N Shakeri, F Eskandari, F Hajsheikholeslami, Aa Momenan, F Azizi,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: Although the population of elderly is increasing in Iran, few studies carried out on this group. The aim of this study was to identify life expectancy and contributory risk factors for the Tehranian elderly of ages above 60 years.
Methods: Individuals above 60 years old whom were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001 were followed up for 12 years and their vital status were registered (1998-2011). Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and by using Cox proportional hazard model the mean of survival time and hazard rates with respect to risk factors were estimated.
Results: Life expectancy for females and males after crossing 60 years of age reaches to 81 and 80 years, respectively without any statistically significant differences between these two groups. Cox model showed that diabetes, BMI>33Kg/m2 and non ischmecic heart disease reduced survival time in women significantly. While diabetes, smoking, hypertension, ischemic heart disease, history of MI, stroke or sudden death of father, brother or son, lack of physical activity and antihypertensive medications are among the hazardous risk factors for men.
Conclusion: Among the variables studied, only three (ABC) of them were found as risk factors of women's life, while for men seven risk factors were identified. It seems that more studies are needed to determine the risk factors for women.
A Khorshidi, K Sayehmiri, M Babanejad,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: Suicide has been recognized as a public health concern in all communities. Several factors are contributing to its incidence in developed and developing countries. Purpose of this study is to investigate seasonal patterns of suicide in Ilam province western Iran.
Methods: Data were recruited from a systematic registry of Ilam province between available from 2001–2009. Overall, 3873 suicides were recorded. According to month and season of suicide, data were analyzed using chi-square test and logistic regression.
Results: Among suicide attempters, a peak of suicide occurrence was observed in summer, especially in August. In general, 16% of suicides were completed. The risk of death (OR)due to suicide was significantly greater in winter and March compared to other seasons and months, respectively.
Conclusion: Suicide occurrence varies by month and season and seasonal-related factors such as psychological, environmental and social aspects should be considered for any prevention programs and strategies.
M Mohammady, N Toghian Chaharsougi , S Abdoli,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: Randomized controlled trials are the most reliable type of study to be able to compare different interventions in scientific research. The introduction of bias into the design and conduct of randomized controlled trials can seriously affect the accuracy of the results and led to the results be invalid. The aim of this study was to assess the bias in randomized controlled trials published in Iranian nursing and midwifery journals.
Methods: We searched all published articles in eight professional nursing and midwifery Iranian journals in 2010. Risk of bias in RCTs was assessed using of Cochrane group risk of bias standard tool by two reviewers independently.
Results: After reviewing the eight journals, 68 randomized controlled trials were retrieved. The majority of studies had unclear or high risk of bias. Random sequence generation in 22%, concealment allocation in 4.5%, blinding in 22%, incomplete outcome data in the 35.3%, selective outcome reporting in 51.5%, and other bias in 36.7% of the studies were in low risk of bias.
Conclusion: A large proportion of the studies had high or unclear risk of bias. It was considerable that none reporting bias led to uncertainty reader from study quality. Bias might significantly affect the internal validity of the studies results therefore in interpretation of the findings of these studies caution should be taken.
H Arazi, A Salehi,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: There have been several reports showing that the rate of anabolic-androgenic steroids abuse has increased in athlete and non-athlete adolescents. Therefore, the objective of this study was to assess, attitude and awareness of side-effects of these drugs in male bodybuilders.
Methods: 227 bodybuilders completed a tridimensional questionnaire that investigated demographic information, prevalence of anabolic-androgenic steroids (AAS) and attitude towards steroids abuse.
Results: Forty percent of participants (40.1%) of bodybuilders had used anabolic-androgenic steroids at least one time. The main reasons for taking this medication were strength, muscle mass, speed and endurance, respectively and 7.73% did not know the reason of using it. 32.6% of bodybuilders believed that anabolic steroids increased muscle size without exercise and without proper exercise and nutrition. The mean score of awareness and attitude of athletes who used these drugs were significantly higher than the athletes who did notuse (P=0.001). Athletes with Championship history were more aware regard to adverse effects of steroids than athletes with no history of championship.
Conclusion: The findings of this indicating that that abusing AAS seems to be increased and become a public health concern that implies the need to implement educational programs by health care professionals and sport specialists.
Hr Tolideie, J Hajavi,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: Asthma and allergic diseases remain among the most important health problem in different societies that affect childhood life. These diseases mostly seem to be occurred in children with family history positive. In this study, we aimed to evaluate the association between family history and the prevalence of allergic diseases in children in Gonabad.
Methods: A cross-sectional study was conducted in the city of Gonabad in 2011 year. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire were completed by 1627 students whom were selected by using multi-level sampling across city. The Chi-Square test was used for comparison of qualitative variables between two groups and Odds ratios (ORs) and 95% confidence intervals (CI) were calculated.
Results: Of the total (1627) participated students, 876 (53.8%) were boys and 751 (46.2%) were girls. Mean age of children was 14.5±1.8. Almost forty percent of children had at least one allergic symptom at sometime in their life and 48/1% had family history and 35/1% did not have family history (P<0.001). However, lifetime and 12-month prevalence of rhinitis symptoms, 12-month prevalence of rhino conjunctivitis and lifetime hay fever and eczema was significantly higher in students with positive family history than those with negative family history (P<0.05).
Conclusion: Our study shows that the prevalence of most allergic disorders was higher in children with positive family history. It seems that heredity plays a major role in the occurrence of allergic diseases in children.
P Bagheri, Aa Haghdoost, E Dortaj Rabori,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives: Nowadays, human values for example quality of life has important place to be considered as health index along with other measurements like morbidity and mortality indexes. This study intended to compare the quality of life for residents living in apartment’s flats more than 15 years with residents living in non-apartment housing in Shiraz.
Methods: The World Health Organization Quality of Life (WHOQOL_BREF) standard questionnaire was completed by participants. This population was chosen by a multi-stage sampling method in Shiraz city. Type of living accommodation, physical, psychological, social, and environmental health factors were adjusted in the linear model.
Results: The mean score of health aspects in people who lived in apartment vs non apartment living were: physical 13.57 and 16.41, psychological 10.71and 14.87, social 8.57and 13.84 and in environmental 13.59 and 10.18 respectively, however after adjustment for gender, education, marital status, age, job, family size, income, type of disease (chronic, acute, chronic- acute), possession of house and area of house, changed to 14.41 for physical and 15.61, psychological 12.6 and 14.47, social 8.74 and 13.72 and environmental 15.42 and 9.23 (P<0.0001).
Conclusion: The results of this study show that the health of apartment-living residents even after adjustment of some other influencing factors, in major of domains was less than non apartment-living residents which indicating this issue should be considered in urban-living health.
T Amiri Parsa, M Khademosharie, Mr Hamedinia, Ms Azarnive,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: Obesity is associated with increased resistance to insulin, hypertension, hyperlipidemia, hyperinsulinemia, and cardiovascular diseases. The purpose of this study was to investigate some factors associated with overweight and obesity among normal, overweight, and obese women aged 30 to 50 years from Sabzevar.
Methods: A questionnaire with 56 questions was prepared. The Beck questionnaire was used to measure the physical activity level. Weight, height, and waist circumference of the participants were measured using standard methods. Overweight (BMI ≥25 kg/m2), obesity (BMI ≥30 kg/m) and abdominal obesity (WHR ≥0.85) were also evaluated. MANOVA, Tukey post-hoc test, Pearson and Spearman correlation coefficients, Kruskal-Wallis and chi-square test were used for the statistical analysis of test variables. P ≤0.05 was considered significant.
Results: The results showed that 22.5% of women had normal weight, 42.4 percent were overweight, 31.6 percent were obese, and only 3.5 percent of women were underweight.
Conclusion: Our results showed that the prevalence of overweight and obesity was 74% in women living in Sabzevar, indicating the necessity of using educational methods to familiarize people, especially women, with weight control issues and prevention of obesity. The findings revealed that age, number of children, number of pregnancies, age at menarche, number of family members, working with the computer, and high-fat meals may increase the risk of obesity. Lifestyle modification and physical activity, as the most affordable and safest methods of preventing obesity, require more attention.
M Koosheshi, A Khosravi, M Sasani Pour , S Asadi,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: The recent researches on mortality in Iran in the past 3 decades have obviously emphasized cardiovascular diseases, unintentional injuries, and neoplasms as the most important causes of shortening Iranian’s lives. We investigated the role of these major causes on the mortality patterns in Fars in 2006.
Methods: The number of registered deaths by age and sex and the distribution of death by cause in Fars in 2006 were derived from the Death Register System of Ministry of Health (MoH). We used the 2006 census to obtain the information on the population exposed to death. The mortality of the people over 5 years of age was estimated and corrected using the Brass Growth Balance method. The mortality rate of the children under the age of 5 was estimated by indirect methods and the data were analyzed using the multi-decrement life table.
Results: Life expectancy was 70.3 years in Fars, about 69 years in males and 72 years in females, in 2006. The results showed that 3 main causes of death were responsible for reducing life expectancy of about 11 years in men and women in Fars. Detailed results revealed that cardiovascular diseases and unintentional injuries played more important roles in the decrease. Unintentional injuries plays more major role in decreasing life expectancy in males than females.
Conclusion: Special attention should be paid to the risk factors of cardiovascular diseases in both genders and unintentional injuries in males in Fars to reduce the mortality level and increase the life expectancy.
Mh Panahi , P Yavari, D Khalili, Y Mehrabi, F Hadaegh, F Azizi,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: We studied the risk of Chronic Kidney Disease (CKD), Metabolic Syndrome (MetS), and their interaction on the incidence of Coronary Heart Disease (CHD).
Methods: A population of 6568 participants (43.4% male) with a mean age of 48.4 years for males and 46.7 years for females and a median follow-up of 10.1 years was investigated. They were divided into 4 groups at baseline: CKD-/MetS-, CKD+/MetS-, CKD-/MetS+, CKD+/MetS+. Hazard Ratios (HRs) were calculated for each group and were compared to the first group using multivariate Cox regression analysis adjusted for age, education, smoking, total cholesterol, and the family history of cardiovascular diseases.
Results: Men with CKD (without MetS) showed an HR of 1.74 (CI 95%: 1.16-2.60) for CHD events. The measured value was 2.34 (1.77-3.08) for men with MetS (without CKD). The respective results were in women 1.18
(0.64-2.19) and 2.59 (1.73-3.88). CKD and MetS had a significant negative interaction with CHD events (HR=0.40, 0.24-0.66). The interaction was not significant in women (P value=0.48).
Conclusion: The results of this study indicated that CKD without MetS was a risk factor for coronary heart disease in men but not in women.
Mr Aflatoonian, I Sharifi, A Nadim, B Aflatoonian,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: Bam is one of the old CL centers and this study aimed to determine and compare the period prevalence among its population and housing units in two periods of 1990-92 and 2010-2012.
Methods: In this descriptive–analytical study, data were collected in the questionnaires through door-to-door visits environmental hygiene, and inquiring the history of the CL disease. A questionnaire was completed for each household, the data were analyzed using SPSS software and t- and X2 tests. P<0.05 was considered significant.
Results: The prevalence rates in the periods 1998-1999 and 2010-2012 were 10.3% and 2.1%, in the study population and 33.6% and 5.5% in the residential units in the period of the last 3 years, respectively with a very significant difference (P<0.0001). The environmental hygiene of the houses in terms of vector breeding was significantly lower in the period 1990-1992 than 2010-2012 (P<0.0001). The mean score of environmental hygiene was 11.5 and 16.6 out of 20 during the two periods, respectively.
Conclusion: According to the results of this study, urban CL is extremely reflective of the environmental changes and probably the best preventive measure is to improve the environmental hygienic conditions in and around the households. Public participation and commitment of the health authorities in this regard could be an important measure for planning preventive programs.
J Yazdani Cherati , E Ahmadi Baseri , M Saki, S Etemadinejad,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: Tuberculosis (TB) is one of the major infectious diseases in Iran and has pulmonary and extra-pulmonary manifestations. Considering the differences in the distribution of the cases across different regions, we decided to study the geographical distribution, epidemiologic characteristics, and disease pattern in Lorestan.
Methods: This ecologic (descriptive analytical) survey was done in Lorestan between 2002 and 2008. The data was collected from the Health Department of Lorestan University of Medical Sciences and included the history of 1481 patients suffering from TB. The study variables were sex, disease type, residential location, age, and year. The data were analyzed using statistical package SAS 9.2 and descriptive and inferential statistics were applied.
Results: From 1481 registered patients 58.4% were male and 41.6% were female among which 68.74% and 29.98% lived in urban and rural areas and 1.28% were nomads. The mean age of the patients was 41.87. The highest and lowest incidence rates were observed in Khoram Abad (19.38 per 100000) and Azna (7.04 per 100000), respectively. Using Poisson regression, it was observed that the effects of age structure and residency on the incidence rate were significant.
Conclusion: The percentage of nomads was identified as the most important demographic factor in the incidence rate of TB in Lorestan. Allocation of better resources and appropriate training can be effective in controlling and preventing the disease.
Mr Miri, Aa Ramazani, Gh Sharifzadeh, M Bahlgerdi,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: Smoking is a global problem and is the most important cause of death due to non- communicable diseases. This study was conducted to evaluate smoking and its correlates in male students in South Khorasan.
Methods: This descriptive-analytical study was undertaken in South Khorasan on high school male students. A sample of 2371 cases was selected through cluster multi stage sampling. The data was collected through a structured questionnaire and analyzed by SPSS software using chi-square and logistic regression tests.
Results: The prevalence of smoking was 12.3 per cent (285 cases).The most important motivating factors for smoking for the first time were curiosity, joy. The most important predictors of smoking were hookah consumption, the presence of a smoker in or outside the living place, and a negative attitude to smoking. Working father and education regarding smoking risks were preventive factors.
Conclusion: Special education and public awareness about the risks of smoking and establishment of consultation centers for adolescents can be major steps toward the prevention and control of smoking among students.
S Zaeri, S Asgharzadeh, M Zaeri, K Holakouie Naeini , A Rahimi Foroushani ,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: The world population is growing old. The rising proportion of the elderly is creating new health care challenges in the current century. This study aimed to determine the quality of life and the associated factors in the elderly population of Azerbaijan district in the city of Tehran, Iran.
Methods: This cross-sectional study was conducted on 287 elderly persons aged 60 and older. Participants were selected through systemic random sampling. The WHOQOL-BREF questionnaire, the Activities of Daily Living (ADL) questionnaire, and a questionnaire for demographic characteristics were used for data collection. Each domain was given a score between 0 to100 based on the WHO manual. The final variables were determined in a multivariate linear regression model using SPSS16.
Results: The mean score of the 4 domains of quality of life (physical, psychological, environmental, and social health) of the elderly population living in Azerbaijan district was 58.41, 53.13, 59.53, and 42.82, respectively.
Conclusion: A variety of correlates affect the quality of life of the elderly. Recognizing and considering these factors are important for planning more effective programs for the elderly and empowering them.
K Holakouie Naieni , S Hashemi Nazari , M Mahmoodi, M Shekari, A Madani,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: One of the major questions in epidemiological and social science researches is studying the relationship of the living place with social and health outcomes. In this study, we measured segregation indices for a number of important socioeconomic indices using the 2006 Iranian census data to find out whether residential segregation is correlated with the available differences in the health level in the subgroups of certain variables.
Methods: Twenty percent of the 2006 national census data was used for measuring segregation indices. Residential segregation indices were measured once for Hormozgan Province among its eleven cities and then for each city among theirs sections. Six segregation indices were measured. We used the common cut points for interpreting the values of dissimilarity index and information theory index.
Results: According to the dissimilarity and information theory index, the segregation of most of the variables in the province fell within the category of mild segregation. Segregation of the variables in some cities fell within the category of moderate, severe, and even extreme. Conclusion: The results indicated improper distribution of some of these variables in geographic units in some of the cities of Hormozgan Province. This information can help the authorities who are committed to implementing the health equity and social justice.
A Mahmoudlou, P Yavari, F Abolhasani, A Khosravi, R Ramazani,
Volume 9, Issue 4 (3-2014)
Abstract
Background and Objectives: Colorectal cancer, as the third common cancer, is one of the main health problems in Iran. We assessed the burden of colorectal cancer, as one of the high-priority indices, in this cross-sectional study in Iran in 2008.
Methods: CANMOD software was used for calculation. The input data included the population of Iran, all-cause and colorectal cancer mortality rates, and incidence rate of colorectal cancer, which were all obtained from the Iran Statistic Center, Mortality Registry System, and Cancer Registry System.
Results: The total burden of colorectal cancer according to DALY in Iran in 2008 was 52534 years in the total population. Years of lost life (YLL) amongst males and females were 26455 and 19887 years, respectively. Years lived with disability (YLD) were 3473 and 2719 years for males and females, respectively. The burden of colorectal cancer per 1000 population was 75.4 years for males and 65.7 years for females. The peak age of colorectal cancer burden rate was in the age group 45-79 years.
Conclusion: The burden of the colorectal cancer in Iran has increased compared to the last study (2003) which is due to the increase in its incidence and the related mortality during this period. Due to the possibility of prevention and effective intervention, this cancer should be a priority in the health care system. However, the final judgment should be made after calculation of the burden of other cancers, diseases, and damages at the country level and their respective rankings.
M Nazarzadeh, D Khalili, B Eshrati, F Hadaegh, F Azizi,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: The case-cohort study is one of the youngest designs in epidemiology and some methodological aspects of it are still in debate. This study aimed at comparing the estimated hazard ratio, standard error, and interaction hazard ratio between the case-cohort and cohort studies for assessing the relationship between diabetes and cardiovascular diseases.
Methods: A total of 1701 men and 2253 women aged between 40 and 75 years were considered as the main cohort. Subcohort sampling was performed using simple random sampling with a sampling fraction of 0.3%. The hazard ratio of the cohort study was calculated using Cox regression model and the 3 methods of Prentice, Self-Prentice, and Barlow were used for calculating the hazard ratio of the case-cohort study. The mentioned regression models were used to assess the interactions.
Results: The results of the two studies were similar in populations with higher incidence (cohort of men) and lower incidence (the cohort of women) when frequency percent of exposure variable was greater than 10%. When the sample size of the initial cohort was less than 1250 subjects, discrepancies were observed between the results of the two studies. In addition, the standard error of the case-cohort study was higher than the cohort study. The results of both studies were similar in assessing the considered interactions.
Conclusion: The results are similar when the initial cohort sample sizes are sufficient. Meanwhile, unlike the percentage of exposure frequency, the outcome incidence has a negligible impact on the discrepancy between the results while the effect of the relative frequency of the exposure levels on the results discrepancy is noticeable.
M Baniasadi, Mr Aflatoonian, R Rooholamini, B Aflatoonian, R Abbasi,
Volume 10, Issue 1 (6-2014)
Abstract
Background & Objectives: Breast cancer is the most common cancer among women. Numerous factors are effective in the improvement of patients undergoing surgery in terms of preventing relapse or need for repeated treatment during 6 months after the surgery. This study aimed to determine the factors affecting improvement of patients undergoing surgery for breast cancer using a logistic regression model.
Methods: In this study information of 150 patients were extracted from the surgical records of patients underwent surgery at the Cancer Institute of Tehran Imam Khomeini Hospital. Data were analyzed through SPSS software and using logistic regression models .
Results: Of 150 studied patients, 18 patients (12%) were not fully recovered while 132 (88%) had complete remission. The mean age of the patients was 43 ± 7.5 years, 92.8% were married, and 87.3% had children. According to the results, the odds of non recovery increased by 1.26 times with each one-year increase in age, 5.3 times with each one lymph node involvement, and 8.67 times in the case of metastasis. Other variables, such as marital status, number of children, tumor size, and location of the metastasis showed no significant relationship.
Conclusion : The Results showed that age at diagnosis, due to its relationship with metastases and number of involved lymph nodes can be directly or indirectly affect the outcome. Therefore, increasing the women's awareness about breast cancer seems to be necessary for early diagnosis which requires planning a sufficient screening program by health policy makers of the country.
Z Asadollahi, P Jafari, M Rezaeian,
Volume 10, Issue 1 (6-2014)
Abstract
Background & Objectives: Due to the increasing tendency to measure the quality of life in recent years and the extensive quality of life questionnaires, it is important to determine the appropriate method of analyzing data derived from these studies. The aim of the present study was to introduce ordinal logistic regression models as an appropriate method for analyzing the data of quality of life.
Methods: The data was derived from a cross-sectional study on quality of life survey of 938 students. For data analysis, two binary logistic regression models and ordinal logistic regression models were used and the results of these models were compared.
Results: The results of goodness of fit showed that all three models were fitted well. Based on the ordinal logistic regression models, the three variables out of the explanatory variables were statistically associated with the response while based on the binary logistic regression model, after combining two categories of response variable, only two variables were significant. Therefore, combining the categories of the response variable should be avoided as much as possible because it may lead to data loss due to ignoring some of the response categories.
Conclusion: It is concluded that to analyze quality of life data, due to the nature of the response variable, ordinal logistic regression models are recommended considering the fewer parameter estimates and easier interpretation of the results
M Kandi Kele , M Kadivar, H Zeraati, E Ahmadnezhad, K Holakoui Naini,
Volume 10, Issue 1 (6-2014)
Abstract
Background & Objectives : The length of stay (LOS) is a useful indicator that can be used according to the objective to improve hospital care performance. The purpose of our study was to find factors affecting infants LOS in NICU at Children's Medical Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, using the Cox multiple hazards regression model.
Methods : This historical cohort study reviewed 369 medical records of all NICU admitted newborns at Children's Medical Center in 2009. The required data were collected through a data collection form. The Cox multiple hazards regression model was used to determine the factors affecting LOS in infants who were discharged on the physician‘s order.
Results: The median of stay in NICU was 9 days. Of 369 infants, 272 were discharged with improvement. The results of multiple Cox proportional hazards regression model showed the following factors were associated with LOS in the NICU: prematurity, referral from other hospitals, gastrointestinal diseases and infections, central venous catheterization, mechanical ventilation, and antibiotic therapy (P < 0.05).
Conclusion : Cox proportional hazards regression model should be used when the dependent variable is time and we have censored data. Improving prenatal health care, constructing NICU in hospitals with high risk labor, reduction of preterm birth risk factors, and improving primary health-care services can help us to reduce LOS in NICU.
Mr Maracy, S Iranpour, A Esmaillzadeh, Ghr Kheirabadi,
Volume 10, Issue 1 (6-2014)
Abstract
Background & Objectives: Since the human diet is a combination of different foods and that this combination will affect the body differently from when these foods are received separately, the evaluation of dietary patterns is of great importance. The primary aim of this study was to examine the association between dietary patterns during pregnancy and postpartum depression.
Methods : This population-based, cross-sectional study was conducted on 771 women who attended the Ardabil's health care network. This study was carried out in a period of 4 months. In this study, systematic random sampling was used. Dietary data was collected using the Willett-format Dish-based 106 items Semi-quantitative Food Frequency Questionnaire (DS-FFQ) which was designed and validated specifically for Iranian adults. Dietary patterns were identified through exploratory factor analysis based on 34 predefined food groups. In the present study, individuals who obtained a rating of 13 or higher were considered to be suffering from postpartum depression. Logistic regression was used to estimate OR and 95% CI for postpartum depression in each quartile of patterns.
Results : In the present study, three dietary patterns were identified: mixed dietary pattern, semi-healthy dietary pattern, and fruits and vegetables dietary pattern. The last one was significantly associated with a reduced risk of postpartum depression.
Conclusion : The findings show that a diet of fruits and vegetables during pregnancy is associated with a reduction in the risk of PPD. Additional studies are recommended to confirm these finding.
