Maternal-Neonatal Attachment in Intended and Unintended Pregnancies during the First 24 Hours after Childbirth.

Introduction: Women's physical and mental health and their mortality at reproductive age depend on fertility behaviors, delivery, and its complications. Unintended pregnancy is a risk to the life of women at reproductive age. The present study aimed to compare maternal and neonatal attachment in intended and unintended pregnancies after the mother and baby skin-to-skin contact immediately after delivery (first hour) and 24 hours after that. Methods: This analytical case-control study was performed on 140 women who gave birth in the hospitals affiliated to Shiraz University of Medical Sciences, Iran. The subjects were categorized into groups of intended and unintended pregnancy. Skin-to-skin contact of the mother and baby was done for 15 minutes in the recovery room at the first hour and 24 hours after birth. Then, the Avant's questionnaire of mother-infant attachment behaviors was completed. Data were analyzed using SPSS ver.13. Results: The mean (SD) attachment score in the first hours in intended pregnancy was 84.22 (12.59), which was higher than that in unintended pregnancy 74.28 (15.81), indicating a significant difference. However, after 24 hours of delivery, there was no significant difference between the two groups. During the first hours after delivery, there was a significant difference in the total score of the emotional behaviors and care between the two groups. Conclusion: Maternal and infant skin contact during lactation increased attachment after 24 hours in unintended pregnancy, while in the first hours after delivery, attachment decreased in these pregnancies.

Comparison of Maternal-Infant Attachment in Cesarean Delivery Based on Robson Classification: A Cross-Sectional Study.

BACKGROUND: The Robson criteria allows for standardized comparisons of data and possible driving changes in Cesarean Section (C/S) rates and complications. The aimed to compare maternal-infant attachment in C/S based on Robson Classification. MATERIALS AND METHODS: This cross-sectional prospective study was conducted on 369 women who had undergone C/S in Hazrate Zeinab Peace Be Upon Him (PBUH), Hafez, and Shooshtari hospitals affiliated to Shiraz University of Medical Sciences, Iran from April 2018 to March 2019. The study data were collected using a demographic form, an obstetric form, and Avant Checklist (AC) at postpartum and pre-discharge stages. Each participant was placed in Robson classification and the attachment score was calculated in each Robson Classification, and a comparison was made among the 10 groups. The data were analyzed into the SPSS 16 software and using descriptive statistics and paired t test. RESULTS: The total mean (SD) score of attachment was 38.73 (18.65) at 1-7 h postpartum and 90.52 (23.79) at pre-discharge. The highest total mean (SD) score of attachment was observed in group 6 (86.78 (8.70) at postpartum and 118.67 (4.47) at pre-discharge). The lowest total mean (SD) score of attachment was observed in group 10 (12.79 (2.37) at 1-7 h postpartum and 45.44 (7.99) at pre-discharge). CONCLUSIONS: Obstetric characteristics in Robson Classification, parity, previous C/S, gestational age, onset of labor, fetal presentation, and number of fetuses were effective in clarifying information. The use of this system is necessary to determine the causes of increased C/S cases in low-income and middle-income countries.

The impact of education on attachment skills in the promotion of happiness among women with unplanned pregnancy.

BACKGROUND: Happiness is among the factors that promote mental health in mothers with unplanned pregnancy. The present study aimed to determine the impact of attachment skills training on happiness among women with unplanned pregnancy. MATERIALS AND METHODS: This clinical trial was conducted on 84 women with unplanned pregnancy referred to three prenatal clinics in Shiraz in 2018. The participants were randomly divided into an intervention group and a control group using permutation block. At first, the participants were requested to sign written informed consent form, demographic information form, and mental health questionnaire. Then, they were asked to complete Oxford Happiness Questionnaire and Cranley's Maternal-Fetal Attachment Scale. The intervention group received attachment training through six 90-min sessions, while the control group underwent the hospital's routine care. The two groups were required to fill out the study questionnaires once more after 4 weeks after the intervention. After all, the data were analyzed using Chi-square test, Fisher's exact test, independent t-test, and ANOVA. RESULTS: There was a significant difference between the two groups' pretest and posttest mean scores of happiness (P = 0.0001). The results showed that in the experimental group, pretraining and posttraining period mean scores were 89.64 (7.2) and 93.13 (6.09), respectively; while in the control group, pretraining and posttraining period mean scores were, respectively, 91.69 (9.96) and 91 (8.82). The difference between the two groups was statistically significant. No significant relationship was observed between happiness and the couples' occupations, number of pregnancies, and number of miscarriages in the two groups (P > 0.05). CONCLUSION: The mean score of happiness increased after the training, being significantly different from that in the control group. Therefore, happiness is a changeable feature that can be promoted among pregnant women via interventional methods.

The Effect of Lactofem Oral Probiotic Capsule on Lactobacilli Colonization and Some Vaginal Health Parameters.

BACKGROUND AND OBJECTIVE: Healthy vaginal ecosystem is conserved with the connection of vaginal epithelium and flora in which lactobacilli play a significant role. The present study aimed to examine the effect of lactofem oral probiotic capsule on Lactobacillus colonization and some other vaginal health indices in women aged 18-55 years. MATERIALS AND METHODS: This interventional, double-blind controlled clinical trial was conducted on 70 women with Nugent score = 4-6 and vaginal pH >4.5. The participants were divided into an oral probiotic group and a control group. The oral probiotic group was required to take one 500 mg lactofem capsule daily for 2 months, while placebo was prescribed for the control group. Samples from 6 visits were examined during the period of prescription. The data were analyzed using the SPSS statistical software, version 18. RESULTS: The results showed no significant difference in the average colonization of vaginal Lactobacillus in the 2 groups before and during the intervention (p = 0.26). Also, no significant difference was observed in the 2 groups' Nugent mean scores before and after the intervention up to the 60th day. However, a statistically significant difference was found in this regard on the 70th day (p = 0.032). Moreover, the results indicated no significant difference in the 2 groups' mean vaginal pH before and after the intervention (p = 0.101). CONCLUSION: Lactofem oral capsule could improve the participants' Nugent scores, but caused no change in Lactobacillus colonization or vaginal pH.

Comparison of the Effect of Massage Therapy and Isometric Exercises on Primary Dysmenorrhea: A Randomized Controlled Clinical Trial.

STUDY OBJECTIVE: Dysmenorrhea is the most common cyclic pelvic pain, and it affects the quality of life of many women. We sought to compare the effects of massage and isometric exercises on primary dysmenorrhea. DESIGN, SETTING, AND PARTICIPANTS: We conducted a randomized controlled trial at the dormitories of Shiraz University among 102 students with primary dysmenorrheal. INTERVENTIONS: The student groups were randomly divided into massage, isometric exercises, and control groups. The first group received 2 consecutive cycles of effleurage massage with lavender oil. The second group had 8 weeks of isometric exercises. No intervention was performed for the control group. MAIN OUTCOME MEASUREMENTS: Pain intensity was measured and recorded by using a visual analog scale. In addition, the duration of pain was measured in hours, and Spielberger's questionnaire was used to measure the anxiety level. RESULTS: Pain intensity had significantly reduced in the massage and exercises groups; the reduction was more significant in the massage group (P < .001). The results revealed a significant difference among the 3 groups in regard to the mean duration of pain after the third cycle (P = .006). However, no significant difference was found among the 3 groups concerning the mean level of anxiety. The results of intragroup comparisons only showed a significant reduction of anxiety level in the massage group after the third cycle (P = .017). CONCLUSION: Based on the present findings, it seems that massage therapy and isometric exercises were effective in reducing some symptoms of dysmenorrhea.

The effect of education on sexual health of women with hypoactive sexual desire disorder: a randomized controlled trial.

BACKGROUND: Sexuality constitutes an important part of women's life. Healthy and proper sexual functioning is one of the signs of physical and mental health. The present study aimed to identify the effect of education on sexual health of women with hypoactive sexual desire disorder. METHODS: In this randomized clinical trial, 80 married women at reproductive age were randomly divided into a control and an education group. These women participated in this study based on self-reporting of having hypoactive sexual desire disorder. After six weekly educational sessions regarding sexual health, percentage of changes in sexual desire was assayed using Hurlbert index of sexual desire. Independent and paired t-test and Chi-square test were used to analyze the data. RESULTS: After the intervention, a significant difference was found between the two groups regarding the sexual desire score (P<0.001). The results also showed a significant difference within groups in this regard (P<0.001). CONCLUSION: According to the results of this study, it seems that educational intervention regarding sexual health was effective for the women with hypoactive sexual desire disorder. Thus, establishing sexual health education units in different health centers is highly necessary. These centers can help couples to promote their sexual knowledge and treat their sexual dysfunctions. TRIAL REGISTRATION NUMBER: IRCT2012101911032N2.

The Effect of Omega-3 Fatty Acid Supplementation on Maternal Depression during Pregnancy: A Double Blind Randomized Controlled Clinical Trial.

BACKGROUND: Depression is one of the most debilitating disorders during pregnancy and its recovery and treatment are among the concerns of obstetrics and gynecology experts. The present study aimed to determine the effect of omega-3 supplement on mild depression during pregnancy among primiparous women. METHOD: In this double-blind clinical trial, 80 primiparous women were randomly divided into 2 groups of omega-3 and placebo. The experimental group received 1 g omega-3 capsules for 6 weeks. The study data were collected by completing Beck Depression Inventory before and 6 weeks after the intervention. RESULTS: The results revealed a significant difference between the two groups regarding the mean score of depression before and after the intervention (P<0.001). Besides, the mean difference of depression score before and after the intervention was significantly higher in the omega-3 group (P<0.001). CONCLUSION: Considering the study results, using omega-3 supplement is a suitable method for recovery from mild depression during pregnancy with no complications for mothers and infants.  TRIAL REGISTRATION NUMBER: IRCT2012121011717.

Comparison of the effect of aromatherapy with Jasminum officinale and Salvia officinale on pain severity and labor outcome in nulliparous women.

BACKGROUND: Using non-pharmacological pain relief methods for reducing labor pain has always been one of the major concerns in obstetrics and gynecology. OBJECTIVE: Comparing the effects of aromatherapy with jasmine and salvia on pain severity and labor outcome in nulliparous women. MATERIALS AND METHODS: In this randomized clinical trial, 156 nulliparous women in labor were randomly selected and divided into salvia, jasmine, and control groups (52 in each group). The study duration was 6 months (from October 2009 to March 2010). Each group underwent aromatherapy using an incense mask for 15 min (distilled water for the control group). Pain severity was measured before and 30 and 60 min after the incense aromatherapy. Also, duration of the first and second stages of labor, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type were measured and recorded in each group. RESULTS: In comparison to the other groups, pain severity and duration of the first and second stages of labor were significantly lower in the aromatherapy group of salvia 30 min after the intervention (P = 0.001). However, no significant difference was found among the three groups regarding pain severity 60 min after the aromatherapy, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type. CONCLUSIONS: The results of the present study indicated that aromatherapy with saliva had beneficial effects on pain relief, shortened the labor stages, and had no negative impact on the baby's APGAR score.