Background: It seems that in vaginal delivery, serum leptin level increases as a cortisol-dependent factor due to the stress of the embryo. Studies have shown that if the level of serum leptin is low, the risk of chronic metabolic diseases, cardiovascular diseases, hypertension, and obesity in the mother and the baby will increase. Objectives: The aim of this study was to determine the relationship between serum leptin levels in pregnancy and the type of delivery. Methods: This study was a descriptive-analytic study which adopted a longitudinal approach to examine mothers in the first and second trimester of pregnancy in Tehran in. The participants were selected by means of cluster random sampling. After obtaining consent from the mothers, their blood samples were collected at-and-weeks of pregnancy and their serum leptin levels were determined. The mothers' examination continued after their delivery. Finally, the mothers were divided into two groups including the vaginal delivery group (participants) and the cesarean group (participants). Independent-Samples ttest, Pearson test, regression test, and Lambda test were used to analyze the data. SPSS was employed to carry out analyses at P value< level. Results: The mean values of the serum leptin level in the first trimester and second trimester were higher in the normal delivery group in comparison with the cesarean group. Nonetheless, there was not a significant relationship between the serum leptin level and the type of delivery despite the fact that there was a statistically significant relationship between the type of delivery and the changes in leptin levels during pregnancy and these changes were reported more frequently in the normal delivery group in comparison with in the cesarean group (P value= .). Conclusion: Based on the results of this study, leptin level changes during pregnancy can have a predictive role in the mothers' type of delivery. However, further studies with larger samples are required to confirm the extent and type of this role.

Introduction:About half a million women worldwide die annually from complications of pregnancy or lack of midwifery care, 99% of which occur in developing countries. High-quality service often leads to customer satisfaction. Staff play a significant role in improving the quality of care. Given the importance of this issue in improving macroeconomic and international indicators, we decided to review the quality of midwifery care in Iran. Materials and Methods:After searching 950 articles with these keywords: quality, care, midwifery and satisfaction in the search engines of Sciencedirect, Iranmedex, SID, Magiran, Google Scholar, Pubmed and IranDoc, about 28 articles were finally selected and the results were filmed. Results:Studies reported the quality of prenatal care, pregnancy, postpartum and family planning at a moderate level, so that the weakest quality was observed in the fourth stage of labor. Satisfaction of pre-natal services, labor and childbirth, post-partum and family planning was stated at a high and very high level, and the satisfaction with the pre-natal period was higher than the labor. Conclusion:The quality of midwifery care was at a moderate level and its satisfaction was high. Therefore, high satisfaction does not always mean high quality of service, as mothers' satisfaction may be due to their low expectation. Therefore, in order to evaluate the quality of midwifery services, in addition to obtaining satisfaction, international standards must always be considered.

Objective:Visfatin is an adipocytokine that functions as an enzyme and a growth factor to investigate the relationship between serum visfatin and the fetus’s anthropometric markers up to a year after birth.Materials and Methods:Forty-one eligible pregnant women in their first trimester were divided and matched in terms of body mass index (BMI) before pregnancy into normal and higher than normal BMI groups, A and B. Serum visfatin levels were measured during 6-12 and 15-20 weeks of gestation using ELISA.Results:The infants were followed up for a mean duration of 10.19±2.83 months. In group A, there was a strong positive relationship between birth head circumference and the first (p1=0.054, r1=0.580) and second trimester visfatin levels (p2=0.051, r2=0.530). In group B, second trimester visfatin levels correlated negatively with birth length (p=0.015, r=-0.523) and infant’s head circumference (p2=0.050, r2=-0.392). In a separate study on group B, visfatin levels in the first and second trimesters showed a significant negative correlation with infant’s weight. A significant correlation was observed between the first and second trimesters visfatin level with infant’s height in both groups, such that this relationship was positive in group A and negative in group B. Linear regression analysis revealed that first and second trimester visfatin levels were significant independent predictors of infant’s weight in group B and infant’s height in both groups. Second trimester visfatin level was a significant predictor of birth height in group B.Conclusion:Maternal serum visfatin level shows a relationship with fetal and infant anthropometric indicators, with different effects in the two groups, suggesting visfatin dysfunction in the overweight group before pregnancy.

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