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Habibelahi A, Heidarzadeh M, Abdollahi L, Taheri M, Ghaffari-Fam S, Vakilian R, Daemi A. Clinical cause of neonatal mortality in Iran: analysis of the national Iranian Maternal And Neonatal network. BMJ Paediatr Open 2024; 8:e002315. [PMID: 38508661 PMCID: PMC10961515 DOI: 10.1136/bmjpo-2023-002315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The neonatal mortality rate is a main indicator of the health and development of a country. Having insight into the cause of neonatal deaths may be the first step to reducing it. This paper depicts the cause of newborn deaths in Iran. METHODS This cross-sectional study was performed on data from the national Iranian Maternal And Neonatal network to investigate all neonatal deaths in the country during the year 2019. The cause of death data were reported according to categories of birth weight, gestational age (GA), death time and place. RESULTS The main causes of the 9959 neonatal deaths during the study period were respiratory distress syndrome (RDS) (37%), malformation (21%), prematurity of <26 weeks (20%), others (12%), asphyxia (7%) and infection (3%). The major causes of neonatal mortality in delivery rooms were prematurity of <26 weeks and in the inpatient wards the RDS. By increasing the GA and birth weight towards term babies, the rate of RDS gets lower, while that of malformation gets higher. CONCLUSIONS RDS was the main cause of neonatal mortality in Iran which is seen mainly in preterm babies. Prematurity of <26 weeks was another main cause. Thus, suggestions include reducing prematurity by preconception and pregnancy care and, on the other hand, improving the care of preterm infants in delivery rooms and inpatient wards.
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Affiliation(s)
- Abbas Habibelahi
- Iran Ministry of Health and Medical Education, Tehran, Iran (the Islamic Republic of)
| | | | - Leila Abdollahi
- Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Majzoubeh Taheri
- Iran Ministry of Health and Medical Education, Tehran, Iran (the Islamic Republic of)
| | - Saber Ghaffari-Fam
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran (the Islamic Republic of)
| | - Roshanak Vakilian
- Iran Ministry of Health and Medical Education, Tehran, Iran (the Islamic Republic of)
| | - Amin Daemi
- Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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Hatami D, Habibelahi A, Changizi N, Heidarzadeh M, Nojomi M, Rast M, Ansari K, Tehrani-Banihashemi A. Perinatal outcomes and sinopharm BBIBP-CorV vaccination during pregnancy. BMC Pregnancy Childbirth 2024; 24:190. [PMID: 38468216 PMCID: PMC10926583 DOI: 10.1186/s12884-024-06389-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND After the outbreak of COVID-19, a huge part of the health care services was dedicated to preventing and treating this disease. In case of COVID-19 infection, severe COVID-19 is reported more in pregnant individuals. Afterward, Vaccination against SARS-CoV-2 became a hot topic due to known effects in preventing severe COVID-19 during pregnancy. Vaccination of pregnant individuals started in August 2021 with the Sinopharm vaccine in Iran. The aim of current study was to determine the incidence of perinatal outcomes in women who were vaccinated during pregnancy. METHOD This retrospective cohort study included 129,488 singleton births from March 21, 2021, until March 21, 2022, in Tehran, Iran. The data was obtained from the Iranian Maternal and Neonatal (IMaN) Network and the Maternal Vaccination Registry. Adverse perinatal outcomes investigated in this study include preterm birth, extremely preterm birth, low birth weight, very low birth weight, intrauterine growth restriction, stillbirth, neonatal intensive care unit admission, congenital anomaly, neonatal death and low 5-minute Apgar score. The risk of all perinatal outcomes was evaluated using multiple logistic regression. The analysis was done using STATA version 14. RESULTS Of all 129,488 singleton births included in this study, 17,485 (13.5%) were vaccinated against SARS-CoV-2 (all with Sinopharm (BBIBP-CorV)). The exposure to the Sinopharm vaccine during pregnancy caused a significant decrease in the incidence of preterm birth (P =0.006, OR=0.91 [95% CI, 0.85 to 0.97]), extremely preterm birth (P =<0.001,OR=0.55 [95% CI, 0.45 to 0.66]), and stillbirth (P =<0.001, OR=0.60 [95% CI, 0.47 to 0.76]). Exposure to vaccination during the first trimester was associated with an increased risk of preterm birth (P =0.01, OR=1.27 [95% CI, 1.04 to 1.55]) Maternal vaccination during pregnancy was not associated with an increased risk of other adverse perinatal outcomes included in this study. CONCLUSION The finding of this population-based study indicated no adverse pregnancy outcome due to vaccination with the Sinopharm vaccine during the second and third trimesters of pregnancy. Overall risk of adverse pregnancy outcomes were lower in the vaccinated individuals compared to the unvaccinated group. Also, vaccination during the first trimester was associated with an increased risk of preterm birth.
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Affiliation(s)
- Donya Hatami
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Habibelahi
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Nasrin Changizi
- Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Heidarzadeh
- Department of Neonatology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Marzieh Nojomi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Moein Rast
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Kiarash Ansari
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Amini E, Heidarzadeh M, Sohbati S, Behseresht M, Amiresmaili M. Exploring causes of neonatal mortality in south east of Iran: A qualitative study. Int J Health Plann Manage 2024; 39:22-35. [PMID: 37717258 DOI: 10.1002/hpm.3708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023] Open
Abstract
AIM Neonatal mortality (NM) is a significant global challenge that has a profound impact on families, particularly mothers. To address this challenge, the first step is to identify its underlying causes. Accordingly, this study aimed to explore the phenomenon by consulting with stakeholders, including mothers and experts. STUDY DESIGN This study utilized a qualitative design, conducting in-depth interviews with 16 mothers and 15 healthcare experts to gather information. A conventional content analysis approach was employed to analyze the data. RESULTS NM is influenced by personal, systemic, and socioeconomic factors. Personal factors can be further divided into those related to the neonate and those related to the mother. Systemic factors are primarily related to the healthcare system, while socioeconomic factors include low literacy, low income, lack of access to healthcare, and consanguineous marriage. CONCLUSION NM is influenced by a wide range of factors that require separate and targeted interventions to reduce its incidence. In the short term, priority should be given to preventable factors that can be addressed through simple interventions, such as screening mothers for urinary tract infections, educating mothers, and preparing them for pregnancy with necessary lab tests and supplements. In the long term, preventing premature birth, addressing maternal addiction, family poverty, and shortages in healthcare equipment and personnel must be thoroughly addressed.
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Affiliation(s)
- Elham Amini
- Health in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Samira Sohbati
- Department of Obstetrics and Gynecology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Behseresht
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Amiresmaili
- Health in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Gharacheh M, Khalili N, Ebrahimi Kalan M, Heidarzadeh M, Ranjbar F. Pregnancy-Related Complications During the COVID-19 Pandemic in Iran. Arch Iran Med 2024; 27:30-35. [PMID: 38431958 PMCID: PMC10915933 DOI: 10.34172/aim.2024.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/24/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND The COVID-19 pandemic has profoundly affected healthcare systems worldwide, with significant collateral damage to vulnerable populations, including the perinatal population. This study sought to compare pregnancy-related complications before and during the COVID-19 pandemic in Iran. METHODS This retrospective data analysis was performed from February 20 to August 20, 2019 (prior to the onset of the COVID-19 pandemic) and from February 20 to August 20, 2020 (during the pandemic), encompassing the initial wave of the pandemic and the subsequent lockdown. To collect data, we utilized the medical records of 168,358 women obtained from the Iranian Maternal and Neonatal Network, which is a comprehensive electronic health record database management system specifically designed to store information pertaining to maternal and neonatal health. RESULTS A total of 168,358 medical records were analyzed, with 87388 (51.9%) and 80970 (48.1%) before and during the pandemic, respectively. The occurrence of pregnancy complications was found to be significantly more frequent during the pandemic compared to the pre-pandemic period. Notably, there was a higher likelihood of experiencing preeclampsia (odds ratio [OR]=1.14, 95% confidence interval [CI]: 1.07‒1.22, P=0.0001) and gestational diabetes (OR=1.14, 95% CI: 1.09‒1.19, P=0.0001) during the pandemic. Furthermore, cesarean section (CS) became more prevalent during the pandemic in comparison to vaginal delivery (OR=1.19, 95% CI: 1.17‒-1.22, P=0.0001). CONCLUSION Our findings demonstrated a significant association between the COVID-19 pandemic and an escalation in adverse pregnancy outcomes, notably preeclampsia, gestational diabetes, and CS deliveries. However, further research is warranted to gain a richer understanding of the intricate interplay between the COVID-19 pandemic and pregnancy complications. This is particularly crucial in light of the evolving landscape of new coronavirus variants.
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Affiliation(s)
- Maryam Gharacheh
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Heidarzadeh
- Department of Pediatrics, School of Medicine, Children Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Mulia IE, Ueda N, Miyoshi T, Iwamoto T, Heidarzadeh M. A novel deep learning approach for typhoon-induced storm surge modeling through efficient emulation of wind and pressure fields. Sci Rep 2023; 13:7918. [PMID: 37193794 DOI: 10.1038/s41598-023-35093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/12/2023] [Indexed: 05/18/2023] Open
Abstract
Modeling typhoon-induced storm surges requires 10-m wind and sea level pressure fields as forcings, commonly obtained using parametric models or a fully dynamical simulation by numerical weather prediction (NWP) models. The parametric models are generally less accurate than the full-physics models of the NWP, but they are often preferred owing to their computational efficiency facilitating rapid uncertainty quantification. Here, we propose using a deep learning method based on generative adversarial networks (GAN) to translate the parametric model outputs into a more realistic atmospheric forcings structure resembling the NWP model results. Additionally, we introduce lead-lag parameters to incorporate a forecasting feature in our model. Thirty-four historical typhoon events from 1981 to 2012 are selected to train the GAN, followed by storm surge simulations for the four most recent events. The proposed method efficiently transforms the parametric model into realistic forcing fields by a standard desktop computer within a few seconds. The results show that the storm surge model accuracy with forcings generated by GAN is comparable to that of the NWP model and outperforms the parametric model. Our novel GAN model offers an alternative for rapid storm forecasting and can potentially combine varied data, such as those from satellite images, to improve the forecasts further.
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Affiliation(s)
- Iyan E Mulia
- Prediction Science Laboratory, RIKEN Cluster for Pioneering Research, Kobe, Japan.
- Disaster Resilience Science Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan.
| | - Naonori Ueda
- Prediction Science Laboratory, RIKEN Cluster for Pioneering Research, Kobe, Japan
- Disaster Resilience Science Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Takemasa Miyoshi
- Prediction Science Laboratory, RIKEN Cluster for Pioneering Research, Kobe, Japan
- Data Assimilation Research Team, RIKEN Center for Computational Science, Kobe, Japan
| | - Takumu Iwamoto
- Tsunami and Storm Surge Research Group, Port and Airport Research Institute, Yokosuka, Japan
| | - Mohammad Heidarzadeh
- Department of Architecture and Civil Engineering, University of Bath, Bath, BA2 7AY, UK
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Suárez-Idueta L, Yargawa J, Blencowe H, Bradley E, Okwaraji YB, Pingray V, Gibbons L, Gordon A, Warrilow K, Paixao ES, Falcão IR, Lisonkova S, Wen Q, Mardones F, Caulier-Cisterna R, Velebil P, Jírová J, Horváth-Puhó E, Sørensen HT, Sakkeus L, Abuladze L, Gissler M, Heidarzadeh M, Moradi-Lakeh M, Yunis KA, Al Bizri A, Karalasingam SD, Jeganathan R, Barranco A, Broeders L, van Dijk AE, Huicho L, Quezada-Pinedo HG, Cajachagua-Torres KN, Alyafei F, AlQubaisi M, Cho GJ, Kim HY, Razaz N, Söderling J, Smith LK, Kurinczuk J, Lowry E, Rowland N, Wood R, Monteath K, Pereyra I, Pravia G, Ohuma EO, Lawn JE. Vulnerable newborn types: Analysis of population-based registries for 165 million births in 23 countries, 2000-2021. BJOG 2023. [PMID: 37156241 DOI: 10.1111/1471-0528.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021. DESIGN Population-based, multi-country analysis. SETTING National data systems in 23 middle- and high-income countries. POPULATION Liveborn infants. METHODS Country teams with high-quality data were invited to be part of the Vulnerable Newborn Measurement Collaboration. We classified live births by six newborn types based on gestational age information (preterm <37 weeks versus term ≥37 weeks) and size for gestational age defined as small (SGA, <10th centile), appropriate (10th-90th centiles), or large (LGA, >90th centile) for gestational age, according to INTERGROWTH-21st standards. We considered small newborn types of any combination of preterm or SGA, and term + LGA was considered large. Time trends were analysed using 3-year moving averages for small and large types. MAIN OUTCOME MEASURES Prevalence of six newborn types. RESULTS We analysed 165 017 419 live births and the median prevalence of small types was 11.7% - highest in Malaysia (26%) and Qatar (15.7%). Overall, 18.1% of newborns were large (term + LGA) and was highest in Estonia 28.8% and Denmark 25.9%. Time trends of small and large infants were relatively stable in most countries. CONCLUSIONS The distribution of newborn types varies across the 23 middle- and high-income countries. Small newborn types were highest in west Asian countries and large types were highest in Europe. To better understand the global patterns of these novel newborn types, more information is needed, especially from low- and middle-income countries.
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Affiliation(s)
| | - Judith Yargawa
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Veronica Pingray
- Department of Mother & Child Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Luz Gibbons
- Department of Mother & Child Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Adrienne Gordon
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kara Warrilow
- Centre for Research Excellence in Stillbirth, MRI-UQ, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Enny S Paixao
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Ila Rocha Falcão
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Sarka Lisonkova
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Qi Wen
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Petr Velebil
- Department of Obstetrics and Gynaecology, Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Jitka Jírová
- Department of Data Analysis, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | | | | | - Luule Sakkeus
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Lili Abuladze
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Maziar Moradi-Lakeh
- Department of Community Medicine, Preventive Medicine and Public Health Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Khalid A Yunis
- Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Ayah Al Bizri
- Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Shamala D Karalasingam
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Ravichandran Jeganathan
- Department of Obstetrics & Gynaecology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia
| | - Arturo Barranco
- Directorate of Health Information, Ministry of Health, Mexico City, Mexico
| | | | | | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hugo Guillermo Quezada-Pinedo
- The Generation R Study Group, Department of Paediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Kim Nail Cajachagua-Torres
- The Generation R Study Group, Department of Paediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | | | - Geum Joon Cho
- Department of Obstetrics and Gynaecology, Korea University College of Medicine, Seoul, South Korea
| | - Ho Yeon Kim
- Department of Obstetrics and Gynaecology, Korea University College of Medicine, Seoul, South Korea
| | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lucy K Smith
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Jennifer Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Estelle Lowry
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Neil Rowland
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Kirsten Monteath
- Department of Maternity and Sexual Health Team, Public Health Scotland, Edinburgh, UK
| | - Isabel Pereyra
- Catholic University of the Maule, Región del Maule, Chile
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Gabriella Pravia
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
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Schwartz DA, Mohagheghi P, Moshfegh F, Zafaranloo N, Khalili N, Heidarzadeh M, Habibelahi A, Ghafoury R, Afrashteh F. Epidemiology and Clinical Features of COVID-19 Among 4,015 Neonates in Iran: Results of the National Study from the Iranian Maternal and Neonatal Network (IMaN). Am J Perinatol 2023. [PMID: 36990455 DOI: 10.1055/a-2065-4714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Objective The COVID-19 pandemic had a significant impact on pregnant women and neonates in Iran. This retrospective study describes the national experience among neonates having suspected and confirmed SARS-CoV-2 infection following hospital admission to examine the epidemiology, demographic and clinical features. Study Design All nationwide cases of suspected and confirmed neonatal SARS-CoV-2 infection were drawn from the Iranian Maternal and Neonatal Network (IMaN) between February 2020 to February 2021. IMaN registers demographic, maternal, and neonatal health data throughout Iran. Statistical analysis of demographic, epidemiological and clinical data were performed. Results There were 4,015 liveborn neonates having suspected or confirmed SARS-CoV-2 infection that fulfilled the study inclusion criteria identified in the IMaN registry from 187 hospitals throughout Iran. There were 1,392 (34.6%) neonates that were preterm, including 304 (7.6%) less than 32 weeks gestation. Among the 2,567 newborns admitted to the hospital immediately after birth, the most common clinical problems were respiratory distress (1,095 cases; 42.6%), sepsis-like syndrome (355; 13.8%) and cyanosis (300 cases; 11.6%). Of 683 neonates transferred from another hospital, the most frequent problems were respiratory distress (388; 56.8%), sepsis-like syndrome (152; 22.2%), and cyanosis (134; 19.6%). Among 765 neonates discharged home after birth and subsequently admitted to the hospital, sepsis-like syndrome (244 cases; 31.8%), fever (210; 27.4%), and respiratory distress (185; 24.1%) were most frequent. A total of 2,331 (58%) of neonates required respiratory care, with 2,044 surviving and 287 having a neonatal death. Approximately 55% of surviving neonates received respiratory support, compared with 97% of neonates who expired. Laboratory abnormalities included elevations of WBCs, CPK, liver enzymes, and CRP. Conclusions This report adds the national experience of Iran to the list of reports from multiple countries describing their experience with COVID-19 in neonates, demonstrating that newborns are not exempt from COVID-19-morbidity and mortality.
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Affiliation(s)
- David A Schwartz
- Pathology, Perinatal Pathology Consulting, Atlanta, United States
| | - Parisa Mohagheghi
- Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Fereshteh Moshfegh
- Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nazanin Zafaranloo
- Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Narjes Khalili
- Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mohammad Heidarzadeh
- Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Abbas Habibelahi
- Neonatal Health Office, Iran Ministry of Health and Medical Education, Tehran, Iran (the Islamic Republic of)
| | - Roya Ghafoury
- Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Fatemah Afrashteh
- Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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Heidarzadeh M, Heidari H, Ahmadi A, Solati K, sadeghi N. Evaluation of parental stress in neonatal intensive care unit in Iran: a national study. BMC Nurs 2023; 22:41. [PMID: 36788549 PMCID: PMC9930338 DOI: 10.1186/s12912-023-01200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND More attention is paid to the survival and treatment of the sick infant in the neonatal intensive care unit (NICU) and parental stress is not considered. The purpose of this study was to determine samples of the level of parental stress in the NICU. METHOD This study is a descriptive-analytical study in which Parental Stress and General Health were used in an analytical national survey in Iran. The research sample consists of 2456 parents of infants admitted to NICU. The sampling method was multi-stage random. We used 11- item parental stress questionnaire and 28-item general health questionnaire for the data collection. RESULT Baloch ethnicity with an average of 11.52 had the highest level of stress. The mean stress score of mothers was higher than fathers. The mean score of all dimensions of physical symptoms, anxiety, social functioning, depression, and total mental health score in mothers was higher than fathers. There was a statistically significant difference in the length of hospitalization in terms of different levels of parental stress scores (p < 0.002). Lack of decisive response to parents was one of the most stressful issues (8.1%). CONCLUSION Our result shows mothers' stress was higher than fathers. So that health policymakers should pay attention to stress risk factors to provide appropriate interventions according stress risk factors Future studies should design appropriate interventions to reduce parental stress, especially in high-risk mothers.
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Affiliation(s)
- Mohammad Heidarzadeh
- grid.488433.00000 0004 0612 8339Zahedan University of Medical Sciences, Zahedan, Iran
| | - Haydeh Heidari
- Faculty of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Ali Ahmadi
- grid.440801.90000 0004 0384 8883Department of Epidemiology and Biostatistics, School of Health and Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Kamal Solati
- grid.440801.90000 0004 0384 8883Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Narges sadeghi
- grid.411757.10000 0004 1755 5416Islamic Azad University, Isfahan, Iran
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Shahkolahi Z, Irajpour A, Jafari-Mianaei S, Heidarzadeh M. Developing patient safety standards for health-care quality promotion in neonatal intensive care units: A mixed-methods Protocol. J Educ Health Promot 2022; 11:291. [PMID: 36439017 PMCID: PMC9683434 DOI: 10.4103/jehp.jehp_1409_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/29/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) is one of the accident-prone settings in the health-care system. There is a series of structural and process threats to the safety of infants hospitalized in this unit, which can be prevented by taking the right actions. For this purpose, developing standards based on current knowledge, available resources, and the context that provides care can determine patient injury prevention requirements. Likewise, it can be a source for national development and application of related guidelines and protocols. This study aims to develop patient safety standards in the NICUs of Iran. MATERIALS AND METHODS This mixed-methods study will apply the exploration, preparation, implementation, and sustainment framework to develop patient safety standards. In each phase of this framework, a set of activities take place. Exploration is based on the world health organization model to develop standards. Determining the validity and applicability of standards will be done in Phase 2 (Preparation) and Phase 3 (Implementation), respectively. Since the long-term effects are not desired, the fourth phase (Sustainment) will not be considered. DISCUSSION Patient safety standards from this study will contribute to efficient and effective, equitable, and high-quality health-care delivery. The application of them will further promote patient safety and the quality of medical care in Iranian NICUs.
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Affiliation(s)
- Zahra Shahkolahi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Irajpour
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soheila Jafari-Mianaei
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
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Heidarzadeh M, Taheri M, Mazaheripour Z, Abbasi-Khameneh F. The incidence of congenital anomalies in newborns before and during the Covid-19 pandemic. Ital J Pediatr 2022; 48:174. [PMID: 36109775 PMCID: PMC9479418 DOI: 10.1186/s13052-022-01368-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pregnant women are one of the most vulnerable groups in the Covid-19 pandemic. Due to the lack of knowledge about fetal and perinatal complications following Covid-19 infection, the association of Covid-19 pandemic and congenital anomalies in babies conceived and born during this pandemic is unclear. Current study aimed to investigate the association between the Covid-19 pandemic and congenital birth anomalies in Iran. The population of newborns whose embryonic period coincided with the Covid-19 crises were compared with a similar group born during the pre-Covid-19 period.
Methods
This is a retrospective comparative analysis of congenital birth anomalies in Iran; desired data was extracted from national birth registry database. All registered congenital anomalies in hospital births were compared between two time periods: During Covid-19 (1st November 2020- 28th February 2021) and Before Covid-19 (1st November 2019-29th February 2020). Incidence of congenital anomalies at birth were compared and analyzed between these two time periods.
Results
The incidence of congenital birth anomalies are significantly increased during Covid-19 pandemic compared with before Covid-19 (P value < 0.00001). The number of all types of anomalies has increased in the current pandemic, but the congenital anomalies of the central nervous system (P value = 0.04) and Genitourinary (P value = 0.03) have a larger contribution than before.
Conclusion
Covid-19 pandemic are associated with congenital anomalies at birth. There are several factors in the Covid-19 pandemic which can affect fetal development in the first trimester of pregnancy. Possible reasons include vertical transmission of Covid-19 infection; maternal fever, stress and anxiety; insufficient preconception and prenatal care; neglect of fetal screening; and poverty imposed by this pandemic.
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11
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Ghavi A, Hassankhani H, Powers K, Arshadi-Bostanabad M, Namdar-Areshtanab H, Heidarzadeh M. Parental support needs during pediatric resuscitation: A systematic review. Int Emerg Nurs 2022; 63:101173. [DOI: 10.1016/j.ienj.2022.101173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/05/2022]
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Ghavi A, Hassankhani H, Powers K, Arshadi-Bostanabad M, Namdar Areshtanab H, Heidarzadeh M. Parents' and healthcare professionals' experiences and perceptions of parental readiness for resuscitation in Iranian paediatric hospitals: a qualitative study. BMJ Open 2022; 12:e055599. [PMID: 35613813 PMCID: PMC9131064 DOI: 10.1136/bmjopen-2021-055599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine parents' and healthcare professionals' experiences and perceptions of parental readiness for resuscitation of their child in a paediatric hospital. DESIGN This exploratory descriptive qualitative study used content analysis. Participants shared their experiences and perceptions about parental readiness for cardiopulmonary resuscitation through semi-structured and in-depth interviews. MAXQDA 2020 software was also used for data analysis. SETTING The setting was two large teaching paediatric hospitals in Iran (Este Azerbaijan and Mashhad). PARTICIPANTS Participants were 10 parents and 13 paediatric healthcare professionals (8 nurses and 5 physicians). Selection criteria were: (a) parents who experienced their child's resuscitation crisis at least 3 months prior and (b) nurses and physicians who were working in emergency rooms or intensive care wards with at least 2 years of experience on the resuscitation team. RESULTS Participants shared their experiences about parental readiness for resuscitation of their child in four categories: awareness (acceptance of resuscitation and its consequences; providing information about the child's current condition and prognosis), chaos in providing information (defect of responsibility in informing; provide selective protection of information; hardness in obtaining information), providing situational information (honest information on the border of hope and hopeless; providing information with apathy; providing information as individual; dualism in blaming; assurance to parents; presence of parents to better understand the child's situation) and psychological and spiritual requirements (reliance on supernatural power; need for access to a psychologist; sharing emotions; collecting mementos). CONCLUSION The results of this study provide insight on the needs of parents and strategies to use to prepare them for their child's resuscitation crisis, which can be used to enhance family centred care practices in paediatric acute care settings.
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Affiliation(s)
- Arezoo Ghavi
- Student Research Committee, Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz, The Islamic Republic of Iran
| | - Hadi Hassankhani
- Road Traffic Injury Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Kelly Powers
- School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Mohammad Arshadi-Bostanabad
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, The Islamic Republic of Iran
| | - Hossein Namdar Areshtanab
- Department of Psychology Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Mohammad Heidarzadeh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, The Islamic Republic of Iran
- Department of Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Pourshirazi M, Heidarzadeh M, Taheri M, Esmaily H, Babaey F, Talkhi N, Gholizadeh L. Cesarean delivery in Iran: a population-based analysis using the Robson classification system. BMC Pregnancy Childbirth 2022; 22:185. [PMID: 35260106 PMCID: PMC8903666 DOI: 10.1186/s12884-022-04517-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. Objective To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. Methods A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. Results Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. Conclusion The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04517-1.
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Affiliation(s)
- Maryam Pourshirazi
- Department of Hospital Management and Clinical Services Excellence, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Heidarzadeh
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran. .,Department of Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahshid Taheri
- Department of Hospital Management and Clinical Services Excellence, Ministry of Health and Medical Education, Tehran, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farah Babaey
- Department of Hospital Management and Clinical Services Excellence, Ministry of Health and Medical Education, Tehran, Iran
| | - Nasrin Talkhi
- Department of biostatistics, School of Health, Mashhad university of Medical Sciences, Mashhad, Iran
| | - Leila Gholizadeh
- Faculty of Health, University of Technology, Sydney, NSW, Australia
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14
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Daniali ZM, Sepehri MM, Sobhani FM, Heidarzadeh M. A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran. J Prev Med Public Health 2022; 55:49-59. [PMID: 35135048 PMCID: PMC8841192 DOI: 10.3961/jpmph.21.401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/31/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.
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Affiliation(s)
- Zahra Mohammadi Daniali
- Department of Industrial Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Mehdi Sepehri
- Department of Healthcare Systems Engineering, Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran
- Corresponding author: Mohammad Mehdi Sepehri Department of Healthcare Systems Engineering, Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Jalal Al-e-Ahmad Highway, Tehran 1411713116, Iran E-mail:
| | - Farzad Movahedi Sobhani
- Department of Industrial Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
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15
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Mohammadi M, Sattarzadeh N, Heidarzadeh M, Hosseini MB, Hakimi S. Implementation Barriers for Practicing Continuous Kangaroo Mother Care from the Perspective of Neonatologists and Nurses. J Caring Sci 2021; 10:137-144. [PMID: 34849357 PMCID: PMC8609115 DOI: 10.34172/jcs.2021.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/01/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: Kangaroo mother care (KMC), as a complement to incubator care, is one of the ten recommendations of the World Health Organization (WHO) for the care of preterm infants. The KMC stabilizes the heart rate, improves oxygen saturation, makes weight gain better, and reduces crying in the infant. In order to launch KMC unit, the barriers for implementing this type of care should be recognized.
Methods: This qualitative research was conducted using a focus group discussion and individual semi-structured interview with nurses, doctors, executive and management staff of a neonatal unit of a third level teaching hospital in Tabriz, northwest Iran. The participants were selected using purposeful sampling. Content analysis was used for analyzing data. Data were analyzed by MAXQDA 10 software.
Results: After analyzing data, four main themes were extracted including mother-related barriers, father-related barriers, physician- related barriers, and system-related barriers.
Conclusion: Based on the findings of the research, it seems that in order to facilitate practicing continuous KMC, much emphasis should be placed on training the parents and health care providers. Furthermore, in some cases, reforming the payment system for physicians, providing an instruction for performing continuous KMC, and continuous assessment of hospitals annually are necessary.
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Affiliation(s)
- Marzieh Mohammadi
- Student's Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Science, Tabriz, Iran
| | - Niloufar Sattarzadeh
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Science, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Mohammad Bagher Hosseini
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Sevil Hakimi
- School of Nursing and Midwifery, Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Science, Tabriz, Iran
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16
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Mirnia K, Heidarzadeh M, Afjeh SA, Alizadeh P, Kashan AA, Bordbar A, Maghsoudi A. Signal Processing of Heart Rate for Predicting Sepsis in Premature Neonates. J Med Signals Sens 2021; 11:222-226. [PMID: 34466402 PMCID: PMC8382031 DOI: 10.4103/jmss.jmss_30_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/27/2020] [Accepted: 04/04/2021] [Indexed: 11/20/2022]
Abstract
The heart rate characteristic (HeRO score) is a figure derived from the analysis of premature neonate's electrocardiogram signals, and can be used to detect infection before the onset of clinical symptoms. The United States and Europe accept this diagnostic technique, but we require more tests to prove its efficacy. This method is not accepted in other developed countries so far. The present study aimed to investigate changes in the heart characteristics of two neonates in Akbar Abadi Hospital in Tehran. Experts chose one newborn as a sepsis case, and the other neonate was healthy. The results were analyzed and compared with previous studies. In this research, a group of five neonates was selected randomly from the neonatal intensive care unit, and cardiac leads were attached to them for recording heart rates. We selected two neonates from the five cases, as a case (proven sepsis) and control, to analyze heart rate variability (HRV). Then, we compared the differences in the heart rate of both neonates. Analysis of HRV of these two neonates showed that the pattern of HRV is compatible with reports from US studies. Considering the results of this study, heart rates and their analysis can provide useful indicators for mathematical modeling before the onset of clinical symptoms in newborns.
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Affiliation(s)
- Kayvan Mirnia
- Children's Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatrics, Pediatric Health Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Seyyed Abolfazl Afjeh
- Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parinaz Alizadeh
- Department of Pediatrics, Mofid Children Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Abbas Abaei Kashan
- Department of Mechanical Engineering School, Iran University of Science and Technology, Tehran, Iran
| | - Arash Bordbar
- Department of Neonatology, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amid Maghsoudi
- Department of Mechanical Engineering, Mechanical Engineering School, Iran University of Science and Technology, Tehran University of Medical Science, Tehran, Iran
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Gopinathan D, Heidarzadeh M, Guillas S. Probabilistic quantification of tsunami current hazard using statistical emulation. Proc Math Phys Eng Sci 2021; 477:20210180. [PMID: 35153568 PMCID: PMC8364761 DOI: 10.1098/rspa.2021.0180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/10/2021] [Indexed: 12/02/2022] Open
Abstract
In this paper, statistical emulation is shown to be an essential tool for the end-to-end physical and numerical modelling of local tsunami impact, i.e. from the earthquake source to tsunami velocities and heights. In order to surmount the prohibitive computational cost of running a large number of simulations, the emulator, constructed using 300 training simulations from a validated tsunami code, yields 1 million predictions. This constitutes a record for any realistic tsunami code to date, and is a leap in tsunami science since high risk but low probability hazard thresholds can be quantified. For illustrating the efficacy of emulation, we map probabilistic representations of maximum tsunami velocities and heights at around 200 locations about Karachi port. The 1 million predictions comprehensively sweep through a range of possible future tsunamis originating from the Makran Subduction Zone (MSZ). We rigorously model each step in the tsunami life cycle: first use of the three-dimensional subduction geometry Slab2 in MSZ, most refined fault segmentation in MSZ, first sediment enhancements of seabed deformation (up to 60% locally) and bespoke unstructured meshing algorithm. Owing to the synthesis of emulation and meticulous numerical modelling, we also discover substantial local variations of currents and heights.
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Affiliation(s)
- Devaraj Gopinathan
- Department of Statistical Science, University College London, Gower Street, London WC1E 6BT, UK
| | - Mohammad Heidarzadeh
- Department of Civil and Environmental Engineering, Brunel University London, Uxbridge UB8 3PH, UK
| | - Serge Guillas
- Department of Statistical Science, University College London, Gower Street, London WC1E 6BT, UK
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Mirbaha-Hashemi F, Tayefi B, Rampisheh Z, Tehrani-Banihashemi A, Ramezani M, Khalili N, Pournik O, Taghizadeh-Asl R, Habibelahi A, Heidarzadeh M, Moradi-Lakeh M. Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks. BMC Pregnancy Childbirth 2021; 21:379. [PMID: 34001015 PMCID: PMC8127274 DOI: 10.1186/s12884-021-03800-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 04/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03800-x.
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Affiliation(s)
- Fariba Mirbaha-Hashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Batool Tayefi
- Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Rampisheh
- Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhdeh Ramezani
- Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Pournik
- Statistics and Information Technology Management, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Habibelahi
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Heidarzadeh
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran.,Department of Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Hemmat Freeway, Next to Milad Tower, Tehran, Iran.
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19
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Akrami F, Mohammadi G, Azizmohammad Looha M, Habibelahi A, Mehrabi Y, Delbarpoor Ahmadi S, Heidarzadeh M. Survival of very preterm infants in the Islamic Republic of Iran: A population-based retrospective cohort study. Med J Islam Repub Iran 2021; 35:41. [PMID: 34268229 PMCID: PMC8271226 DOI: 10.47176/mjiri.35.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Estimation of the survival of very preterm infants is necessary to make decisions and design interventions in order to improve their quality of care. This survey aimed to estimate the survival of very preterm infants born at 23 up to 33 weeks of gestational age (GA) in Iran. Methods: This population-based retrospective cohort study included 8536 infants born before 33 weeks of GA, from March 21st to December 22nd 2013 in Iran. The primary data were extracted from the Iranian national maternal and neonatal registration network (IMAN). All infants who have been discharged alive, followed up by telephone contact up to one year after birth. The Kaplan-Meier and Log-rank tests were performed to estimate survival and to compare survivals, respectively, using SPSS version 26 and R 3.5.2 softwares. Results: The overall survival was estimated at 56.70% (95% C.I: 55.60%-57.80%) at the end of the follow-up period. Total death rate was estimated at 43.30% and was significantly decreased with increasing birth weight (p<0.0001). Survival was increased significantly with increasing GA (p<0.0001), from 5.7% at 23 weeks to 79.6% at 32 weeks. The estimated cumulative proportion of death until the end of the neonatal period had a decreasing trend and then had a steady trend until the end of the follow-up period. The hazard ratio of quadruple or more birth and GA were 1.46 (p=0.021) and 0.83 (p<0.001), respectively. Conclusion: The overall estimated survival of very preterm infants was not high. Even with modern perinatal technology and care, early deaths of very preterm infants were still common.
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Affiliation(s)
- Forouzan Akrami
- Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gohar Mohammadi
- Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Administration and Resources Development affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Azizmohammad Looha
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Habibelahi
- Neonatal Health Office, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Heidarzadeh
- Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
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20
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Mohammadi M, Bergh AM, Heidarzadeh M, Hosseini M, Sattarzadeh Jahdi N, Valizadeh L, Sarvaran B, Hakimi S. Implementation and effectiveness of continuous kangaroo mother care: a participatory action research protocol. Int Breastfeed J 2021; 16:24. [PMID: 33685495 PMCID: PMC7938260 DOI: 10.1186/s13006-021-00367-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background The efficacy of continuous kangaroo mother care (C-KMC) in reducing neonatal mortality and morbidity among low birthweight and premature infants has been confirmed. Despite the recommendations of the World Health Organization, UNICEF, and the Ministry of Health of Iran to use C-KMC for eligible hospitalized neonates, this type of care is not performed due to implementation problems. This protocol aims to describe the design, implementation, and assessment of C-KMC in one tertiary hospital by means of participatory action research. Methods The objective of this study is to design and implement a C-KMC program for neonates that will be performed in two phases using a stages-of-change model. The first phase will be conducted in three consecutive activities of designing, implementing, and assessing the introduction of C-KMC. The second phase of the study has a before-and-after design to assess the effectiveness of C-KMC by comparing the length of preterm neonates’ stay in hospital and exclusive breastfeeding at discharge before and after implementing C-KMC. Discussion KMC is an important component of neonatal developmental care as part of family-centered care. Applying this type of care requires creating appropriate strategies, budget allocation, and clear and coordinated planning at different levels of the health system. The stages-of-change model is one of the appropriate approaches to the implementation of C-KMC.
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Affiliation(s)
- Marzieh Mohammadi
- Student Research Center Committee, Tabriz University of Medical Science, Tabriz, Iran
| | - Anne-Marie Bergh
- SAMRC Unit for Maternal and Infant Health Care Strategies and Research Centre for Maternal, Fetal, Newborn and Child Health, University of Pretoria, Pretoria, South Africa
| | - Mohammad Heidarzadeh
- Pediatric health research center, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Niloufar Sattarzadeh Jahdi
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Science, Tabriz, Iran
| | - Leila Valizadeh
- Department of Pediatric Nursing, Tabriz University of Medical Science, Tabriz, Iran
| | - Behzad Sarvaran
- Taleghani Training Hospital, Tabriz University of Medical Science, Tabriz, Iran
| | - Sevil Hakimi
- Student Research Center Committee, Tabriz University of Medical Science, Tabriz, Iran. .,Department of midwifery, School of Nursing and midwifery, Research center of psychiatry and behavioural science, Tabriz University of Medical Science, Tabriz, Iran.
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21
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Ghazi M, Zare M, Ramezani M, Heidarzadeh M, Behnam Vashani H. The Effect of Home Visit Program Based on the Continued Kangaroo Mother Care on Maternal Resiliency and Development of Premature Infant: A Randomized Clinical Trial. Int J Community Based Nurs Midwifery 2021; 9:64-75. [PMID: 33521150 PMCID: PMC7829586 DOI: 10.30476/ijcbnm.2020.86141.1321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant. METHODS This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-al-Banin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0.05. RESULTS The resiliency score of the mothers one month after discharge was112.50±5.50 and 76.40±5.60 in the experimental and control groups, which was significantly different (P<0.001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280.40±15.60vs223.80±22.00) (P<0.001). CONCLUSION The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number IRCT20181121041718N1.
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Affiliation(s)
- Marzieh Ghazi
- Department of Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Zare
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatric, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Behnam Vashani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Khosravan S, Khoshahang M, Heidarzadeh M, Basirimoghadam M. Effect of NIDCAP home care follow-up program of preterm newborns on maternal anxiety and stress. Ann Ig 2020; 32:627-634. [PMID: 33175074 DOI: 10.7416/ai.2020.2384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Birth of the preterm babies creates a huge amount of stress in mothers and makes it hard for them to contribute to the care of their off springs. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP)is designed to empower the parents in comprehensively caring for their preterm baby after discharge from the hospital. The present research was intended to study the effects of NIDCAP follow up on the stress and anxiety of the mothers. METHODS In this clinical trial, 20 mothers of preterm babies with the gestational age of 26 to 32 weeks were studied at Omolbanin Hospital, Mashhad, Iran. The NIDCAP was performed during the hospital stay and two times after discharge. The control group received routine care without the NIDCAP. Anxiety and stress of the mothers were assessed through the Spielberger and Cohen questionnaires. Data were analyzed by Independent t-test, Chi-square and Fisher's Exact test in SPSS 20 software. RESULTS At the baseline, there were no statistically significant differences between the experimental and the control group. After the intervention, the average score of anxiety was significantly lower among mothers in the experimental group compared to the control group(P=0.009). NIDCAP and its follow up also reduced the stress of the mothers in the experiment group (P=0.033). CONCLUSIONS Implementation of the NIDCAP and its home follow up was effective in reducing the stress and the anxiety of the mothers of preterm babies. Execution of the NIDCAP is recommended to all hospital of the country for mothers of preterm babies.
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Affiliation(s)
- S Khosravan
- Department of Community Health and Nursing Management, Faculty of Nursing, Research Center for Social Factors Affecting Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - M Khoshahang
- Department of Community Health and Nursing Management, Faculty of Nursing, Research Center for Social Factors Affecting Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - M Heidarzadeh
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Basirimoghadam
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Khalili N, Heidarzadeh M, Habibelahi A, Tayefi B, Ramezani M, Rampisheh Z, Tehrani-Banihashemi A, Mirbaha F, Raji F, Babaee E, Taghizadeh Asl R, Moradi-Lakeh M, Naghavi M, H. Mokdad A. Stillbirth in Iran and associated factors (2014-2016): A population-based study. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Hailegebriel TD, Bergh AM, Zaka N, Roh JM, Gohar F, Rizwan S, Asfaw AG, Heidarzadeh M, Zeck W. Improving the implementation of kangaroo mother care. Bull World Health Organ 2020; 99:69-71. [PMID: 33658737 DOI: 10.2471/blt.20.252361] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/08/2020] [Accepted: 07/22/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Anne-Marie Bergh
- UP/SAMRC Unit for Maternal and Infant Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Bophelo Road, Prinshof 349-Jr, Pretoria 0084, South Africa
| | - Nabila Zaka
- Health Services Academy, Islamabad, Pakistan
| | - Jung Min Roh
- Columbia University School of Social Work, Columbia University, New York, USA
| | - Fatima Gohar
- United Nations Children's Fund, Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - Samia Rizwan
- United Nations Children's Fund, Pakistan Country Office, Islamabad, Pakistan
| | | | - Mohammad Heidarzadeh
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Willibald Zeck
- Health Section, United Nations Children's Fund, New York, United States of America (USA)
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25
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Khalili N, Heidarzadeh M, Habibelahi A, Tayefi B, Ramezani M, Rampisheh Z, Tehrani-Banihashemi A, Mirbaha F, Raji F, Babaee E, Taghizadeh Asl R, Moradi-Lakeh M, Naghavi M, Mokdad AH. Stillbirth in Iran and associated factors (2014-2016): A population-based study. Med J Islam Repub Iran 2020; 34:38. [PMID: 32617277 PMCID: PMC7320973 DOI: 10.34171/mjiri.34.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. The aims of this study were to determine stillbirth rate at national and subnational levels and to investigate its associated risk factors in Iran. Methods: Using all data from Iranian Maternal and Neonatal Network (IMaN), we calculated stillbirth rate of Iran from 2014-2016. This network registers information of almost all births across the country. The logistic regression was used to estimate the adjusted odds ratio (aOR) with 95% confidence intervals (CIs) for stillbirth. Results: In 2014, still birth rate was 7.40 per 1000 births. In 2015 and 2016, stillbirth rates were 7.22 per 1000 births and 7.63 per 1000 births, respectively. The most important related factors of stillbirth were preterm birth (aOR= 62.53, 95% CI; 60.77-64.34), sexual ambiguity (aOR= 14.51, 95% CI; 12.76-16.50), and post term birth (aOR= 3.31, 95% CI; 2.66-4.13). Conclusion: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. Iran has achieved stillbirth target of ENAP at national level. It is important for the health care system to establish and improve specific and focused policies, interventions, and programs for achieving this target even in the most deprived areas.
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Affiliation(s)
- Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Habibelahi
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Batool Tayefi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhdeh Ramezani
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Rampisheh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fariba Mirbaha
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farima Raji
- Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Ebrahim Babaee
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Rahim Taghizadeh Asl
- Maastricht University, CAPHRI, Department of Health Promotion, Maastricht, Netherlands
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Nasri K, Hantoushzadeh S, Hugh O, Heidarzadeh M, Habibelahi A, Shariat M, Tara F, Kashanian M, Radmehr M, Yekaninejad MS, Homeira VC, Francis A, Gardosi J. Customized birthweight standard for an Iranian population. J Matern Fetal Neonatal Med 2019; 34:3651-3656. [PMID: 31766924 DOI: 10.1080/14767058.2019.1689557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To produce a customized birthweight standard for Iran.Method: Retrospective study of a pregnancy database collected from five hospitals across Iran. The cohort consisted of 4994 consecutive term births with complete data, delivered between July 2013 and November 2014. Coefficients were derived using a backwards stepwise multiple regression technique.Results: Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as significant physiological variables affecting birthweight. Paternal height and weight were also significant although weaker factors. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3390 g. Pathological factors found to affect birthweight in this cohort included village housing, anemia, preexisting and gestational diabetes and preeclampsia.Conclusion: The analysis confirmed the main physiological variables that affect birthweight in other countries and shows paternal factors also to be significant variables. Development of a country-specific customized birthweight standard will aid clinicians in Iran to distinguish between fetuses that are either constitutionally or pathologically small, thereby avoiding unnecessary interventions, and improving identification of at-risk pregnancies and perinatal outcome.
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Affiliation(s)
- K Nasri
- Department of Obstetrics and Gynecology, Arak University of Medical Sciences, Arak, Iran
| | - S Hantoushzadeh
- Maternal-Fetal & Neonatal and Breast-Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - O Hugh
- Perinatal Institute, Birmingham, UK
| | | | | | - M Shariat
- Maternal-Fetal & Neonatal and Breast-Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - F Tara
- Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Kashanian
- Department of Obstetrics and Gynecology, Iran University of Medical Sciences and Health Services, Akbar Abadi Teaching Hospital, Tehran, Iran
| | - M Radmehr
- Clinical Research Center, Milad General Hospital, Tehran, Iran
| | - M S Yekaninejad
- Department of Epidemiology & Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - V C Homeira
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Khalili N, Moradi-Lakeh M, Heidarzadeh M. Low birth weight in Iran based on Iranian Maternal and Neonatal Network (IMaN). Med J Islam Repub Iran 2019. [DOI: 10.47176/mjiri.33.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Khalili N, Moradi-Lakeh M, Heidarzadeh M. Low birth weight in Iran based on Iranian Maternal and Neonatal Network (IMaN). Med J Islam Repub Iran 2019; 33:30. [PMID: 31380320 PMCID: PMC6662536 DOI: 10.34171/mjiri.33.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Narjes Khalili
- Preventive Medicine and Public Health Research Center, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Mirnia K, Akrami F, Jodeiry B, Heidarzadeh M, Safavinia S. Clinical Outcomes of High-Risk Infant Follow-Up Program in a Tertiary Care Centre. Iran J Nurs Midwifery Res 2017; 22:476-480. [PMID: 29184588 PMCID: PMC5684797 DOI: 10.4103/ijnmr.ijnmr_62_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND High-risk infant follow-up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran. MATERIALS AND METHODS In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria. After doing necessary measurements and family education, information was recorded in HRI health certificate and then entered in the access database for analysis. RESULTS From 253 eligible HRIs registered, 241 (95%) infants attended the follow-up clinic after discharge. A total of180 cases were recalled for further visits, 110 of which attended the clinic. Anthropometric indices had an increasing trend in the first 6 months of life. There was no significant relation between ages and stages questionnaire (ASQ) results and infant birth weight, height, and head circumference. The ratios of intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) were 8.7% and 3.1%, respectively. The incidence of congenital hypothyroidism was 2:341 in HRIs. CONCLUSIONS Although some outcomes, such as ROP, improved in our study compared to similar studies, the findings indicate an impairment of the current follow-up processes and highlight the necessity to modify the current HRIF program. Ethically, we insist on integrating HRIF program in child health services to promote early childhood development.
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Affiliation(s)
- Kayvan Mirnia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Jodeiry
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Safavinia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Eskandari Z, Razavi Nejad M, Akrami F, Almasi-Hashiani A, Heidarzadeh M. Assessing staff-oriented care with developmental support approach in Iranian NICUs. J Matern Fetal Neonatal Med 2017; 32:1009-1013. [PMID: 29065751 DOI: 10.1080/14767058.2017.1397127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Regarding improvements in preterm infants' survival rates, it is necessary the improvement of Neonatal Intensive Care Unit (NICUs) status in order to provide comprehensive care. The aim of this study was to assess the aspects of staffing-oriented neonatal care in NICUs affiliated to Universities of Medical Sciences in Iran. METHODS This survey is a cross-sectional study which was conducted in 23 NICUs of nine type-1 Universities of Medical Sciences across country. The study checklist contained 39 items in four domains, including "Composition, Philosophy, Training, and Support", "Management", "Resources", and "Transition Systems". Data were gathered through observation and analyzed using Stata software, version 13. RESULTS In this study, the mean score of staffing-oriented care was 43.5 of 100. In none of the studied domains, the mean score obtained was not above 50. Among the four domains studied, the highest score was related to "Management", (the mean score of 50 of 100) and the lowest score related to "Resources" (the mean score of 35 of 100). CONCLUSIONS Considering the importance of the role of health professionals in the neonatal comprehensive care, and also the low mean score of staffing-oriented care (43.51 out of 100) and also its items in NICUs in this study, it is concluded that more attention is needed for staff-oriented care as well as the strengthening of this dimension of developmental care along with other dimensions, through designing of appropriate interventions to improve the health outcomes of preterm infants.
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Affiliation(s)
- Zahra Eskandari
- a Ali Asghar children's Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Mostajab Razavi Nejad
- b Neonatal Research Center, Department of Pediatrics , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Forouzan Akrami
- c Medical Ethics and Law Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Amir Almasi-Hashiani
- d Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center , Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Mohammad Heidarzadeh
- e Children Health Research Center, Department of Pediatrics , Tabriz University of Medical Sciences , Tabriz , Iran
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Razavi Nejad M, Eskandari Z, Heidarzadeh M, Afjeh A, Almasi-Hashiani A, Akrami F. Assessing infant-oriented care with developmental support approach in Iranian NICUs. J Matern Fetal Neonatal Med 2017; 31:1851-1855. [PMID: 28508672 DOI: 10.1080/14767058.2017.1330879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Developmental care program is a comprehensive program to reduce secondary effects of NICU and special care on brain development in premature infants. This study aimed to assess neonatal care situation in Iranian NICUs based on developmental approach to design and provide clinical guidelines for daily care for the caregivers and the infant's family. METHODS This was a cross-sectional study conducted in NICUS in Iran. A total of 23 NICUs of 9 Universities of Medical Sciences were investigated. The checklist contains 30 items in 6 domains. Data were analyzed using STATA software, version 13. RESULTS The total mean score obtained from all six domains was 31.29 of 100, and in all domains, the mean scores calculated were not above 50. In "supporting infant," "developmental caregiving activities," "supporting the infants' state organization," "providing neonatal pain management," "developmental care approaches in documentation," and "developmental care approaches in NICU staffing," the total mean scores were 34.76, 21.6, 20, 30.18, 31.30, and 50, respectively. CONCLUSION The low mean score of infant-centered developmental care implies health staff's focus on neonatal care with at least the quality of care and its impact on development in preterm infants, and inadequate attention to the infant as an active member in care.
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Affiliation(s)
- Mostajab Razavi Nejad
- a Pediatric Department, Neonatal Research Center , Shiraz University of Medical School , Shiraz , Iran
| | - Zahra Eskandari
- b Ali Asghar Children's Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Mohammad Heidarzadeh
- c Pediatric Health Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Abolfazl Afjeh
- d Department of Pediatrics, School of Medicine, Mahdieh Medical Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Amir Almasi-Hashiani
- e Department of Epidemiology and Reproductive Health , Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Forouzan Akrami
- f Medical Ethics and Law Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Mehrnoush N, Ashktorab T, Heidarzadeh M, Momenzadeh S. Knowledge and Attitude of Personnel, Key Factors in Implementation of Neonatal Pain Management in NICU: A Qualitative Study. J Clin Diagn Res 2017. [DOI: 10.7860/jcdr/2017/26290.10851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Heidarzadeh M, Hakimi S, Habibelahi A, Mohammadi M, Shahrak SP. Comparison of Breast Crawl Between Infants Delivered by Vaginal Delivery and Cesarean Section. Breastfeed Med 2016; 11:305-308. [PMID: 27171469 DOI: 10.1089/bfm.2015.0168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Exclusive breastfeeding is the single most cost-effective intervention to reduce infant mortality. Breast crawl (BC) is deemed a natural way for the baby to behave immediately after delivery. BC is the method that may help initiation of breastfeeding in the most natural way. The aim of this study is to compare successful BC between neonates born through vaginal delivery and those born through cesarean section (CS) and factors associated with a positive outcome. METHODS Participants were mothers who delivered their babies during the period of October 2012 to December 2013 in Alzahra Hospital in Tabriz, through cesarean or vaginal delivery. Infants were placed prone on their mothers' abdomen after delivery. RESULTS Data show that babies delivered through vaginal delivery had significantly more success in BC than babies born through the cesarean delivery (88.01% versus 11.21%). Moreover, babies in the CS group used significantly less time to achieve BC (45 versus 28 minutes). CONCLUSION There is a remarkable difference in completion and length of time used to achieve BC between infants with regard to the delivery mode. Encouraging BC in all dyads, especially in cesarean births, may unduly delay the infant's first breastfeed.
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Affiliation(s)
- Mohammad Heidarzadeh
- 1 Department of Pediatrics and Neonates, School of Medicine, Tabriz University of Medical Science , Tabriz, Iran
| | - Sevil Hakimi
- 2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tabriz University of Medical Science , Tabriz, Iran
| | - Abbas Habibelahi
- 3 Department of Neonatal Health, Ministry of Health and Medical Education , Tehran, Iran
| | - Marzieh Mohammadi
- 2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tabriz University of Medical Science , Tabriz, Iran
| | - Shakiba Pourasad Shahrak
- 2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tabriz University of Medical Science , Tabriz, Iran
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Boskabadi H, Zakerihamidi M, Heidarzadeh M, Avan A, Ghayour-Mobarhan M, Ferns GA. The value of serum pro-oxidant/antioxidant balance in the assessment of asphyxia in term neonates. J Matern Fetal Neonatal Med 2016; 30:1556-1561. [PMID: 27377567 DOI: 10.1080/14767058.2016.1209655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Asphyxia is a major cause of disabilities in term-born infants. Here we have explored the value in HIE (hypoxic-ischemic-encephalopathy) of using a combination of serum pro-oxidant/antioxidant balance (PAB) assay for predicting the prognosis of asphyxia. METHOD Ninety term neonates with asphyxia were enrolled and followed up for two years. Serum PAB, demographic/biochemical characteristics of mothers, and their neonates were determined. The Denver II test was used to assess outcomes. RESULTS Of the 90 asphyxiated neonates, 47 (52.2%) had a normal outcome and 43 babies (47.8%) had abnormal outcome. Serum PAB levels in neonates with normal and abnormal outcomes were 17.1 ± 9.23 and 48.27 ± 41.30 HK, respectively. A combination of HIE intensity and PAB, compared to other indicators, had a higher predictive-value (95.2%) for outcomes in asphyxiated babies. CONCLUSION We demonstrate that PAB in combination with HIE grade may have a better predictive value for the prognosis of asphyxiated babies and predicting future neurologic problems in asphyxiated term infants.
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Affiliation(s)
- Hassan Boskabadi
- a Department of Pediatrics , Neonatal Research Center, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS) , Mashhad , Iran
| | - Maryam Zakerihamidi
- b Reproductive Health, Department of Midwifery, School of Medicine, Tonekabon Branch, Islamic Azad University , Tonekabon , Iran
| | - Mohammad Heidarzadeh
- c Department of Pediatrics , Community Medicine and Public Health, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Amir Avan
- d Department of Modern Sciences and Technologies , School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Majid Ghayour-Mobarhan
- e Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran , and
| | - Gordon A Ferns
- f Division of Medical Education , Brighton and Sussex Medical School , Brighton , UK
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Abstract
BACKGROUND AND AIMS Newborn death is an unexpected outcome for parents. Parents face with several needs in infant end-of-life. The health care team is responsible for meet these needs. This qualitative study aim was to explore of parental needs in infant end-of-life and bereavement. MATERIALS AND METHODS For this qualitative study, 24 single semi-structure interviews were done. A qualitative content analysis method was used. Sampling conducted on purposeful with maximum variation in five Neonatal Intensive Care Unit (NICU) environments in Isfahan city. Inclusion criteria for nurses and doctors were having at least one experience of caring for an infant and their family at end-of-life. Inclusion criteria for parents and their families were having at least one infant at end-of-life or had lost their infant for 6 months before in NICU. RESULTS Data analysis uncovered two main themes. Family's support needs with two subthemes (family's support needs before infant's death and family's support needs after infant's death) and family's preparatory needs upon infant's death with two subthemes (management of the bad news of infant's death by treatment team and management of the bad news of infant's death by family). DISCUSSION Mourning mother's need for her husband's presence by her side, getting hospitalized in a separate room, and management of infant's death news by father and family were among items rarely pointed out in other studies. Exploration of these needs cab be helpful for the health care team for providing care.
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Affiliation(s)
- Marzieh Hasanpour
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Sadeghi
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Nursing, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Neonatal Health, Ministry of Health and Medical Education, Tehran, Iran
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Jabbari H, Abdollahi Sabet S, Heidarzadeh M. Hospital Care for Newborn Babies: Quality Assessment, A Systematic Review. Iran J Pediatr 2015; 25:e3706. [PMID: 26495100 PMCID: PMC4610340 DOI: 10.5812/ijp.3706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/17/2015] [Indexed: 11/16/2022]
Abstract
Context: Neonatal mortality rate is declining globally. The aim of the present study is to identify relevant indicators for assessing newborn care in hospitals by a systematic review. Evidence Acquisition: A search on electronic data base and manual searches of personal files for studies on quality indicators of newborn care were carried out. Searching 9 bibliographic databases, we found 85 articles of which 22 exactly related ones were selected and studied. Hand search yielded 1 record were also searched and 2 records were included. Results: A list of 87 structure, process and outcome indicators was formulated from the articles. Also 26 excess measures were identified in gray literature. After removing duplicates, and categorizing in 3 domains, 18 measures were input, 41 process and 34 outcome measures. Conclusions: These 93 indicators provide a framework for assessing how well the hospitals are providing neonatal care. These measures should be discussed in each context expert panels to address nationally applicable indices of neonatal care and may be adapted for local health settings.
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Affiliation(s)
- Hossein Jabbari
- Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Somayae Abdollahi Sabet
- Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Somayae Abdollahi Sabet, Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran. E-mail:
| | - Mohammad Heidarzadeh
- Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Jodeiry B, Heidarzadeh M, Mirnia K, Akrami F, Heidarabadi S, Ebadi A. Innovation of High-risk Infants Follow-up Surveillance System in Iran. Int J Prev Med 2015; 6:35. [PMID: 25969705 PMCID: PMC4421883 DOI: 10.4103/2008-7802.156072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 02/23/2015] [Indexed: 11/28/2022] Open
Abstract
Background: Early childhood development is one of the most social determinants of health that must be notified in order to reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow-up surveillance system to identify high-risk infants (HRI) and their health problems for timely intervention after discharge. This study was carried out to design and pilot high-risk infant follow-ups (HRIFs) surveillance system, in Alzahra Hospital, a tertiary level center of Tabriz University of Medical Sciences (TUOMS), in 2012–2013. Methods: In this qualitative research after studying international documents, consensus about criteria of HRIs accomplished by focus group discussion. Then, Delphi agreement technique was used to finalizing assessment timetable. In the second phase, we piloted the designed surveillance system in Alzahra Hospital, a tertiary level center of TUOMS. Pilot study was implemented by follow-up team organized in designed model at the first phase of the study. Then, the findings of the pilot study were being assessed by an expert panel. If the members agreed on made decisions, they were being placed on the agenda of the national committee of development care of newborns for final approval. Results: High-risk infants follow-up surveillance system was designed in following steps: Defining of evidence-based criteria of HRIs, organizing the follow-up team, regulating the organs and neurodevelopment assessment timetable, publishing a health certificate notebook for HRIs, and designing Access database software for data collection, report and evaluation. Conclusions: We designed and piloted HRIFs surveillance system, so this system was institutionalized in Alzahra Hospital, finally. It can be prepared to apply in the whole country, after detecting the quantitative outcomes and developing the program in East Azarbijan.
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Affiliation(s)
- Behzad Jodeiry
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kayvan Mirnia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Ebadi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Heidari F, Dastgiri S, Akbari R, Khamnian Z, Khanlarzadeh E, Baradaran M, Jabbary-Fam S, Badrazar S, Heidarzadeh M, Tajaddini N. Prevalence and Risk Factors of Consanguineous
Marriage. Electron J Gen Med 2014. [DOI: 10.15197/sabad.1.11.81] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mirnia K, Samad Soltani T, Rezaei M, Heidarzadeh M, Piri Z. Design and evaluation of electronic briefs of neonatal intensive care unit in Taleghani hospital, Tabriz, Iran. Glob J Health Sci 2014; 6:125-31. [PMID: 25168989 PMCID: PMC4825516 DOI: 10.5539/gjhs.v6n5p125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 04/26/2014] [Accepted: 03/31/2014] [Indexed: 11/12/2022] Open
Abstract
More than 9 million neonatal deaths are reported through out the world each year happening in the early weeks of life most of which relate to developing countries. Thus it is very important to present a better way to keep the infants healthy which could be possible by accessing accurate information at any time required during hospitalization of infants. Therefore the required data should be collected, stored and analyzed before which is best possible by using computer. The main objective of this research is enabling researchers and clinicians quick access to the data of the babies admitted in NICU. This study involves the stage of developing a system design and its implementation following the evaluation of the electronic records which is done in a query form. By defining the neccessary terminology and designing a data model, the database and user interface are developed by using a programing language and data base tools. Finally, the system has been evaluated by user satisfaction showing to be about 85% As a result we suggest the hospitals take serious in buying the suitable technology for the NICU ward along with teaching the staffs how to work with it.
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Affiliation(s)
| | | | | | - Mohammad Heidarzadeh
- Assistant professor of neonatology , pediatric health research center, Tabriz university of medical sciences, Tabriz , Iran.
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Hosseini MB, Jannati A, Gholipour K, Heidarzadeh M, Iezadi S, Mojahed F, Vahidi RG. Perception and expectation of iran neonatal transport expert regard to developing neonatal transport system in iran: a qualitative research. J Clin Neonatol 2014; 3:25-34. [PMID: 24741537 PMCID: PMC3982336 DOI: 10.4103/2249-4847.128726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: This study was aimed to reach expert's expectations of neonatal transport system for developing neonatal transport system in Iran. Materials and Methods: This is a qualitative study conducted by using focus group discussion (FGD) to present expert's perspectives and expectancy about neonatal transport system. Participants was selected from all experts and specialist about neonatal transport in Iran countryside. Finally 48 experts, participate in this study. To data collection 4 FGD were conducted, data were analyzed by content analyses. All subthemes were categorized in main themes according to conceptual relationship as an expert panels opinions. In order to comply with the ethical issues involved in the study was voluntary, also permission for the recording session were taken and confidentiality was also ensured. Result: According to FGD results, 11 themes and 90 subthemes were founded related to neonatal transport system, the main identified themes included: Aims, necessity and models of neonatal transport system, organizing the transport system, management and quality of instruments in the transport system, Neonatal transport system staff, Human resource management and issue related to human resources, conditions and requirements of neonatal transport system, facilitating factors in neonatal transport system, information management and communication system and weakness of neonatal transport system. Conclusion: Neonatal transport systems in different countries must adapted according to situation and component of each country have different strength and weakness and in implementing a system must attend to geographical conditions, financial ability and access to professionals, health system structure, facilities related to neonatal health care, antenatal services in regain, health care related, health care program about neonates and pregnant women and epidemiological status and mortality and morbidity in deferent locals and regains in countryside.
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Affiliation(s)
- Mohammad-Bager Hosseini
- Department of Neonatology, School of Medicine, Children Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Jannati
- Department of Neonatology, School of Medicine, Children Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran ; Department of Health Services Management, Iranian Center of Excellence for Health Management, Faculty of Management and Medical Informatics, Tabriz, Iran
| | - Kamal Gholipour
- Department of Neonatology, School of Medicine, Children Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran ; Tabriz Health Service Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Department of Neonatology, School of Medicine, Children Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shabnam Iezadi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farokh Mojahed
- Department of Health Services Management, Iranian Center of Excellence for Health Management, Faculty of Management and Medical Informatics, Tabriz, Iran
| | - Reza Gholi Vahidi
- Department of Health Services Management, Iranian Center of Excellence for Health Management, Faculty of Management and Medical Informatics, Tabriz, Iran ; Tabriz Health Service Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Nahidi F, Tavafian SS, Heidarzadeh M, Hajizadeh E, Montazeri A. The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ): development and psychometric evaluation among Iranian midwives. BMC Pregnancy Childbirth 2014; 14:85. [PMID: 24564830 PMCID: PMC3937427 DOI: 10.1186/1471-2393-14-85] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/19/2014] [Indexed: 11/12/2022] Open
Abstract
Background Despite the benefits of mother-newborn skin-to-skin contact immediately after birth, it has not been universally implemented as routine care for healthy term neonates. Midwifes are the first person to contact the neonate after birth. However, there is evidence that many midwives do not perform mother-newborn skin-to-skin contact. The aim of this study was to develop and psychometrically evaluate an instrument for measuring factors associated with mother-newborn skin-to-skin contact (MSSCQ) based on the PRECEDE-PROCEED model. Methods This was a two-phase qualitative and quantitative study. It was conducted during 2010 to 2012 in Tehran, Iran. In the qualitative part, 150 midwives working in labor room participated in 19 focus group discussions in order to generate a preliminary item pool. Then, content and face validity were performed to provide a pre-final version of the questionnaire. In the quantitative phase, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the instrument. Results A 120-item questionnaire was developed through the qualitative phase. It was reduced to an 83-item after content validity. The exploratory factor analysis loaded fifteen-factors and three constructs (predisposing, enabling and reinforcing) containing 82 items (38, 18, and 26 statements, respectively) that jointly accounted for 60.61% of observed variance. The Confirmatory factors analysis determined a model with appropriate fitness for the data. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha = 0.92), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MSSCQ (ICC = 0.94). Conclusion The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ) is a reliable and valid theory-based measurement and now can be used in clinical practice, midwifery and nursing studies.
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Affiliation(s)
| | - Sedigheh Sadat Tavafian
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Nazari M, Zainiyah SYS, Lye MS, Zalilah MS, Heidarzadeh M. Comparison of maternal characteristics in low birth weight and normal birth weight infants. East Mediterr Health J 2013; 19:775-781. [PMID: 24313038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Low birth weight is a key determinant in the risk of morbidity and mortality in the neonatal period and during childhood. This unmatched case-control study in Hamadan, Islamic Republic of Iran, compared the characteristics of mothers of low- and normal-birth-weight infants. Maternal sociodemographic data, pregnancy history, anthropometric data and cord plasma zinc level were collected from 134 mothers of low-birth-weight infants and 134 mothers of normal infants at the time of delivery. Significant differences in maternal characteristics namely gravida, parity, body mass index, maternal weight gain during pregnancy and plasma cord blood zinc were found between low- and normal-birth-weight infants. There were no significant differences in maternal age, maternal education, maternal occupation, family income, previous abortion, previous preterm labour, birth Iinterval, type of clinic and place of residence between the 2 groups.
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Affiliation(s)
- M Nazari
- Research Centre for Child and Maternity Care, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
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Nazari M, Zainiyah SS, Lye M, Zalilah M, Heidarzadeh M. Comparison of maternal characteristics in low birth weight and normal birth weight infants. East Mediterr Health J 2013. [DOI: 10.26719/2013.19.9.775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dastgiri S, Heidarzadeh M, Dastgiri A. Tabriz Registry of Congenital Anomalies: a report of 10 years of monitoring birth defects in Iran. Congenit Anom (Kyoto) 2013; 53:98-9. [PMID: 23751046 DOI: 10.1111/cga.12009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/20/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Saeed Dastgiri
- Tabriz Health Services Management Research Centre; School of Medicine
| | - Mohammad Heidarzadeh
- Pediatric Health Research Centre; Tabriz University of Medical Sciences; Tabriz; Iran
| | - Ali Dastgiri
- Aras School of Medicine; Tabriz Health Services Management Research Centre; Tabriz University of Medical Sciences; Tabriz; Iran
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Heidarzadeh M, Hosseini MB, Ershadmanesh M, Gholamitabar Tabari M, Khazaee S. The Effect of Kangaroo Mother Care (KMC) on Breast Feeding at the Time of NICU Discharge. Iran Red Crescent Med J 2013; 15:302-6. [PMID: 24083002 PMCID: PMC3785903 DOI: 10.5812/ircmj.2160] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 03/25/2012] [Accepted: 04/20/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exclusive breastfeeding is one of the most important essential components of Kangaroo Mother Care. OBJECTIVE This study was performed to evaluate the effects of KMC on exclusive breastfeeding just at the time of discharge. PATIENTS AND METHODS In this cross sectional study, 251 consecutive premature newborns admitted to neonatal intensive care unit (NICU) between May 2008 and May 2009 in Alzahra University Hospital in Tabriz were evaluated. All of candidate mothers were educated for KMC method by scheduled program. Standard questionnaire was prepared by focus group discussion, and mothers filled it prior to infant hospital discharge. RESULTS In this study 157(62.5%) mothers performed kangaroo mother care (KMC group) versus 94 (37.5%) in conventional method care (CMC group). In KMC group exclusive breast feeding was 98 (62.5%) vs. 34 (37.5%), and P =.00 in CMC group, at the time of hospital discharge. Receiving KMC, and gestational age were the only effective factors predicting exclusive breastfeeding. Our result indicated that there was a 4.1 time increase in exclusive breastfeeding by KMC, and also weekly increase in gestational age increased it 1.2 times, but maternal age, birth weight, mode of delivery, and 5 minute Apgar score had no influence on it. CONCLUSIONS KMC is more effective, and increases exclusive breast feeding successfully. It can be a good substitution for CMC (conventional methods of care). It is a safe, effective, and feasible method of care for LBWI even in the NICU settings.
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Affiliation(s)
| | | | | | - Maryam Gholamitabar Tabari
- Department of Midwifery, Islamic Azad University of Sari, Sari, IR Iran
- Corresponding author: Maryam Gholamitabar Tabari, Department of Midwifery, Islamic Azad University of Sari, Sari, IR Iran. Tel: +98-9111189968, Fax: +98-1112273953, E-mail:
| | - Soheila Khazaee
- Department of Pediatrics, Tabriz Medical Science University, Tabriz, IR Iran
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Mirnia K, Heidarzadeh M, Hosseini MB. Comparison Outcome of Surfactant Administration Via Tracheal Catheterization During Spontaneous Breathing with Insure. ACTA ACUST UNITED AC 2013. [DOI: 10.12816/0002647] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hosseini MB, Heidarzadeh M, Balila M, Ghojazadeh M, Janani R, Safavi-nia S, Naghavi-Behzad M, Alikhah H. Randomized controlled trial of two methods of nasal continuous positive airway pressure (N-CPAP) in preterm infants with respiratory distress syndrome: underwater bubbly CPAP vs. Medijet system device. Turk J Pediatr 2012; 54:632-640. [PMID: 23692790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
There has been an increasing interest in the application of non-invasive respiratory support in preterm infants, and different types of nasal continuous positive airway pressure (N-CPAP) devices are being used in Neonatal Intensive Care Units (NICUs). The objective of the present study was to compare the duration of CPAP need and possible complications of two methods of (N-CPAP) delivery: Bubble CPAP (B-CPAP) and Medijet (MJ) system device in preterm infants with respiratory distress syndrome (RDS). This prospective randomized clinical trial was performed on 161 preterm infants (28-37 weeks of gestational age) with RDS and eligible for CPAP therapy. The infants were inborn and admitted in a level III NICU of Al-Zahra Teaching Hospital (Tabriz, Iran) from April 2010 to September 2011. All infants were randomized in the first hour of life to B-CPAP or MJ system. Short binasal prongs were used in both groups and CPAP was set at the level of 5-6 cm H2O. The primary outcome of this study was duration of CPAP need (hour). Other outcomes, such as complications of the two methods of N-CPAP, were evaluated using a checklist. Ninety infants were randomized to the MJ system, and 71 were randomized to B-CPAP. The mean gestational age and birth weight were similar in the two groups, as was the duration of CPAP need (44.3 ± 20.64 vs. 49.2 ± 21.2 hours, respectively; p=0.66). Moreover, the probability of complications, such as CPAP failure rate, pulmonary hemorrhage, pneumothorax, intraventricular hemorrhage, abdominal distention, necrotizing enterocolitis, and bronchopulmonary dysplasia, was the same between the two study groups (p>0.05). There was a trend of more hyperemia of the nose in the B-CPAP group in comparison to the MJ system group (10% versus 3.3%, respectively), but the difference was not significant (p=0.08). In conclusion, the MJ system is as effective as B-CPAP in the management of infants with RDS.
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Jodeiry B, Heidarzadeh M, Sahmani-Asl S, Hoseini M, Javaherizadeh H, Eliasi S, Abedini K. Study of intraventricular hemorrhage in VLBW neonates admitted in Al-Zahra Hospital, Tabriz, Iran. Niger J Med 2012; 21:92-97. [PMID: 23301457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION AND AIM Intra-ventricular hemorrhage (IVH) is an important predictor of adverse neurodevelopmental outcome. IVH risk factor identification may conduct improvement of quality of care in neonatal intensive care units. The aim of the current study was to determine possible risk factors associated with IVH in VLBW neonates admitted in our hospital. PATIENTS AND METHODS All neonates with birth weight below 1500 gr admitted to NICU. Cranial ultrasonography was done for premature neonates weighed <1000 g in 3 to 5 days and in 1 month again. In premature infants weighed >1000 g, sonography was done in 7 days and 30 days of life respectively. If there is any conditions such as apnea, seizure, significant decrease in level of hemoglobin, increased head circumference, increased oxygen consumption, and other significant changes another sonography was done again. Exclusion criteria were cerebral malformations, metabolic disturbances, chromosomal anomalies, central nervous system infection, and genetic syndromes. Data was analyzed by SPSS ver 16.0 (SPSS Inc, Chicago, IL, USA). RESULTS In this study 64 cases with IVH and without IVH were included. Mean of gestational age was 28.78 +/- 12.08. From neonates, 54.6% were boys and 45.4% were girls. Vaginal delivery and cesarean section was done in 56 (32.2%) and 118 (67.8%) cases respectively. Mean +/- SD of pH in cases with IVH and without IVH was 7.19 +/- 0.22 and 7.30 +/- 0.12 respectively (p = 0.001). Mean ISD of pco2 in cases with IVH and without IVH was 65.15 +/- 29.89 and 49.88 +/- 40.89 respectively(p = 0.001). Mean of 5th min APGAR score in patients required CPR was 7.36 +/- 1.57 and in patients without CPR was 8.68 +/- 1.25 (P = 0.001). From cases with IVH, hydrocephaly was detected in 20 cases. From cases without IVH, hydrocephaly was detected in 6 cases. Result of chi-square show significant correlation between IVH and prematurity (chi2 = 21.94, df=1, P < 0.001). From cases with IVH, 18 cases (28.1%) expired. From cases without IVH, 11 cases (10%) expired (chi2 = 9.398, df=1, P = 0.002). Results of chi-square test showed that there were a corelation between IVH and PDA, pressure support, surfactant therapy drug administration, vaginal delivery, neonatal resuscitation, and antenatal corticosteroid therapy (p < 0.05). Hyaline membrane disease, history of preclampsia in mother was significantly higher in cases without IVH (chi-square, p < 0.05). CONCLUSION PDA, pressure support, surfactant therapy, inotrop drug administration, vaginal delivery, neonatal resuscitation, and antenatal corticosteroid therapy were significantly higher in cases with IVH. Hyaline membrane disease and preeclampsia in mother was significantly higher in cases without IVH.
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Affiliation(s)
- B Jodeiry
- Pediatric Health Research Center, Dept. of Pediatrics, Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Gharagozlou M, Ebrahimi FA, Farhoudi A, Aghamohammadi A, Bemanian MH, Chavoshzadeh Z, Heidarzadeh M, Mehdizadeh M, Moin M, Movahedi M, Nabavi M, Pourpak Z, Rezaei N. Pulmonary complications in primary hypogammaglobulinemia: a survey by high resolution CT scan. Monaldi Arch Chest Dis 2008; 65:69-74. [PMID: 16913576 DOI: 10.4081/monaldi.2006.567] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Primary hypogammaglobulinemia disorders are a group of heterogeneous immunodeficiency syndromes with an increased susceptibility to pulmonary complications. METHODS The aim of this study was to evaluate the extent of lung abnormalities in primary hypogammaglobulinaemic patients by high resolution computed tomography (HRCT) scan and pulmonary function test (PFT). HRCT and PFT were performed in 22 Iranian patients with primary hypogammaglobulinemia. RESULTS Pathological bronchial findings were observed in thirteen patients: three patients showed only peribronchial thickening and the remaining ten patients suffered from both bronchiectasis and peribronchial wall thickening. Mild type of bronchiectasis and peribronchial wall thickening were the most common type, predominantly observed in the right middle and both right and left lower lobe segments of lungs. Although bullae were not found, emphysema, air-trapping, and collapse/consolidation were observed in two patients. Bronchial involvement was mostly limited to 1 up to 5 bronchopulmonary segments; only one HRCT indicated bronchial involvement in more than nine bronchopulmonary segments. Pathological bronchial findings mostly observed in the proximal bronchi; meanwhile the involvement of the distal bronchi was less common. Decreasing FEVI and FVC were observed in 65% and 55% of patients, respectively. There was a significant correlation between the HRCT score and the predicted values by PFT. The delay of diagnosis in patients with bronchiectasis was significantly higher than those without bronchiectasis. CONCLUSIONS It seems that the majority of hypogammaglobulinaemic patients suffer from the mild type of bronchiectasis, which is mostly observed in the proximal bronchi of the lower lobe segments. The delay of diagnosis plays an important role in the occurrence of this complication in these patients.
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Affiliation(s)
- M Gharagozlou
- Department of Allergy and Clinical Immunology, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
BACKGROUND At least one congenital anomaly is present in between 1% and 6% of all infants throughout the world. The aim of this study was to document some epidemiological features of congenital anomalies in the North-West of Iran. METHODS The study cases (n = 1574) comprised all births registered/notified to three university-hospitals of Tabriz University of Medical Sciences, Iran, from 2000 to 2004. RESULTS Total prevalence of congenital anomalies was 165.5 per 10 000 births [95% confidence interval (CI): 157-174]. Genito-urinary tract and kidney defects, anomalies of nervous system and limb anomalies accounted proportionally for more than 65% of anomalies in the region. The total prevalence of congenital anomalies in the study area increased from 104.6 per 10 000 births in 2000 (95% CI: 90-119) to 170.1 per 10 000 births in 2004 (95% CI: 152-189). CONCLUSIONS It is concluded that the data from this cross-sectional study of congenital anomalies in the North-West of Iran may be used as the baseline information to establish a population-based registry of birth defects in the area for health care and research purposes.
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Affiliation(s)
- S Dastgiri
- Department of Community and Family Medicine, National Public Health Management Centre (NPMC), Tabriz University of Medical Sciences, Tabriz, Iran.
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