Perceived Psychological Traumatic Childbirth in Iranian Mothers: Diagnostic Value of Coping Strategies

OBJECTIVES: The aim of this study was to investigate the diagnostic value of a stress coping scale for predicting perceived psychological traumatic childbirth in mothers. METHODS: This cross-sectional study was performed on 400 new mothers (within 48 hours of childbirth). Psychological traumatic childbirth was evaluated using the 4 diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders. Coping was measured using Moss and Billings' Stress Coping Strategies Scale. RESULTS: The overall mean score of stress coping was 29 ± 14.2. There were 193 (43.8%) mothers that had experienced a psychological traumatic childbirth. A stress coping score ≤ 30, with a sensitivity of 90.16 (95% CI = 85.1–94.0), and a specificity of 87.44 (95% CI = 82.1–91.6), was determined as a predictor of psychological traumatic childbirth. So that among mothers with stress coping scores ≤ 30, 87% had experienced a psychological traumatic childbirth. CONCLUSION: Investigating the degree of coping with stress can be used as an accurate diagnostic tool for psychological traumatic childbirth. It is recommended that during pregnancy, problem-solving and stress management training programs be used as psychological interventions for mothers with low levels of stress control. This will ensure that they can better cope with traumatic childbirth and post-traumatic stress in the postpartum stage.

Quality of life and its related factors in infertile couples

Health related quality of life [QoL] has now been considered as a main tool for outcome measurement in infertility. The present study aimed to determine the association be-tween general and specified QoL with different psychological aspects of self-esteem, social sup-port, sexual satisfaction, and marital satisfaction in a sample of Iranian infertile couples. This cross-sectional study was conducted on 385 infertile couples referred to the Fatemieh Hospital in Hamadan City, western Iran in 2012.To measure the self-esteem, the Iseng test was used. The social support scaling developed by Cassidy and Long was used for as-sessment of social support. The sexual satisfaction was also assessed by the Lindaberg ques-tionnaire. For assessing the general QoL state, the WHO-QoL-BREF and FertiQoL tools were employed. Self-esteem scores were lower in the couples with longer infertility duration. The social support mean score was lower in low income couples. Those with higher educational level, shorter infertility duration, and higher income were more satisfied from their marital relationships. Besides, we revealed that the previous failed efforts for treatment of infertility were adversely associated with the lower social support and sexual satisfaction. The higher educational level, higher monthly income, living in urban area, shorter duration of marriage and infertility, and male gender were associated with better QoL status in the most components. Associations between QoL and self-esteem, social support, sexual satisfaction, and marital satisfaction were significant [P<0.05]. The QoL status in infertile couples is directly associated with their self-esteem, social support, sexual satisfaction, and marital satisfaction.

[Maternal Quality of life in women with wanted and unwanted pregnancy: a longitudinal study]

Introduction: Unwanted pregnancy imposes great psychological pressure on women.The aim of this paper is to compare quality of life of in women withwanted andunwanted pregnancy, from 3rd trimester of pregnancy to postpartum

Methods and materials: This longitudinal study was conducted in 10 urban health centers of Shahroud city, in 2010. There were 43 women with unwanted pregnancy among 358 pregnant women. In order to exclude the selection bias, all pregnant women were included in the study. Inclusion criteria were being in the third trimester of pregnancy and giving birth to a healthy baby. Exclusion criteria were fetal or infant death during the period of the study. WHO-Quality of life questionnaire was filled out in the third trimester of pregnancy and 8 weeks after delivery. Statistical analysis was done by SPSS version 18 using mann witney-u, wilcoxon, chi-square and multiple regression analysis

Results: Although there was no significant difference between the scores of QOL of women with wanted and unwanted pregnancy in third trimester of pregnancy, women with unwanted pregnancy had lower score in perceived overall health [p=0.03] and social domain [p=0.042] than wanted pregnancy group in postpartum periods. Also, means of scores of physical and social domains of QOL in women with wanted pregnancy has improved from pregnancy to postpartum while there was no change in unwanted group and even their perceived overall health declined in the postpartum [p=0.009]. Multiple regression analyses showed that unwanted pregnancy was a predictor of maternal QOL in postpartum.[]

Conclusion: Designing interventions to improve QOL of women with unwanted pregnancy is recommended

[Pre marriage relationship: perspectives of male students]

Objective [s]: The objective of this study was to investigate on pre-marriage relationship between young adolescents from male students' perspectives

Method: This was a qualitative study of a sample of 20 male students. Focus group discussions were conducted to collect data. Content analysis was performed to explore the data

Results: Three themes emerged from the analysis: motivation for pre-marriage relationship; facilitating and preventive sexual behaviors, reproductive health needs

Conclusion: Larger scale studies are needed to understand the topic more fully. However, as indicated by young male students there are different reasons for pre-marriage relationship between girls and boys. Such data could contribute to implementing more reproductive health orientated interventions in order to improve adolescents' health

Assessment of questionnaires measuring quality of life in infertile couples; a systematic review

Infertility has potentially inappropriate effects on quality of life in infertile couples. Various general and specific questionnaires have been structured for assessing different aspects of quality of life in infertile men, women, or couples. The present systematic review was designed to assess these questionnaires and also identify different factors affecting infertile couples based on the aforesaid questionnaires. The research strategy involved general and specific terms in relation to couples's infertility and their quality of life. A review was done for studies published from 1982 to 2012 that were indexed in Medline, ISI Web of Science and Scopus as well as abstract books on this subject. We also corresponded with the authors of the references in related studies for introducing more resources and references. In all reviewed studies, different aspects of the quality of life in couples were evaluated including sexual, psychological, social, communicational, environmental, occupational, medical, as well as economical ones. In total, after initial screening of all studies, 10 general and 2 specific questionnaires were retrieved. Although no meta-analysis was found in the review, infertility had a negative effect on quality of life in couples. This study revealed that some general questionnaires such as SF-36 and WHO-QOL were mostly used for assessing quality of life in infertile couples and some specific questionnaires such as FERTI-QoL and Fertility Problem Inventory were rarely used. Thus, it seems that the evaluation of quality of life in infertile couples needs valid instruments for measurement

Quality of life after cesarean and vaginal delivery

Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery. This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum. In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65 +/- 12.7 and 72.12 +/- 11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group [p<0.05]. In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical [R[2]=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350]] and social [R[2]=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023]] domains of QOL and the global QOL score [R[2]=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]]. While multiparas, there was no relationship between QOL and type of delivery. In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery