfaction (P = 0.061), social support (P = 0.13), sleep quality (P = 0.58), history of chronic disease (P = 0.64), and place of residence (P = 0.058) were not significantly different between the two groups. After adjusting the data, the rate of depression in childless women is twice that of women with children (AOR=2.06 95% CI: 1.11-3.82). Stress (P = 0.38) and anxiety (P = 0.9) were not significantly different between the two groups.

Having children not only does not increase the rate of stress and anxiety, but also protects women against depression. Therefore, encouraging childbearing seems to promote the mental health of women in Iranian society.

Episiotomy is one of the causes that can affect mothers' postpartum quality of life. Aloe Vera plant has been suggested as one of the ways to heal wounds and reduce pain. Regarding to these properties, several clinical trial studies have been conducted to determine the effect of aloe vera on episiotomy pain relief and wound healing, and different findings have been reported. This study was performed with aim to determine the effect of Aloe Vera on episiotomy pain relief and wound healing.

In this systematic review study, the databases of Scopus, PubMed (MEDLINE), Embase, Proquest, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library and Web of Science were searched using the keywords of "pain", "Wound", "Healing", "Episiotomy", " Perineum" and "Aleo Vera" by OR and AND without time, language and geographical limitation until 23 April 2021. The quality of the articles was evaluated using the Cochran Group tool and data were analyzed by Stata software (version 14). Cochran test and I2 index were used to assess the heterogeneity of the articles.

Finally, 9 articles with sample size of 611 people were included in this systematic review study. Preliminary studies showed the effectiveness of Aloe Vera in wound healing and pain relief. Four studies with sample size of 258 patients had the potential to perform the meta-analysis for pain outcome. Results of the meta-analysis showed that Aloe vera can reduce pain intensity compared to the control group (P<0.05).

Aloe Vera seems to be effective in repairing episiotomy wounds and reducing pain; however, high quality studies with sufficient sample size are recommended for definitive results.

Preeclampsia is one of the major causes of maternal mortality and morbidity, and its prevention is one of the most challenging topics in obstetrics. Magnesium supplementation has been suggested as a way to prevent preeclampsia; therefore, this systematic review study was conducted with aim to determine the effect of magnesium supplementation on the prevention of preeclampsia.

In this systematic review to find relevant clinical trial articles, databases of Scopus, PubMed, Embase, and Web of Science were used. The keywords of Preeclampsia, Pregnancy Toxemia, Dietary Supplement, Supplement, Supplementation, Magnesium, Intervention study, Clinical Trial, Clinical Studies, Randomized Clinical, and Controlled Clinical Trials were searched with Boolean operators (OR, AND) without time limitation until February 2, 2021. The inclusion criteria were oral magnesium supplementation and English language studies. There were no geographical restrictions. The quality of the articles was assessed with Cochran collaboration's tool (Risk of bias) and "Review Manager program" software (RevMan 3.5). Data were analyzed qualitatively.

Finally, 7 articles with a sample size of 2111 people were included in the study. Magnesium supplementation was used as magnesium citrate, magnesium aspartate, Effervescent magnesium, magnesium, and a multivitamin containing 200 mg of magnesium. The result showed that magnesium supplementation in low-risk individuals with hypomagnesemia reduces the incidence of preeclampsia.

It seems that taking magnesium supplements in low-risk pregnant women with hypomagnesemia can be effective in preventing preeclampsia; however, the studies with high quality and sufficient sample size are recommended for definitive conclusions.

Premature Rupture of Membranes (PROM) is one of the common problems of midwifery, which its early diagnosis is essential in the process of treatment and prevention of pregnancy adverse outcomes. Therefore, this study was performed with aim to evaluate the diagnostic accuracy of Creatinine and human chorionic Gonadotropin (HCG) test of cervical mucusdischarge to diagnose PROM in pregnant women.

This prospective study was conducted in 2017-2018 on 150 pregnant women with gestational age of 24 to 37 weeks and suspected to PROM. The subjects were divided into two groups of Rupture Membranes (Pooling and Fern test both of them were positive) and control group (Pooling and Fern test both of them were negative and AFI was normal). Creatinine was measured with Automated Analyzer method (Prestige device) and βHCG with Chemi-luminescence Signal Band method (Abbott device). Cut-off point and diagnostic accuracy were measured for two tests by rock curve. P-value<0.05 was considered statistically significant.

The highest sensitivity and specificity for creatinine in the diagnosis of PPROM was obtained at cut-off point 0.135 and for βHCG at cut-off point 26.78, with sensitivity of 91.7% and specificity 56.1%, and positive predictive value of 39.75% and negative predictive value of 95.52% and overall accuracy was 64.66% and the agreement rate was 0.33 (P <0.001). For βHCG, the sensitivity 58.3% and specificity 63.2%, and positive predictive value 33.33%, and negative predictive value of 82.75% and overall accuracy was 62% and the agreement rate was 0.171 (P=0.023).

The sensitivity and diagnostic power of Creatinine in preterm women was higher than βHCG. Reasonable price, simplicity, and safety are the advantages of both methods. The diagnostic accuracy obtained in this study was low, but due to the limited studies in preterm patients, the clinical use of these markers cannot be recommended or rejected; therefore, more studies are suggested.

Hydatidiform mole is one of the emergency risks in pregnancy that can threaten the life of women of childbearing age with risk of death. Various studies have reported different risk factors for this disease. One of these factors is nutritional deficiency, especially vitamin deficiencies, which can lead to this condition. Therefore, this study was performed with aim to systematic review of the relationship between the blood level of vitamins in women and hydatidiform mole.

In this systematic review study, for finding the related articles, the international databases such as: Web of Science, Scopus, PubMed and Embase, Google Scholar and national databases such as: MagIran, SID, IranDoc and IranMedex were evaluated using the keywords of: "Hydatidiform Mole", "Gestational Trophoblastic Disease", "Molar Pregnancy" and "Vitamin" which were combined with the OR and AND Boolean operators without time limitation. Finally, two researchers independently reviewed the articles for assessment of the quality (by using NOS checklist) and data extraction.

Finally, 10 articles were included with total sample size of 1134 women. The publication¢s year of papers was from 1988 to 2018 and all studies were case-control. The findings showed that level of vitamins A, D, E, C, B9 and B12 are associated with hydatidiform mole, so that decreasing of these vitamins leads to molar pregnancy. In most of the studies, there was decreased level of these vitamins in both complete and incomplete molar pregnancy.

Decreased level of vitamins A, D, E, C, B9 and B12 can increase the risk of molar pregnancy. Therefore, by examining and determining the nutritional deficiencies in women with history of molar pregnancy, we can evaluate the effect and administration of vitamin supplements on recurrence of hydatidiform mole can by designing clinical trials.

Preterm birth is one of the most important complications of pregnancy, which has a significant impact on the health and mortality of neonates, so early diagnosis and prediction is vital. This study was performed with aim to investigate the relationship between amniotic fluid alpha-fetoprotein (αFP), alkaline phosphatase (ALP) and ferritin in the second trimester of pregnancy and preterm birth. 
This cross-sectional analytical study was performed on 60 subjects with gestational age of 15-20 weeks (mean of 17 weeks) who had performed amniocentesis due to positive first-trimester screening from September 2014 to February 2015. The levels of αFP, ALP and ferritin were tested using spectrophotometric and ELISA method in freeze samples of 40 subjects with term birth and 20 subjects with preterm birth. Data were analyzed by SPSS software (version 22) and t-test and Chi-square test. P<0.05 was considered statistically significant.
The mean amniotic fluid αFP in term and preterm birth was 382.14 ± 96.44 and 547.47 ± 122.83(ng/ml), respectively; the mean ALP in term and preterm birth was 27.35 ± 13.01 and 74.45±15.51 (IU/ L), respectively; and the mean ferritin was 382.14 ± 96.44, and 547.47±122.83 (ng/ml), respectively. The level of all three markers was significantly higher in preterm birth than term birth (p < 0.001).
There is significant and positive relationship between amniotic fluid αFP, ALP and ferritin levels with preterm birth that may help to increase our understanding of the pathophysiology of preterm birth. According to the results, it is recommended to perform further research with larger sample sizes.

For many years, electrocardiogram have been used to diagnose fetal distress around childbirth. If the heart cells are damaged, troponin T is released. Few studies have been performed about the relationship between abnormality of fetal heart rate and troponin T. So, this study was performed with aim to determine the relationship between fetal distress and umbilical venous troponin T level (utTl). This case-control study was conducted on 80 neonates in Zanjan Ayatolah Mousavi hospital in 2016. The neonates were compared in two groups of 40 cases with Fetal heart rate abnormalities and control group. utTl was measured using a kit (Bioassay Technology biology) and Elisa technique with sensitivity of 2.54 ng / L. The demographic and obstetric information were recorded. Data were analyzed by SPSS software (version 22), and independent and paired t-test. P<0.05 was considered statistically significant. utTl of fetal distress group was 531.04 ± 499.55 ng/l and was significantly higher than control group (187.47 ± 59.66 ng/l) (p<0.001). utTl in the early deceleration was the lowest and in the variable deceleration was the highest, but it was not significantly different (p= 0.195). In neonates with abnormal fetal ECG, the troponin level of the umbilical cord blood was significantly higher, indicating that abnormalities of fetal heart rate during labor may cause neonatal heart damage.

The use of misoprostol and transcervical Foley catheter is an effective method in cervical ripening. According to the literature, there is a controversy surrounding the results of the comparison of these two methods and the combined method. This study was conducted to compare the individual and combined administration of misoprostol and transcervical Foley catheter in Ayatollah Mousavi Hospital, Zanjan, Iran, during 2013-14.
This randomized clinical trial was carried out among 85 nulliparous women with the gestational age of 40 weeks or more and the Bishop score of equal to or less than 4 with less than two contractions every 10 min. The subjects were randomly assigned into three groups of misoprostol (n=30), transcervical catheter (n=30), and combined (n=25). The misoprostol group received the maximum dose of 100 µg of misoprostol in equally divided doses every 4 h. A transcervical Foley catheter 18 F, inflated with 50 cc of normal saline was inserted into the cervices of the participants in the transcervical catheter group. Additionally, the combined group were simultaneously treated with both methods. The time interval between the intervention and the onset of labor, duration of the latent and active phases, and method of delivery (cesarean section or natural vaginal delivery), and the rates of neonatal and maternal complications were compared in these three groups. Data analysis was performed using the Chi-squared test and one-way analysis of variance in the SPSS software, version 22. The P-value less than 0.05 was considered statistically significant.
No significant difference was observed between the groups in terms of the method of delivery, duration of the active phase, meconium, fetal distress, chorioamnionitis, and uterine tachysystole (P>0.05). However, the duration of latent phase was significantly shorter in the combined group compared to the misoprostol group (P=0.002, P=0.001). The duration of the first phase of labor was significantly shorter in the combined group in comparison to the transcervical Foley catheter group (P=0.009).
Given the results, both methods were effective in cervical ripening; nevertheless, the combined method was more effective than using transcervical Foley catheter in shortening the duration of the first phase of labor.

Considering the importance of preeclampsia and its effect on hematologic indices, and also the studies showing the effect of lead as a toxic metal on these indices, the present study was performed with aim to investigate the correlation of serum lead with hematologic indices in women with preeclampsia with no occupational exposure to lead.
This correlation study was performed on 80 pregnant women with preeclampsia hospitalized in Zanjan Ayatolah Mousavi hospital in 2015. At entry to the study, 3.5 ml of venous blood samples were taken from participants to assess serum lead level and hematologic indices. Demographic and obstetric characteristics of participates were also recorded. Serum lead level was measured using potentiometric method with Ion3 device, and hematologic indices were analyzed with Symex device. Data were analyzed by SPSS software (version 22) and Chi-square and Pearson correlation test. P Mean serum lead level among 80 participants was 8.04±3.4µg/dl. Blood lead level showed a positive correlation with Platelet Distribution Weight (PDW: r=-0.300, P=0.17), and a negative and significant one with Platelet Large Cell Range (PLCR: r=-0.260, P=0.047). Blood lead level also showed positive significant relationship with BUN (BUN: r=0.377, P=0.001) and blood creatinine (Cr: r=0.288, P=0.012), but showed no relationship with other blood indices.
Blood lead affects on blood biomarkers, so it is recommended that strategies be planned and implemented for reducing exposure to environmental lead especially in pregnant women.