BackgroundMaternal obesity has been associated with adverse pregnancy outcomes, such as pre-eclampsia, eclampsia, pre- and post-term delivery, induction of labor, macrosomia, increased rate of caesarean section, and post-partum hemorrhage. The objective of this study was to determine the effect of maternal Body Mass Index (BMI) on pregnancy outcomes.Methods1000 pregnant women were enrolled in the study. In order to explore the relationship between maternal first trimester Body Mass Index and pregnancy outcomes, participants were categorized into five groups based on their first trimester Body Mass Index. The data were analyzed using Pearson Chi-square tests in SPSS 18. Differences were considered significant if p < 0.05.ResultsWomen with an above-normal Body Mass Index had a higher incidence of pre-eclampsia, induction of labor, caesarean section, pre-term labor, and macrosomia than women with a normal Body Mass Index (controls). There was no significant difference in the incidence of post-term delivery between the control group and other groups.ConclusionIncreased BMI increases the incidence of induction of labor, caesarean section, pre-term labor and macrosomia. The BMI of women in the first trimester of pregnancy is associated with the risk of adverse pregnancy outcome.

Background Listening to music can reduce or manage stress, fatigue, and accompanying symptoms in mothers. Music increases oxytocin secretion which affects breast milk. This study aimed to examine the effect of lullaby on volume, fat, total protein and albumin concentration of breast milk in mothers of premature infants admitted to the NICU. Methods This clinical trial was performed on 100 primiparous mothers whose premature infants were hospitalized in the NICU of Ayatollah Rouhani Hospital from January 2020 to December 2020. Using block randomization method, the participants were divided into three groups: control (A), playing lullaby for mother (B) and playing lullaby for a mother while holding a photo of her own baby (C). The mothers of the intervention groups listened to lullabies through headphones for 30 minutes every morning for 6 days. On the first and the sixth day of birth, the volume of breast milk (ml) and two milliliters of breast milk samples of all three groups were measured and compared in terms of fat, albumin concentration and total protein (mg/DL). ANOVA, Paired T-Test and ANCOVA model (the included variables were: basic value of dependent variable, group type, Maternal age, Birth weight, Gestational age and Maternal weight) was used for analytical statistics. Results The difference between the mean compositions of breast milk before and after the intervention in three groups of A, B and C: in terms of the breast milk volume were 66.33 ± 4.80, 71.30 ± 4.18 and 75.91 ± 6.80 ml; in terms of triglyceride level was 177.84 ± 50.57, 210.72 ± 34.55 and 224.17 ± 12.97 mg/DL, cholesterol level was 14.57 ± 3.70, 21.96 ± 3.82 and 26.26 ± 5.16 mg/DL, albumin concentration was 0.90 ± 0.30, 1.22 ± 0.19 and 1.46 ± 0.28 mg/DL and total protein level was 1.61 ± 0.61, 2.20 ± 0.57 and 2.72 ± 0.30 mg/DL. Finally, the results of ANCOVA analysis for the effects of the intervention, taking into account the baseline values, showed that the intervention was effective and had the greatest effect on cholesterol levels. Conclusion In this small trial, there was a statistically significant association between trial arm and biochemical composition of breastmilk though further studies are needed to see if these changes result in meaningful clinical outcomes to the infant. Trial registration IRCT, IRCT20191114045439N1. Registered 14 January 2020- prospective, https://en.irct.ir/trial/43671

Background: Functional immaturity of the gastrointestinal tract in premature infants can cause several problems, leading to feeding intolerance.Objectives: This study aimed to investigate the effect of abdominal massage on the feeding tolerance of neonates with very low birth weight. Methods: This randomized single-blind clinical open-label trial was conducted on low-birth-weight neonates, who were hospitalized in the neonatal intensive care units (NICUs) of two tertiary university hospitals from March 2016 to March 2017. The neonates were randomly assigned to two groups. In the massage group, massage was applied three times a day, while in the control group, the patients received routine care. The gastric residual volume (GRV), vomiting, defecation frequency, and abdominal circumference were measured before and after massage in the massage group, as well as the control group. Results: There was no significant difference between the massage and control groups regarding gender, birth weight, age, feeding mode, and gestational age (P = 0.711, 0.076, 0.082, 0.612, and 0.629, respectively). None of these variables changed significantly in the controls (P = 0.06, 0.264, 0.421, and 0.07, respectively). Conclusions: We found that premature infants who received massage therapy experienced a significant decline in GRV, vomiting frequency, and abdominal circumference and a significant increment in the defecation frequency. Therefore, abdominal massage, which results in less abdominal distension and GRV, is recommended prior to enteral feeding for infants with very low birth weight.

Background: One of the benefits of delayed cord clamping is a reduction in the rate of intraventricular hemorrhage. The findings in this regard are controversial and some negative effects of the procedure have been reported. Objectives: The purpose of this study was to investigate the effects of delayed cord clamping on intraventricular hemorrhage in preterm infants. Methods: This clinical trial was carried out on 70 preterm neonates delivered via cesarean section. Their gestational age was less than 32 weeks and the birth weight less than 1500 grams. Neonates were randomly assigned to two groups of early cord clamping (less than 10 seconds) or delayed clamping of the umbilical cord (30 -45 seconds after birth). 3 to 7 days after birth, presence of Intraventricular hemorrhage (IVH) in both groups was checked by ultrasonography (Mindray machine, model m7) and. Rate and severity of IVH was compared between the two groups. Results: There was no significant difference in mean gestational age, birth weight, gender distribution and medications in both groups of delayed cord clamping and early clamping of the umbilical cord. The incidence of seizures in the early clamping was 8.6% and in the delayed clamping zero (P = 0.239). The incidence rate of IVH and periventricular leukomalacia (PVL) was 11.43% and 5.7%, respectively in the early clamping, while this rate was zero in the delayed clamping group. This difference was not statistically significant in both indicators (P = 0.12 and P = 0.493, respectively). Conclusions:The results showed that intraventricular hemorrhage in premature neonates with delayed clamping was less prevalent than those with early clamping, and may be used as a reliable method.

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.