ABSTRACT
To determine the impact of a national intervention program on some pregnancy complications in Iran. This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- [of 3,978 and 3,958 pregnancies] and post- [3,958 pregnancies] measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants. The following pregnancy complications were reduced significantly as compared to before intervention: 1] bleeding or spotting, 2] urinary tract complications, 3] blurred vision and severe headache, 4] premature labor pain, 5] anemia, 6] severe vomiting, 7] inappropriate weight gain, 8] endometritis, 9] urinary incontinence, 10] breast abscess or mastitis, 11] wound infection, and 12] bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1] hypertension, 2] fever and chills, 3] convulsion, shock, and loss of consciousness, and 4] obstetric fistula. National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries
ABSTRACT
To evaluate predictive factors of adolescents' appraisal of their health. The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases [CASPIAN] study," was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self-rated health [SRH] and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH [beta = 0.08, P value = 0.003]. Smoking, violence, and family history of disease associated to SRH non-linearly [P value < 0.05]. Family smoking [beta = -0.01] and hygienic habits [beta = 0.27] related to SRH both linearly and non-linearly. Physical health and high risk behavior, either of linear or non-linear effect, are factors, which seem to shape the adolescents' perception of health