Search published articles
Volume 59, Issue 6 (11-2001)
Hyperbilirubinemia is one of the common and major problems during neonatal period. Our propose was to determine the etiologic and predisposing factor in neonatal hyperbilirubinemia. We analyzed the patients record of 312 neonate including 184 male and 128 female with median age of 16.5 days (range 6-28 days) in children medical center hospital at 1998. The main cause of hyperbilirubinemia in our study was breast feeding (76.6 percent), followed by sepsis (11.5 percent) and hypothyroidism (10.6 percent). Also other uncommon etiology of hyperbilirubinemia that were seen in our patients were TORCH, G6PD deficiency and cephalhematoma. The age of 60 out of our patients (19.2 percent) was 6 days and others were 7 days (15.7 percent), 8 days (14.4 percent) and only 2 out of 312 patients were at age of 28 days. According to our study we suggest that role of breast-feeding should be considered in any neonate with hyperbilirubinemia.
Volume 64, Issue 4 (7-2006)
Background: The aim of the study was to investigate associations between maternal characteristics, with emphasis on hematological status, and risk of low birth weight and preterm delivery among pregnant women
Methods: In a cohort study, 1,500 pregnant women attending Hazrat Zaynab Hospital for prenatal care and delivery in the period 2000-2001, without any risk factors for preterm delivery and low birth weight were included. Maternal characteristics including hematocrit values were recorded at the first antenatal visit. Main outcome measures included birth weight and gestation at delivery. Linear and logistic regression models were used to analyze data.
Results: Severe anemia (hematocrit< 24%) was associated with a significantly increased risk of low birth weight (<2500 g) and preterm delivery (< 37 weeks gestation). High hematocrit values (> 40%) did not increase the risk of low birth weight and preterm delivery. Teenagers, women with short height or low body mass index had significantly higher risk of delivering low birth weight infants.
Conclusion.: Severe maternal anemia, particularly in the first trimester, was significantly associated with adverse pregnancy outcome. Low maternal age, height or body mass index also increased the risk of low birth weight. Improved nutritional status of young women could contribute to improved health among their infant.
Volume 65, Issue 2 (3-2008)
Background: Preterm labor is defined as delivery before 37 weeks of gestation. Recurrence of preterm labor in future pregnancies is 6-8%. History of preterm labor is a strong risk factor for future preterm labor. Preterm labor is the leading cause of neonatal mortality in developed countries, but permanent morbidity in these premature neonates has many side effects for the newborn as well as their family members and society. For this reason we conducted a survey to identify risk factors for recurrent preterm delivery among primiparous women with previous preterm delivery.
Methods: This prospective case–control study included patients from three university hospitals, namely Imam Khomeini, Shariati and Mirza Koochakkhan Hospitals, all in Tehran, Iran. Subjects, including 539 primiparous women who delivered preterm (22–36 weeks), were divided into two groups: 47 had a second preterm delivery (study group) and 492 had first preterm delivery (control group). Exclusion criteria were induced preterm delivery due to medical indications in mother and primigravid. Data collection and analysis was performed using SPSS 10 and t-test and χ2 test were used to analyze the significance of the results.
Results: From a total of 6,537 deliveries, we found 539 cases of preterm delivery, among which 47 cases were identified as recurrent preterm delivery. The control group was composed of 492 deliveries. The recurrence of preterm delivery was 8.7%. Uterine anomaly, cardiovascular, renal and thyroid disease in mother and blood group A had a significant correlation with recurrent preterm delivery.
Conclusion: Expectant mothers with uterine anomalies, cardiovascular, renal or thyroid diseases or group A blood type should receive extra care, observation and instructions in order to limit the risk of preterm delivery and its subsequent effects.
Volume 65, Issue 7 (10-2007)
Background: Over the past two decades we have seen a marked increase in the survival of very low birth weight infants. This increase in survival has been attributed to increased use of corticosteroids, regionalization of perinatal care, improved methods of mechanical ventilation, availability of exogenous surfactant, and improved nutritional therapy. However, the reduction in mortality has not been accompanied by a reduction in neonatal morbidity or long-term handicaps. Preterm labor is a major issue in Iran. Besides various etiologies, preterm labor may be due to a biochemical alteration, such as magnesium. It is known that magnesium plasma levels fall during pregnancy. Since magnesium has an inhibitory role on myometrial contractions attention has been paid to the role of magnesium deficiency in preterm labor. Hypomagnesemia leads to neuromuscular hyperexcitability resulting in muscle cramps and uterine hyperactivity. The aim of this study was to determine the relationship between serum magnesium levels and preterm delivery in order to circumvent the high morbidity of preterm delivery by early diagnosis of this deficiency.
Methods: Serum magnesium was measured in 42 cases of preterm labor of idiopathic etiology (28-37 weeks) and 42 normal pregnancies at the same gestational age.
Results: Hypomagnesemia was variable in preterm labor cases, with only slightly low values in normal pregnant women.
Conclusion: Our study indicates that serum magnesium levels during pregnancy can be a valuable predictive tool for preterm labor. Hypomagnesemia must be considered in all pregnant women with preterm labor and supplementation must be provided effectively.
Volume 66, Issue 10 (1-2009)
Background: Tumor cells need food and oxygen supply for growth and division. Therefore one of the most promising areas of cancer therapy focuses on using agents that inhibit tumor angiogenesis. Inhibition of angiogenesis prevents cell growth, division and metastasis. Previous studies showed that plasminogen related Protein-B has an anti-tumor activity in mice. This protein has a high level of homology with preactivation Peptide (PAP) of human plasminogen. According to this high homology, antiangiogeneic activity of PAP was investigated in an in vitro angiogenesis model.
Methods: PAP encoding region of human plasminogen gene was isolated by Polymerase Chain Reaction and cloned in pGEX-2T vector. This plasmid was expressed in Escherichia coli as a fusion protein (GST-PAP). GST-PAP was expressed as inclusion body and purified by affinity chromatography on GSH-sepharose resin after refolding. antiangiogenic effects of purified protein were surveyed with Matrigel assay.
Results: The GST-PAP was expressed and purified and its accuracy was confirmed by SDS-PAGE analysis and immunoblotting. Microscopic studies showed that GST-PAP inhibited angiogenesis in Matrigel system which is shown by shrinking the length of capillary like structures and a decrease in the number of tubule. While applying concentarations of 25μg/ml of GST-PAP and concentrations above that, antiangiogenic activity of GST-PAP was significant comparing to the controls.
Conclusion: Finding shows that GST-PAP can inhibit network formation in Matrigel system. This findings support the theory that PAP is a potent angiogenesis inhibitor.
Volume 67, Issue 3 (6-2009)
Normal
0
false
false
false
EN-GB
X-NONE
AR-SA
MicrosoftInternetExplorer4
B ackground: Preterm birth which is
defined as delivery before 37 completed weeks was implicated in approximately two
thirds of neonatal death. Also preterm labors are the most common cause of
mortality and morbidity of infants in recent years and it costs high prices for
health system. We evaluate the relationship between prepregnancy maternal body
mass Index (BMI) and spontaneous and indicated preterm birth.
Methods: This study included 250 healthy pregnant
women, without any risk factors of preterm birth, were classified into
categories that were based on their body mass index. Association between BMI, weight gain and rout
of delivery were examined. Rates of indicated and spontaneous preterm birth
were compared.
Results: Obese women delivered
at a more advanced gestational age. (38/34±1/66 weeks vs 37/61±2/44, p=0/006). Obese patients had
significantly lower incidence of spontaneous preterm birth at < 37 weeks of gestation (16/8% vs 31/2% p=0/008). Obese women had
larger infants (3354/95±596/75 vs 311.24±558/357 p=0/001), and had more
frequent cesarean delivery (69/6% vs 52/8%, p=0/006). Weight gain during
pregnancy is poorly correlated with prepregnancy BMI (14/41±7/93 kg vs 13/78±4/94kg, p=0/4) and preterm birth.
Conclusion: In
this survey, there was adverse correlation between body mass index (BMI) before
pregnancy and preterm labor less than 37 completed weeks and we suggest more study for
evaluation between spontaneous and induced preterm labor mechanism and in obese and non obese women. However according to
this survey obesity before pregnancy is associated with a lower rate of
spontaneous preterm birth.
Volume 67, Issue 6 (9-2009)
Background: Cerebral palsy (CP) is a group of nonprogressive motor impairment syndromes with potentially different risk factors and causal pathways which is caused by damage in the very young brain. The etiology of CP is mostly unknown and the prevalence has not decreased in comparison to past decades, although many advances have occurred in obstetric and neonatal care. In fact, it seems that the prevalence might have even increased in term infants. The aim of this study was the evaluation of cerebral palsy risk factors in Iran to compare them with other countries.
Methods: In this case-control study, all one to six years old children who were referred to a rehabilitation center from Shahid Beheshti child-health-care centers during the years 2007–2008, with documented cerebral palsy for evaluation of perinatal and neonatal risk factors were enrolled in the study, with matched controls.
Results: 112 in the case and 113 in the control group were studied. The main factors associated with CP, were: preterm delivery, neonatal and postnatal seizures, Apgar score of zero to three at twentieth minute after birth, low birth weight, and multiple gestations. The majority of infants with CP were born at term and only 37.8% before 37 weeks.
Conclusions: Preterm birth, hypoxic-ischemic encephalopathy and low birth weight were the independent predictors of CP in this population.
Volume 67, Issue 11 (2-2010)
Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Preterm delivery is a relevant public health problem since it is an important factor determinant of morbidity and the main reason for neonatal mortality. Many publications have pointed at clinical methods, biological, biochemical and ultrasonographic markers, which applied in combination or on their own, aim at predicting spontaneous preterm delivery. Transvaginal sonography is an effective method for the study of uterine cervix during pregnancy since it permits to assess the cervical morphology and biometry in detail with a high degree of reliability. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of the cervix length and cervical funneling.
Methods: A prospective cohort of 200 women carrying high
risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation.
Results: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence
of cervical funneling presented a satistically significant association with
spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p<0.005 OR=92.15) and before 35 weeks' gestation (p<0.001 OR=32.33). The logistic regression analysis suggested the
cervical length with less than 18mm as the only variable that revealed satistically significance association
with SPTD.
Conclusion: The results seem to indicate
that the assessment of cervical length is an important ultrasound marker for
predicting spontaneous preterm delivery.
Volume 68, Issue 10 (1-2011)
Background: Preterm delivery is a relevant public health problem. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age and the measurement of the cervix length, cervical funneling and Cervical Gland Area (CGA), in high risk pregnant population.
Methods: A prospective cohort of 200 women carrying high risk pregnancies was evaluated by transvaginal sonography between 14th and 28th gestational weeks. The data were analyzed using statistical methods. A multiple linear regression model was estimated in order to examine the relationship between the gestational age at delivery and the cervical markers. A multiple logistic regression was estimated in order to analyze the factors associated to spontaneous preterm delivery and the transvaginal sonographic markers.
Results: Cervical length less than 18 mm and the presence of cervical funneling presented a statistically significant association with spontaneous preterm delivery before 35 weeks. The nondetection of Cervical Gland Area demonstrated a strong association with spontaneous preterm delivery before (p=0.0001, OR=169.1, CI=2.6-3.1) and 35th and 37th gestational week (p=0.001, OR=115, CI=2.12-3.5). The multiple logistic regression analysis suggested the non-detection of CGA as the only variable to reveal statistically significance association with spontaneous preterm delivery.
Conclusion: Based on results of present study the absence of cervical gland area (CGA) can be a new and important ultrasound marker for predicting spontaneous preterm delivery and needs to confirm with future multicenter investigations.
Volume 71, Issue 3 (6-2013)
Background: Very preterm birth (26-32 weeks) has an important effect on infant morta-lity and disability of infancy. The aim of this study was to investigate the prevalence of very preterm delivery and early neonatal morbidity (the first 28 days after birth).
Methods: In this cross-sectional retrospective study, among 4393 delivery in Arash Women's Hospital in Tehran, 59 deliveries were very preterm that resulted in 79 very preterm neonate births. We assessed maternal risk factors and neonatal complications in women who were admitted for delivery from March 2009 to March 2010.
Results: Among 59 pregnant women, 17 (12/27%) had multiple pregnancies and 17 (12/27%) had premature rupture of fetal membranes. Caesarean section method was more common than normal vaginal delivery (46 cases- 97/77%). Women aged 18 to 35 had the highest rate of preterm delivery (45/86%). Among 79 very preterm neonates about half of them were very low birth weight, 74 neonates (93/67%) suffered from respiratory distress syndrome and 13 deaths were reported.
Conclusion: Premature birth is a multi-factorial phenomenon. Identifying maternal risk factors and increasing knowledge about it can decrease the rate of preterm labor. The prevention of premature labor is better than cure. Further prospective studies with large number of patients and long-term follow-up are recommended for better understanding of the phenomenon.
Volume 71, Issue 9 (12-2013)
Low birth weight (LBW) and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory), contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and preterm newborns.
Volume 72, Issue 10 (1-2015)
Background: Preterm premature rupture of membranes (PPROM) occurs in 17% of pregnancies, which leads to 20% of perinatal death. According to previous studies uterine anomalies are one of the risk factors for preterm birth, PPROM and pregnancies complications. The aim of this study was to evaluate the relationship between PPROM and rupture of membrane (ROM) with uterine cavity anomalies based on hysteroscopic findings. Methods: This cross-sectional study was conducted in Imam Khomeini Hospital, Ahvaz, Iran, from May 2011 to May 2012. After conducting a pilot study, 66 nulliparous pregnant women at 14-37 weeks of pregnancy with PPROM and ROM were selected randomly. Then the women were evaluated by hysteroscopy at least six weeks after delivery or miscarriage. The control group includes 66 women with at least one normal pregnancy (without history of PPROM, secondary infertility or recurrent abortion), who underwent diagnostic or therapeutic hysteroscopy for other reasons than PPROM. The hysteroscope instrument specifications were KARL STORZ model (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany), inner sheet 26153 BI, outer sheet 26153 BO, and BA lens with 30 degree. Normal saline solution (Sodium Chloride 0.9%) also was applied as distention medium. The study was approved by Ethic Committee of Ahvaz Jundihspur University of Medical Sciences. Informed consent was obtained for all participants. Results: Overall, the frequency of uterine anomalies in case and control groups was 12.12% and 3%, respectively (P<0.05 based on Chi-square test). Possibility of uterine cavity anomalies in the women with preterm premature rupture of membranes (PPROM) was significantly higher than the women with normal pregnancy (OR=4.41, CI 95%: 0.9-21/63). About 3% of patients in the case group had undefined uterine anomalies. This anomaly was not in mentioned uterine anomalies classification of American fertility association. We did not observe such anomaly in control group. Conclusion: In conclusion, we found that the possibility of occurring PPROM in women with uterine cavity anomaly was four-fold more than women without these anomalies. Hence, we recommend women with history of PPROM to undergo diagnostic hysteroscopy for detecting uterine anomalies before next pregnancy.
Volume 73, Issue 2 (5-2015)
Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants. Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant. Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27). Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.
Volume 80, Issue 10 (1-2023)
Methods: This descriptive-analytical study was conducted in Afzalipour Hospital in Kerman from January 2018 to January 2019. All pregnant women with PPROM and normal pregnant women referred to this Hospital were included in the study through convenient sampling. The data collection tool was a checklist containing patients' demographic information (age, education, occupation, gestational age, number of pregnancies, urinary tract infection (confirmed by the attending physician), history of premature rupture of the water sac, vaginal bleeding (bleeding in any period of pregnancy as the person had visited the doctor), history of premature birth, pregnancy care and trauma (any trauma)). To analyze the data, descriptive statistics (frequency, percentage, mean, and standard deviation), analytical (Chi-square test) and SPSS software version 22 were used.
|
Results: In this descriptive-analytical study, 400 pregnant women were studied. Two hundred of pregnant women had preterm premature rupture of membranes and 200 of pregnant women did not have such condistion and were normal. The mean age of pregnant women was 27.4±5.4 years old and the mean gestational age of pregnant women was 34.1±2.1 weeks. The mean parity of pregnant women was 2.3±1.4. Risk factors such as maternal age (P=0.011), number of pregnancies (P=0.035), maternal education (P=0.018), history of preterm premature rupture of membranes (P=0.046), history of preterm delivery (P=0.019), trauma (P=0.037) and pregnancy care (P=0.037) affected preterm premature rupture of membranes.
Conclusion: The results of this study showed that maternal age, number of pregnancies, maternal education, and history of preterm premature rupture of membranes, history of preterm delivery, trauma, and prenatal care are risk factors for PROM. Therefore, by educating pregnant mothers about these risk factors, the incidence and complications of preterm premature rupture of membranes can be reduced. |
Volume 81, Issue 8 (11-2023)
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.
|
Results: Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture.
Conclusion: In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors. |
Volume 82, Issue 2 (5-2024)
Methods: This retrospective cross-sectional study involved 317 pregnant women with premature rupture of membranes (PPROM) at Shahid Beheshti Hospital in Isfahan, between April 2020 and April 2022. Data were collected from medical records, including demographic information, risk factors, and maternal and neonatal outcomes. Patients were categorized into two groups: those receiving care (24-34 weeks of gestation) and those undergoing pregnancy termination (less than 24 weeks or more than 34 weeks). The chi-square test was used for qualitative variables, while the T-student test was applied for quantitative variables.
|
Results: In this study, the average age of patients was 29.42±6.56 years. The most common risk factors for PPROM were 20.2% for abortion records, 20.2% for urinary infections, 18% for cervical insufficiency, and 13.6% for gestational diabetes. Comparing maternal outcomes between the two groups revealed that chorioamnionitis occurred more frequently in the care group (18% vs. 2%, P=0.0001), as did emergency cesarean sections (37% vs. 4.5%, P=0.0001) and NICU hospitalization (71% vs. 17%, P=0.001). In the next stage, a regression test identified the independent effects of variables on maternal and newborn outcomes without intervention or confounding factors. The analysis indicated that mothers in the care group experienced significantly more complications than those in the pregnancy termination group, and their babies also faced significantly more complications.
Conclusion: The study results indicate that a history of abortion, urinary infections, cervical insufficiency, and gestational diabetes are significant risk factors for PPROM. Expectant management of PPROM is associated with more neonatal and maternal complications than pregnancy termination. Thus, timely identification of these risk factors allows healthcare providers to educate mothers and potentially prevent and manage them, significantly reducing the incidence of PPROM and its complications. |
| Page 1 from 1 |
Related Websites
Site Keywords
Cardiology, Anatomy, Biology, Epidemiology, Immunology, Neuroscience, Physical therapy, Physiology, Dermatology, Endocrinology and metabolicSite Statistics
- Registered users: 8146 users
- Online users: 3 users
- Guest users: 229 users
- All visits: 36053166 visits
- Visits in 24 Hours: 23135 visits
- Total articles: 11945 articles
- Published articles: 5077 articles
© 2026 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by : Yektaweb