mohammad hossein baghianimoghadam

Some studies have shown that Socioeconomic Status (SES) is positively related to insulin resistance among different population groups, except for pregnant women. Therefore, we examined the relationship between SES and Homeostasis Model Assessment‑Insulin Resistance (HOMA‑IR) index as well as mediating variables.

This study was performed on 138 primiparous healthy women at 6–10 weeks of pregnancy. The association between SES and HOMA‑IR was analyzed by regression analysis, and mediating variables were determined by mediation analysis.

SES score was positively correlated with HOMA‑IR index [β </em>= 0.02, t</em>101 = 2.20, p </em>= 0.03, 95% CI: (0.00–0.05]. The higher percentage of mediation was related to maternal weigh (70.80%). Job activity had a protective effect on the association between SES and HOMA‑IR (‑62.50%). The total percentage of two mediators was 25%.

The positive relationship between SES and (HOMA‑IR) in early pregnancy may provide a way to control this condition. 

Follow‑up studies have shown an increased risk of thyroid dysfunction in individuals with normal serum thyroid‑stimulating hormone (TSH) levels. Furthermore, the possible consequences of minor differences in thyroid function (without achieving poor thyroid function) in the risk of weight gain during pregnancy are questionable, too. The production of TSH is under the hypothalamus–pituitary control, and food is one of the most effective environmental agents that control hypothalamic–pituitary– thyroid axis activity. Regarding the few available studies, we assessed the association of minor variations of TSH concentrations and nutritional status in the first trimester of pregnancy.

This cross‑sectional descriptive and analytical study was performed on 150 primiparous healthy women. Demographic and family characteristics were collected using a researcher‑administered questionnaire. Nutrients intake were extracted from a 72‑h recall, and physical activity scores were determined by the pregnancy physical activity scale.

The prepregnancy body mass index (BMI) (β =0.022, P = 0.004) and participants’ weight at 6–10 weeks of gestation (β =0.006, P = 0.024) were positively associated with TSH concentrations, while total physical activity score was negatively correlated (β = ‒0.006, P = 0.047). We did not find any significant association between TSH values and energy‑adjusted nutrients intake (P > 0.05).

We suggest that differences in TSH concentrations within normal range in the first trimester are correlated with gaining weight, physical activity level, and prepregnancy BMI. TSH concentration and consequently thyroid function may influence on gestational weight gain or vice versa.

Progressive insulin resistance (IR) is a physiologic state during pregnancy which could be ended to gestational diabetes. Given the relationship between weight and insulin resistance (IR), the study of the association between nutrients intake and insulin resistance is particularly rational and predictive.

The current descriptive cross-sectional study was performed on 138 nulliparous women with healthy and single pregnancies. Individual characteristics were collected by a researcher-administered questionnaire. At 6th</sup>-10th</sup> weeks of pregnancy, physical activity scores and nutrients intake were determined using the Pregnancy Physical Activity Questionnaire and 24-hour recall for three consecutive days, respectively. At the same time, fasting serum glucose and insulin levels were also measured to calculate IR by the formula.

Square root transformation of IR index at the first trimester was significantly correlated with household income, occupational activity, pre-pregnancy body mass index (BMI), weight, and physical activity at 6th</sup>-10th</sup> weeks of gestation. However, after adjusting the effect of related variables, household income and maternal weight were significantly associated with IR, and occupational activity had a trend toward the significant association. Moreover, vitamin D, linolenic acid, beta-carotene, vitamin E, and carbohydrate intake were significantly correlated with IR index. However, after adjusting for the related variables, vitamin E had a direct significant relationship with IR, and glucose and maltose intakes were inversely associated with IR.</div>

Significant association between household income and maternal weight at the first trimester can be used to control IR, which is a key component for gestational diabetes. The association of vitamin E, glucose, and maltose intakes with IR may be a guide to get new results. We suggest further studies about the association between occupational activity and insulin resistance in pregnant women.

Weight gain more than the recommended range by the Institute of Medicine (IOM) is one of the most common complications of pregnancy, which would be ended to gestational diabetes, preeclampsia, cesarean section, or maternal, and child obesity. Few successful studies in this area include nutrition and physical activity. We examined a simple, practical, and cost-effective solution as nutrition training based on the Pender’s model, because this is one of the most effective patterns for nutritional behavior.

This single-blind randomized controlled clinical trial study was performed on 192 nulliparous pregnant women. During training sessions, mothers of intervention group learned how to prevent excessive weight gain over healthy eating habits. Mothers’ weight, nutrients intake, and physical activity levels were estimated before, during, and after intervention.

The constructs of perceived benefits, perceived self-efficacy, behavior-related feelings, interpersonal influences, competing demands and preferences, and commitment to action increased significantly. In the intervention group, 58.6% gained weight within the recommended range compared to 50.0% in control group. Moreover, 28.7% in the intervention group versus 45.6% in the control gained weight more than the IOM limits while 12.6% in the intervention group and 4.4% in the control gained weight less (P = 0.020). The perceived self-efficacy and commitment to the plan constructs were associated with normal weight gaining.

Pender model-based nutrition education considering the national guideline prevented excessive gestational weight gain in pregnant women.

A great proportion of pregnant women gain weight above the recommendations of the Institute of Medicine (IOM), which is associated with adverse maternal and child health outcomes. We did not find any nutrition education intervention in this field and the available significant results are related to lifestyle trials. Thus, we examined the effect of a nutrition education intervention on gestational weight gain and adherence to IOM limits as the first study in this field. We surveyed the impact of the intervention on the birth anthropometric indices, as well.

192 pregnant mothers were recruited to this prospective randomized clinical trial from 15 health centers, five hospitals, and 15 private obstetrical offices in Isfahan. They were randomly divided into an intervention (n = 96) or a control (n = 96) group. Each woman met the same nutritionist at the time of enrollment for nutrition assessment and an individualized nutrition intervention plan was developed. Then, the nutrition education intervention including three 45 - 60 min training sessions at 6 - 10, 18, and 26 weeks of pregnancy was performed.

The proportion of excessive gestational weight gain (GWG) during pregnancy decreased in the interventional group (27.9% vs. 46.0%, P = 0.01). In addition, the mean of total GWG in the intervention group decreased significantly compared to the control group (13.11 ± 3.95 vs. 15.37 ± 5.16, P = 0.001). The nutrition education intervention did not decrease the mean of birth weight, length, and head circumference in the intervention group compared to the control group (P > 0.05).

Nutrition education considering the national comprehensive guidelines is effective to prevent excessive GWG and control GWG without adverse effects on the birth size.

Different types of nutrients in adequate amounts are required to meet the increased demands of the mother and the developing fetus. Therefore, we examined the impact of nutrition education on the number of food servings per day.

Pregnant mothers were recruited to a prospective, randomized clinical trial from May to September, 2016. At 6–10 weeks of gestation, the participants were randomly divided into the intervention (n = 96) or the control group (n = 96), and were followed‑up until the end of pregnancy. Each woman in the experimental group met the study nutritionist at the time of enrollment and an individualized nutrition plan was developed. In addition, the nutrition education based on Pender’s Health Promotion Model (HPM) was designed, including three 45–60 min training sessions in 6–10, 18, and 26 weeks of pregnancy. The participants’ usual food intake using a three‑day dietary record was assessed at 6–10 weeks and 34–36 weeks of gestation.

The mean scores of the perceived benefits, self‑efficacy, activity‑related affect, interpersonal influences (husband support), and commitment to action increased while the competing demand scores decreased in the interventional group compared with the control group. The mean standard deviation (SD) of food portions from grain [10.40 (1.96) versus 12.70 (1.93) in the control group], vegetable [3.88 (1.33) versus 2.96 (0.91)], fruit [4.02 (0.05) versus 3.95 (0.91)], dairy [2.33 (0.68) versus 2.11 (0.45)], and meat [3.17 (0.68) versus 2.96 (0.67)] were improved in the experimental group.

Pender’s HPM for nutrition education is effective based on the compliance of pregnant women to the dietary guideline and the food guide pyramid.

Thalassemia is regarded as a genetic hematologic disease that affects various aspects of patients’ life. Measuring the health-related quality of life is a multidimensional concept that focuses on the disease as well as its treatment.

This cross-sectional study consisted of 50 adolescents aged 12-18 years suffering from Thalassemia major, out of which 30 were females and 20 were males with the mean (±SD) age of 15.38(±2) years old. The present study was carried out applying the Kidscreen-27 health-related questionnaire.

There was no statistically significant difference between urban and rural patients’ scores (P-value=0.22). Comparison of quality of life amongst female and male patients indicated male patients'' better scores in regard with physical well-being, psychosocial well-being and the total score of quality of life compared to the females (P-value

The study findings revealed that there was neither a significant difference between urban and rural patients with thalassemia major, nor a relation between adolescent patients'' quality of life and their fathers’ education level. Nonetheless, male patients were demonstrated to have better quality of lifethan females.

Children are more risk‑prone group of the population and low birth weight (LBW) is the leading cause of newborns’ mortality and morbidity. LBW is defined as child’s birth weight lower than 2500 g. Many maternal and fetal factors are determined as risk factors of LBW. This study tries to detect related factors to LBW and effect of them on children’s growth pattern up to sixth month of life in Health centers of Urmia city, Iran.

A cross‑sectional study was carried out in Urmia city using registered data from mothers` documents. All related data such age and weight of infants, mothers’ age, gestational age (GA) at the time of delivery, time gap between two pregnancies, past history of abortion, prenatal care history, systemic and underlying diseases, hemoglobin of mothers during pregnancy, and pattern of infant’s growth up to sixth month of age were registered in a questionnaire. All registered data were transferred to SPSS 15 software and analyzed.

Mean ± SD of birth weight was 3071 ± 625.66 g. There was a significant relationship between birth weight and mother’s age (P < 0.001) and weight (P < 0.001). Children of mothers younger than 18 years had much birth weights. There was a significant relationship between birth weight and GA during delivery (P < 0.001). Children of preterm labor had lower birth weights. In twins, LBW was more prevalent (P < 0.001).

Our results show that LBW is related to multiple causes and that most of them are preventable with educational programs and also strict and regular prenatal care. Decreasing incidence of LBW children can be achieved by cooperation between different parts of health and clinical systems.