Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review

Menopause is associated with the onset of climacteric symptoms due to low estradiol levels, which may cause insufficient maturation of the vaginal mucosa. Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels, thereby restoring vaginal health. The objective of this systematic review, the first on this subject, was to investigate the effect of vitamin D on the vaginal health of menopausal women. PubMed, Embase, Scopus, Web of Science, and Google Scholar databases and reference lists of hand-searched articles were searched for published studies from February 2000 to November 2018. The selection criteria were as follows: randomized or quasi-randomized trials that compared the effects of vitamin D or related compounds, alone or with calcium, on vaginal health (growth and differentiation of epithelial cells, dryness, acidity [pH]) outcomes in menopausal women. The methodological quality of these studies was examined using the Cochrane tool checklist by two independent investigators, following which the data were extracted. Of six examined studies, two showed that vitamin D administration improved the growth and differentiation of vaginal epithelial cells, improved vaginal pH, and decreased vaginal dryness in menopausal women. Although the level of evidence for the effects of vitamin D on vaginal health is low in our study, we concluded that vitamin D may improve the vaginal health of women, especially during menopause.

Prediction of adequate prenatal care utilization based on the extended parallel process model

Background: Pregnancy complications are one of the major public health concerns. One of the main causes of preventable complications is the absence of or inadequate provision of prenatal care. The present study was conducted to investigate whether Extended Parallel Process Model's constructs can predict the utilization of prenatal care services

Methods: The present longitudinal prospective study was conducted on 192 pregnant women selected through the multi-stage sampling of health facilities in Qeshm, Hormozgan province, from April to June 2015. Participants were followed up from the first half of pregnancy until their childbirth to assess adequate or inadequate/non-utilization of prenatal care services. Data were collected using the structured Risk Behavior Diagnosis Scale. The analysis of the data was carried out in SPSS-22 using one-way ANOVA, linear regression and logistic regression analysis. The level of significance was set at 0.05

Results: Totally, 178 pregnant women with a mean age of 25.31+/-5.42 completed the study. Perceived self-efficacy [OR=25.23; P<0.001] and perceived susceptibility [OR=0.048; P<0.001] were two predictors of the intention to utilize prenatal care. Husband's occupation in the labor market [OR=0.43; P=0.02], unwanted pregnancy [OR=0.352; P<0.001], and the need to care for the minors or elderly at home [OR=0.35; P=0.045] were associated with lower odds of receiving prenatal care

Conclusion: The model showed that when perceived efficacy of the prenatal care services overcame the perceived threat, the likelihood of prenatal care usage will increase. This study identified some modifiable factors associated with prenatal care usage by women, providing key targets for appropriate clinical interventions

Comparison of lifestyle in fertile and infertile couples in Kermanshah during 2013

Infertility is a major reproductive health in gynecology. According to the world health organization, there are currently 50-80 million infertile couples in the world. Considering the critical effects of lifestyle on reproductive health, this study aimed to compare the lifestyle of fertile and infertile couples in Kermanshah during 2013. This research is a descriptive cross sectional study that was done on 216 fertile and infertile couples attending Infertility Center and six medical centers that were selected through the convenience sampling. Data were collected using a researcher-made questionnaire containing demographic and fertility-related information and also lifestyle items on nutrition, physical activity, perceived social support, responsibility for health, and inappropriate health behaviors. Descriptive statistics, logistic regression analysis, independent t, chi-square and Generalized Estimating equation were performed to analyze the data. Fertile and infertile women [86.1% and 73. 1% respectively, p= 0. 03] as well as fertile and infertile men were significantly different in terms of physical activity [87% and 96.3% p<0.001, respectively] and perceived social support [p<0.001]. Moreover, there was a significant difference between fertile and infertile women in nutrition [p<0.001]. Similar differences were observed in responsibility for health and inappropriate health behaviors between fertile and infertile men. However, all of the dimensions of lifestyle, except nutrition, were significantly different between fertile and infertile couples. As lifestyle plays a crucial role in reproductive health, the inappropriate lifestyle of infertile couples has to be modified through effective measures such as awareness promotion, behavioral changes, and development of a healthy environment

Awareness of pregnant women about folic acid supplementation in Iran

The purpose of this study was to determine the level of knowledge of folic acid supplementation amongst Iranian pregnant women. We selected 322 women through simple randomized method in a cross section study. Data was gathered on the base of questionnaire and interview. Statistical analysis was performed using SPSS software. The value of p<0.05 was considered as significant level. The obtained information revealed that 7.8% with high level of knowledge, 43.8% with intermediate level, 30.4% with low level knowledge, and 18% with no knowledge. Hospitals and health centers are two major sources for promoting popular awareness about folic acid. There is a significant relationship between the knowledge, education, employment, time of prenatal care beginning, age, gravidity, and sources of health information. The number of women with high level of knowledge was more among those with lower parity, higher level of education, employment, young age and looking for health information. Awareness of folic acid is low among Iranian women. The different strategies are required to elevate the knowledge about folic acid among the women in reproductive age and provide them with some information about the benefits of this supplement

pattern of folic acid intake in pregnant women referring to Fatemieh hospital in Hamadan [2005]

Half a million of newborns are annually born with neural tube defect around the world. Folic acid intake prevents neural tube defects in newborns significantly. Therefore, this study was performed to determine the pattern of folic acid intake during pregnancy. This descriptive-analytic study was performed using questionnaire and interview. Three hundred and twenty-two women who had terminated their pregnancies at Fatemieh hospital were participated in the study. The results showed that 81.4% of women had used folic acid during pregnancy. 23.9% of women took it from the first month of pregnancy and 16.4% after the third month. Most of women had taken it for more than three months. The lack of knowledge about Folic acid necessity [73.3%] was the main reason for the women who had not taken folic acid during pregnancy. Folic acid intake during pregnancy was significantly associated with education [P=0.004], employment [P=0.052], parity [P=0.000], the number of abortions [P=0.046], the number of newborns with neural tube defects [P=0.034]. Also, there was a significant relationship between the use of folic acid during pregnancy and planned pregnancies [P=0.006] and also prenatal care [P=0.047]. Although most of women had taken folic acid during pregnancy, the time of initiation was not right. Therefore, it seems that it is necessary to educate women about folic acid advantages and its usage