ABSTRACT
Background: This study evaluated the impact of body mass index [BMI], total calorie intake and physical activity [PA] as energy expenditure related factors on oxidative stress [OS] in follicular fluid [FF]
Materials and Methods: This prospective study conducted on 219 infertile women. We evaluated patients' BMI, total calorie intake and PA in their assisted reproduction treatment cycles. Malondialdehyde [MDA] and total antioxidant capacity [TAC] in pooled FF at oocyte retrieval were additionally assessed
Results: There was no relation between OS biomarkers to total calorie intake and PA. The TAC levels in FF adjusted for age, duration of infertility, etiology of infertility, number of used gonadotrophin and PA showed a positive relation to BMI [p=0.001]. The number of used gonadotrophin and PA had a negative relation to duration of infertility [p=0.03] and anovulation disorder as an etiology of infertility. The MDA level in FF had a positive association with anovulation disorder as the etiology of infertility [p=0.02]. MDA in FF was unaffected by BMI
Conclusion: Increasing age, BMI and PA do not affect OS in FF. In women with longtime infertility and those with anovulation disorder as an etiology of infertility, decreased potent antioxidant defense in the follicular microenvironment may contribute to ovarian function. Therefore antioxidant supplements may be beneficial for these groups of women
ABSTRACT
Objective[s]: Maternal mortality surveillance system has been functioning from 2000 in Iran. This system is implemented to reduce pregnancy-related deaths through illuminating the path that took the deceased mother to her death, identify preventable factors and devising and implementing intervention to resolve the problem and prevent similar death. To know executive personnel's attitude about this system and identify how can be improved by interview with experts
Methods: This study had two sections. at the first one[quantitative] a questionnaire developed which included phrases about 3 steps of maternal mortality surveillance system. Reliability and validity of the tools were tested. Then 104 head quarters and staffs completed it and data in Spss software were analyzed. In the second section [qualitative] we interviewed with 6 experts and health manager who had previous study in safe motherhood subject
Results: all 3 steps of system are moderately good in their opinion. Mean score in implementation of intervention [59 from 100] was lower than designing intervention [63 from 100] and information collection [67 from 100].The information collected is often insufficient to identify demographic data. Poor cooperation from the obstetrician due to lack of time, leads that death cases haven't been reviewed perfectly. Obstetrician isn't charge for maternal health in the provinces. Interventions should be done in high level of treatment team but because it is very difficult, it is focused on lower level of team such as health workers. Therefore interventions are not effective and they can't prevent avoidable factors
Conclusion: current forms and questions using in maternal mortality surveillance system in general is suitable. Some suggestions for improvement are these: - Demographic and socioeconomic information [father's name, ID number, literature and socioeconomic level of deceased woman and her husband] should be added in the forms as check mark or optional questions to evaluate relation of social factors and maternal deaths.- In educational and treatment deputies a job vacancy as in charge of maternal mortality be added- Considering these items in faculty members promotion are recommended: [attending in questionnaire team and active attendance in mortality committee]- Considering the implementation of intervention in hospital annual evaluation score.- Using the national clinical guidelines by the providers to prevent mismanagements or faults