Background Respiratory distress syndrome (RDS) is a life-threatening pulmonary disorder which mainly related to the premature infants. This study was conducted to evaluate Continuous Positive Airway Pressure (CPAP) and High Flow Nasal Cannula (HFNC) intervention effectiveness among premature infants with RDS. Methods Overall, 60 preterm infants with RDS at Valiasr Hospital, Tehran, during 2018 in this randomized control trail participated as CPAP and HFNC groups’ treatment. CPAP group received the nose with a peep of 4-6 centimeters from birth and continued to improve respiratory distress and the need for oxygen (O2). HFNC group received hot and humid flowing 2 to 5 liters/min in nose cannula, until respiratory distress and O2 needing to be resolved. Short clinical outcomes were compared between two groups. Data were analyzed by SPSS version 16 using t-test and logistic regression statistical tests at 95% significant level. Results There were no significant differences in Pneumothorax, PDA, chronic lung disease, surfactant injection, tracheal intubation, death, NEC, number of full feeding days, duration of hospitalization, and number of oxygen therapy days between the both CPAP and HFNC groups. Conclusions CPAP and HFNC techniques have the same efficacy in confronting RDS in neonates and there is no difference between the two techniques in terms of in-hospital clinical outcomes. However, considering the same efficacy of two methods and less invasive of HFNC compared with CPAP, we concluded this method can be recommended for the improvement of respiratory distress in newborns. Trial Registration Iranian Registry of Clinical Trials identifier IRCT20190623043988N1 Registered 2019-07-05.

Background: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing a significant public health disaster. Objectives: The present study aimed to evaluate the clinical features and laboratory data of neonates born to mothers with COVID-19. Methods: A retrospective multicenter cohort study was conducted from March 20 to September 5, 2020, on all neonates born to mothers with positive real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 or clinically suspected COVID-19. Neonates enrolled in this study were from five different hospitals affiliated with the Tehran University of Medical Sciences. All the newborns were tested for SARS-CoV-2 using nasopharyngeal swabs during the first 24 - 48 hours of life, and a second-time swabbing was performed as indicated at subsequent visits. All categorical data were manifested as frequency (%), and continuous data were shown as mean ± SD. Results: Forty-four neonates born to 39 infected mothers were evaluated during the study period. Nineteen women had complications during pregnancy, including hypertensive disorders, gestational diabetes, preterm labor, etc. Besides, 54.5% of the neonates were born preterm. The mean gestational age and birth weight were 35.11 ± 4.01 weeks and 2,567 ± 898 g, respectively. Fifteen (34.1%) neonates were symptomatic at birth, and during the observation, more neonates became symptomatic. Finally, 27/44 (61.3%) neonates became symptomatic, and 17/44 remained asymptomatic. The most common clinical manifestations were respiratory distress (77.7%), followed by fever or hypothermia (18.5%), gastrointestinal problems (14.8%), and neurologic findings (3.7%). Also, the most common clinical feature of eight neonates with positive RT-PCR was respiratory distress, followed by neurologic symptoms, temperature instability, and gastrointestinal disorder, in sequence. Few abnormalities were seen in laboratory findings. Chest X-rays were abnormal in 22.2% of the neonates. Conclusions: The SARS-CoV-2 infection during pregnancy may cause severe maternal and neonatal morbidities. Neonates with positive SARS-CoV-2 may demonstrate a spectrum of clinical features. The most common feature of neonates born to mothers with COVID-19 was respiratory distress.

Background: Breastfeeding mothers’ decision to donate their milk is influenced by their knowledge, attitude and subjective norms such as their family’s opinions on milk donation. In Iran, mothers have limited access to information and education about milk donation and milk banks. Therefore, this study aims to evaluate whether an educational program based on the theory of planned behavior affects breastfeeding mothers’ decision to donate their breast milk. Methods: this quasi-experimental study will enroll 66 breastfeeding mothers (intervention, n=33; control, n=33). After collecting baseline data, the intervention group will begin receiving a 60-minute weekly educational program based on TPB components for four weeks. The first follow-up assessment will be conducted immediately after the intervention, and the final one will be conducted 12 weeks later. The primary outcomes are the number of mothers who have donated their breast milk and changes in breastfeeding mothers’ knowledge, attitude, subjective norms, perceived behavioral control about DHM and intention to milk donation. Discussion: A well-designed educational program can improve breastfeeding mothers’ knowledge and promote their behavioral factors regarding milk donation and can lead to a significant increase in the number of potential milk donors. Trial registration: irct.ir (IRCT20230124057203N1) registered February 14, 2023