Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 1 7 Zahra Shahraki Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran Mohsen Rastkar Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran Elnaz Rastkar Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mahsa Ghajarzadeh Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran Mehdi Mohammadifar Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran 2024 06 10 2025 03 11 Objective: Sex hormones play role in development of autoimmune diseases such as multiple sclerosis (MS). In our previous systematic review, we included three studies and reported the pooled odds ratio (OR) for increasing 1 year of age at menarche and risk of MS as 0.88. So, we designed this systematic review and meta-analysis to estimate the pooled mean age at menarche difference between women with MS and controls and also update the odds of developing MS by increasing age at menarche. Materials and methods: We performed a comprehensive systematic search on PubMed, Scopus, EMBASE, and Web of Science on July 1st, 2023. Also, grey literature including conference abstracts and references of the references were investigated to find potentially relevant articles. Results: A total 634 records were retrieved by systematic search. Also, one relevant record was identified from grey literature. After deduplication, 331 articles were remained for title/abstract screening and of those, 29 full-texts were evaluated. Finally, 15 studies were included in final analysis. The SMDs of age at menarche (control group – case group) ranged between -0.18 and 1.41. The pooled SMD of age at menarche (controls-cases) was 0.17 (95% CI: 0.09-0.25) (I2=85.1%, p<0.001). OR for age at menarche and risk of MS ranged between 0.8 and 1.76, and the pooled OR for increasing 1 year of age at menarche estimated as 0.92(95% CI: 0.89-0.94) (I2=41.6%, P=0.07). Conclusion: The results of this systematic review show that the mean age at menarche is higher in controls than women with MS, and the risk of MS decreases by increasing age at menarche https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2776 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2776/708

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 8 13 Mohammadreza Salehi Department of Infectious Disease and Tropical Medicine, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Marjan Ghaemi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Asadi Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Nafisseh Saedi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Mohammad Haddadi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Nasim Eshraghi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Maryam Rabiei Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran Parshang Nazeri Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Maryam Forouzin Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Sedigheh Hantoushzadeh Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2024 05 06 2025 03 11 Objective: Influenza causes significant mortality and morbidity in pregnant women and neonates especially in developing countries. This study aimed to investigate the maternal and neonatal outcomes in pregnant women with influenza and compare them with non-infected mothers. Materials and methods: This case-control single-center cohort study was conducted during the influenza season in 2022 and included all pregnant women with influenza during pregnancy. Baseline characteristics including age, body mass index, job, vaccination, and ethnicity were documented and outcomes including premature rupture of membranes (PROM), preterm labor, cesarean section, neonatal distress, and neonatal hospitalization were evaluated and compared with the control group. Results: In this study 39 pregnant women in each case and control group were evaluated. There was no significant difference in demographic data between the two groups. None of the participants in the case group received the influenza vaccine during pregnancy. The rate of cesarean section (63.2% vs 43.5%), neonatal distress (38.5% vs 12.8%), and neonatal hospitalization (43.5% vs 15.3%) was significantly higher in the case group than in healthy women (P-value=0.022, 0.010, 0.006 respectively).  Although, the rate of PROM was not significantly different between the two groups (P=0.556). Preterm labor was higher in the case group than in the control group, but the difference was insignificant (P=0.135). Conclusion: The study findings suggest that pregnant women infected with influenza are at higher risk of neonatal complications and vaccination is helpful in these mothers as preventive measures to reduce complications. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2730 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2730/709

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 14 18 Mahbod Kaveh Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran Maryam Noory Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Kaji Yazdi Pediatric Hematology and Oncology Department, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran Shima Jeiroodi Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran 2024 08 28 2025 01 26 Objective: To investigate the relationship between maternal and neonatal vitamin D serum levels in term infants with and without sepsis. Materials and methods: This is a case-control study with 320 participants which include , 80 mothers and babies with neonatal sepsis and 80 control mothers and babies without neonatal sepsis that included in  their quantitative vitamin D levels were compared with each other survey. Results: Demographic and clinical characteristics of infants (age at admission, gender) and mothers (age, education level) were recorded. Blood samples were taken to check serum vitamin D levels of these babies along with their mothers. Vitamin D levels were classified as deficiency less than 10 ng/ml, moderate deficiency 10-30 ng/ml, mild deficiency 20-30 ng/ml and normal 100-30 ng/ml.33 (41.3%) of the infants born in the neonatal sepsis group and 45 (56.3%) of the control infants were male. Using Fisher’s exact test, no significant difference was found between the two groups in terms of gender distribution, P=0.082. The median age of infants in the neonatal sepsis group was 5 (3-9) days and in the control group was 5 (4-6) days. The mean (age of mothers in the patient group was 29.6 (6.4) years and in the control group was 29.7 (5.6) years. The median range of maternal vitamin D levels in the neonatal sepsis group was 23.8 (15.0-30.0) and 28.6 (17.1-34.0) ng/ml in the control group. According to the Mann-Whitney U statistical test, the vitamin D level of mothers in the neonatal sepsis group was significantly lower than that of the group was the control (p=0.020). Conclusion: According to the result of the Mann-Whitney U test, the vitamin D level of mothers in the neonatal sepsis group was significantly lower than the control group (P=0.020). Mother’s vitamin D level maybe related to the incidence of neonatal sepsis. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2896 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2896/710

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 19 30 Daniel Del Rio Forero Center for Studies and Research in Psychopathology and Health Psychology (CERPPS), Doctoral School of Behavior, Language, Education, Socialization, Cognition (CLESCO), Federal University of Toulouse, Toulouse, France Claudia Pineda Marín Faculty of Psychology, Konrad Lorenz University, Bogotá, Colombia and Universidad Oberta de Catalunya, Catalunya, Spain Diego Andrés Alfonso Murcia Faculty of Psychology, Konrad Lorenz University, Bogotá, Colombia María Teresa Muñoz Sastre Center for Studies and Research in Psychopathology and Health Psychology (CERPPS), Doctoral School of Behavior, Language, Education, Socialization, Cognition (CLESCO), Federal University of Toulouse, Toulouse, France Etienne Mullet Institute of Advanced Studies (EPHE), Paris, France 2024 09 26 2025 03 11 Objective: The study aimed to identify Colombian adults' positions in cases in which a counsellor can and should not do so in a situation where parents who are uncomfortable with all issues related to sexuality ask their daughter's school counsellor to help answer her questions about these topics. Materials and methods: A convenience sample of 180 adults, including 19 school counsellors, was presented with a set of 24 vignettes created by orthogonally crossing three factors: (a) the context of the request (e.g., parents ask the educator to limit sexual information to purely biological aspects), (b) whether the adolescent requests additional information, and (c) the type of information provided by the educator (e.g., comprehensive information, including abortion). Results: A cluster analysis of participants' appropriateness judgments regarding counsellor’s behavior revealed four qualitatively different positions: Depends on adolescent’s request (5%), Completeness of information (26%), Biological information is insufficient (31%), and at educator's discretion (16%). In addition, 18% (most religious) expressed no discernible position. Conclusion: The majority of participants (57%) thus expressed the view that the most appropriate behavior on the part of the counselor was to provide the most comprehensive information possible, and certainly not to focus solely on the biological aspects of sex education during counseling. This view was largely independent of contextual elements such as the limits to communication set by the parents or even the limits to communication set by the adolescent. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2933 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2933/711

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 31 36 EN Pradip Saha Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Seema Sheokand Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India L Dhaliwal Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Rashmi Bagga Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Lekha Saha Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 2024 12 06 2025 03 11 Objective: Eclampsia is a major life-threatening complication of preeclampsia with severe features leading to significant perinatal and maternal mortality and morbidity. Magnesium sulphate (MgSO4) is the first-line therapy for eclampsia prevention and treatment, however, its use is associated with serious adverse effects and there is no consensus on the optimal duration of its therapy. This study compares the efficacy and safety of abbreviated 12-hour versus standard 24-hour MgSO4 therapy during postpartum in patients having preeclampsia with severe features. Materials and methods: Patients having preeclampsia with severe features were randomized 1:1 into the 12-hour and 24-hour groups. Modified Pritchard regimen was used. The primary outcome was the incidence of seizures. Secondary outcomes included serious maternal morbidity and other adverse effects associated with MgSO4 use. Perinatal outcomes were also recorded. Analyses were intention-to-treat. Results: A total of 116 patients [57 (12-hour group) and 59 (24-hour group)] were included. The mean age was 25(±4) years, while the mean gestation period was 34 (±4) weeks. The incidence of seizures was comparable in the two groups [1 (2%), 3 (5%), p=0.62]. Patients in the 12-hour group [1 (2%)] had lesser postpartum drowsiness compared to the 24-hour group [15 (25%), p<0.001] and consequently, lesser problems in breastfeeding [1 (2%) versus 10 (17%), p=0.008]. There were no inter-group differences in other adverse effects including loss of reflexes, oliguria, respiratory depression, and proportion of patients requiring interruption of therapy. Perinatal outcomes were also similar. Conclusion: In patients having preeclampsia with severe features, 12-hour postpartum MgSO4 therapy is equally effective in preventing eclampsia and has lesser postpartum drowsiness and problems with breast feeding compared to the standard 24-hour therapy. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3050 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3050/712

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 1 2025 04 13 37 43 Anima Shrestha Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal AND Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal Dev Joshi Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal Dijan Vaidya Creator’s IVF Nepal Pvt. Ltd., Lalitpur, Nepal Sanu Shrestha Creator’omen’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Afsaneh Tehranian Department of Obstetrics and Gynecology, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Elham Feizabad Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Parvin Nikabadi Department of Obstetrics and Gynecology, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2024 03 01 2024 05 12 Objective: This study aimed to evaluate the effect of random biopsy and endo-cervical curettage (ECC), alone and together, in the diagnosis of high-grade cervical lesions in women with normal colposcopy. Materials and methods: This cross-sectional study was conducted on 356 women who underwent colposcopy examination in the gynecology-oncology clinic of Roointan-Arash Women’s Hospital, affiliated with Tehran University of Medical Sciences. All eligible women underwent colposcopy. In colposcopy examination, up to four biopsy samples were randomly taken for each quartile of the cervix and ECC was performed. Finally, the rate of intraepithelial neoplasia (CIN) and the relation between random biopsy and ECC and CIN diagnosis was determined. Results: In total, 27 (7.6%) low-grade squamous intraepithelial lesions (LSIL) and 19 (5.3%) high-grade squamous intraepithelial lesions (HSIL) were detected in cases that underwent random biopsy. There was a significant association between the abnormal random biopsy results and having multiple sexual partners (p=0.001), cigarette (p=0.041), and hookah (p=0.033) smoking. Furthermore, 31 (8.7%) LSIL and 42 (11.8%) HSIL were reported in women who underwent ECC. There was a significant relation between the abnormal results of ECC and hookah consumption (p=0.008) and human papillomavirus (HPV) infection (p=0.011). The concordance (p=0.001) between random biopsy and ECC result was 71.2% and only in 28.8% of the cases one of the methods was normal and the other was abnormal. Conclusion: The present study showed that the simultaneous use of ECC and random biopsy in women with normal colposcopy increases the detection rate of precancerous lesions by up to 28.8%.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2649 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2649/683

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 2 2024 06 30 115 121 Zinat Ghanbari Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Asadi Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Shahrzad Amirlatifi Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mamak Shariat Maternal, Fetal & Neonatal, Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Tahereh Eftekhar Department of Obstetrics and Gynaecology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Maryam Deldar Department of Obstetrics and Gynaecology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Razieh Vahdani Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2024 02 18 2024 06 05 Objective: Voiding Dysfunction (VD) is one of the most common disorders among women, which is characterized by a disorder in urination. Pelvic organ prolapse is one of the factors that can affect VD. In this study, the relationship between prolapse in the anterior, posterior, and apical areas and VD has been evaluated. Materials and methods: This is a cohort retrospective study. The participants in this study were women with VD, who referred to the pelvic floor disorders clinic of Imam Khomeini Hospital in Tehran in 2018-2020. Clinical information was obtained retrospectively from the hospital's electronic data system, also symptoms (intermittent stream, incomplete voiding, poor flow, post void dribble, straining to void, stage anterior, posterior and apical) and urodynamic parameters (including EMG, PVR100, Qmax12, and pdet20) were evaluated, which included detailed questionnaires (Urinary Distress Inventory 6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7)), pelvic examination, and complete urodynamic evaluation. Results: There was a direct relationship between the age of the patients and the stage of prolapse (p<0.001). So that, the stage increased with age. In addition, it was found that the severity of urinary symptoms is related to the stage of prolapse in the apical area (p=0.001). Also, the results showed that intermittent stream symptoms and the symptoms of staining to void had a significant relationship with the stage of prolapse (III and IV) in the apical and anterior areas. Also, it was shown that only PVR > 100 had a significant relationship with the stage of prolapse in the apical area (p=0.001). Conclusion: Intermittent stream and straining to void were related to the stages of prolapse in the apical and anterior regions. It was also concluded that the greater the prolapse, the higher the value of PVR > 100.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2631 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2631/684

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 2 2024 06 30 122 128 EN Mahbod Ebrahimi Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran AND Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Firoozeh Akbari Asbagh Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mojgan Tavakoli Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nasim Eshraghi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Naghmeh Poormand Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Marjan Ghaemi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2023 12 25 2024 06 05 Objective: This study aimed to measure the correlation of sperm DNA fragmentation with semen parameters, lifestyle, and fertility outcomes after intracytoplasmic injection (ICSI). Materials and methods: The partners who were candidates for ICSI with a history of one In vitro fertilization (IVF) failure or male factor were recruited in the study. Semen parameters including sperm count, motility, and morphology as well as DNA fragmentation index (DFI) (that were divided into 2 groups as high (>15%), and low (≤15%) fragmentation scales) were evaluated either. The correlation of DFI with semen parameters, lifestyle, and clinical pregnancy after ICSI were compared between groups. Results: In 120 included couples, 59 men (49.2%) had DFIs ≤ 15% and 61 (50.8%) cases had DFIs >15%. In the group with higher DFI, abnormal morphology (p=0.010) was higher whereas, progressive motility (p=0.001), total motility (p<0.001), and total count (p<0.001) of sperm were significantly lower. In addition, the DFI was significantly higher in the subgroup of male infertility (0.012). Logistic regression showed that a lower risk of DFI>15% was associated with higher values of progressive motility (OR=0.97, p=0.001), total motility (OR=0.96, p=<0.001), count (OR=0.96, p=<0.001) and even clinical pregnancy (OR=0.27, p=0.011). However, a history of testicular surgery was associated with a higher risk of DFI>15% (OR=3.37, p=0.046). Although no correlation was found between male age and lifestyle components with DFI, the number of embryos was lower in DFI≥15% (p<0.001). Conclusion: DFI provide a clinically important measurement of sperm quality and have an impact on IVF outcomes; however, lifestyle components may not correlate with DFI. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2561 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2561/685

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 2 2024 06 30 129 139 Maryam Behyari Department of Biology, School of Sciences, University of Tehran, Tehran, Iran Mahla Behyari Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran 2023 11 11 2024 03 05 Objective: In breast cancer early detection is associated with reduced mortality and it is essential to identify new biomarkers for early detection and appropriate management of cancer patients with the best response to treatment. Long non-coding RNAs (LncRNAs) have attracted much attention as potential diagnostic, prognostic, or predictive biomarkers due to their high specificity, easy access to non-invasive methods, and their aberrant expression under various pathological and physiological conditions. Ha