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Background & Aim: Gestational diabetes mellitus is the most common medical disorder during pregnancy that has many negative psychosomatic effects on the pregnant women and their fetus. According to existing studies, the role of counseling and husband’s support in gestational diabetes has been less studied, so the present study aimed to determine the effect of coupleschr('39') supportive counseling on self-care behavior in women with insulin-treated gestational diabetes. Methods & Materials: In this randomized clinical trial, 64 pregnant women (26-30 weeks of gestation) with gestational diabetes referred to the diabetes clinic of Umm al-Banin Hospital in Mashhad in 2018-2019 were divided into the intervention or control groups using the 4-way blocking method. For the women and their husbands in the intervention group, coupleschr('39') supportive counseling was conducted by the researcher in the form of three one-hour sessions with one week interval. A diabetes self-care questionnaire was completed in two stages, before and four weeks after the intervention for both groups, and data were analyzed by independent t-test and paired t test using the SPSS software version 16. Results: There were no statistically significant differences between the two groups in pre-intervention self-care scores (P>0.05). After the intervention, the difference between the mean of self-care scores before and after the intervention in the intervention group was 12.09±7.56 and in the control group was 0.00±3.60, which a significant increase was observed in the self-care score for the intervention group compared to the control group (P

BACKGROUND: Gestational diabetes is the most common medical complication and a common metabolic disorder during pregnancy. Increasing people's self-efficacy is one of the best ways to control this disease. As there is a lag of intervention in this regard, the purpose of this study was to determine the effect of couple supportive counseling on self-efficacy in women with insulin-treated gestational diabetes. MATERIALS AND METHODS: In this randomized clinical trial, 64 women with gestational diabetes who referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention and control groups through block randomization during 2019. Their gestational age was in 26–30 weeks. For the couples in the intervention group, three couple supportive counseling session was held. Each session lasted 1 h and was held one time per week. The instruments were diabetes self-efficacy questionnaire, fasting and 2-h postprandial checklist and Cassidy social support, which were assessed before and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25 through Mann–Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant. RESULTS: In the preintervention, the diabetes self-efficacy score had no significant difference in the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, in the postintervention, the diabetes self-efficacy score was significantly higher in the intervention group (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before the intervention, there was no significant difference between the intervention (30/2 ± 72/10) and control group (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there was a significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11, P < 0/001 respectively). Also, data analysis showed a significant correlation between self-efficacy and social support (r = 0.451, P < 0.001), self-efficacy and fasting blood sugar (P < 0.001, r = -0.577), and 2 h post prandial (r = -0.778, P < 0.001). CONCLUSION: Couple supportive counseling leads to increased self-efficacy and social support in pregnant women with gestational diabetes. Therefore, it is recommended to use this counseling as an effective method in the management of diabetic pregnant women during their prenatal care to have a healthier pregnancy.

Background & aim: Paternal-fetal attachment develops an emotional relationship between father and his infant which can affect their future interactions. Therefore, the present study aimed to determine the effect of attachment training on paternal-fetal attachment. Methods: This clinical trial was conducted in Karmandan and 22 Bahman health centers in Mashhad in 2015. The participants of the study consisted of 60 randomly-selected fathers whose wives `gestational age was 28 to 32 weeks. The intervention group received three 120-min sessions of attachment training once a week in the forms of group discussion, lectures, question and answer, film screenings, and educational booklet. Data collection was performed by means of two questionnaires, named personal and fertility characteristics questionnaire and Weaver Cranley paternal-fetalattachment questionnaire. Two groups were assessed before, immediately after, and 3 weeks after intervention (follow-up) by paternal-fetal attachment questionnaire. Data analysis was performed in SPSS (version 22) using the Chi-square, independent t-test, Fisher, Mann-Whitney U test, and repeated measure tests. P Results: The results of repeated measures showed that mean scores of paternal-fetal attachment was not significantly different between the control and intervention groups before training (P=0.527) However, paternal-fetal attachment significantly increased at post-test (P=0.069) and follow-up (P=0.006) in the experimental group. Conclusion: Attachment training increases paternal-fetal attachment; therefore, pregnancy care programs should include training sessions for fathers.

Background: Pregnant women are often ill-prepared for the health of their unborn child in the case of abnormal findings, and experience several difficulties following the detection of fetal anomalies. Therefore, this study was conducted to explore the emotional and cognitive experiences of pregnant women following prenatal diagnosis of fetal anomalies in Mashhad, Iran. Methods: This qualitative conventional content analysis study was designed through two referral centers for fetal anomaly. The data were collected from April 2017 to January 2018 in Mashhad (Iran) through individual semi-structured in-depth interviews, from 25 pregnant women with a prenatal diagnosis of fetal anomalies. Results: Four categories and 10 subcategories emerged. Category one, grief reactions during the time of diagnosis, contained two subcategories: shocked and panicked, and distressed and disbelieved.Category two, perinatal loss through a pregnancy termination, contained four subcategories: guilt and shame during pregnancy termination, loss of their expected child, suffering and emotional distress process, and unmet needs by health professionals. Category three, fears of recurrence in future pregnancies, had two subcategories: worried about inadequate prenatal care in the future pregnancies and worried about abnormal fetus in next pregnancies. Finally, Category four, a dilemma between hope and worries contained two subcategories: hope for normality and worried about future. Conclusion: It is important to monitor emotional reactions of women following prenatal anomaly diagnosis. So, training clinicians and health-care professionals for proper response to grief reaction in post therapeutic abortion is essential.

Introduction: Congenital anomalies is one of most important causes of hospitalization, disability and neonatal death; the cost of admission and treatment of these children imposes a heavy burden on the health system and their families. Therefore, the present study was performed with aim to investigate the status of congenital anomalies in Iran through systematic review and meta-analysis. Methods: In this review for finding the related articles, the databases of SID, Iranmedx , Irandoc, Magiran ,Scopus, Pubmed and Google scholar were searched using the keywords such as Prevalence, Iran, Congenital anomalies in Persian and English journals from 1986 to 2018. Data were analyzed by meta-analysis method using random effects model. The heterogeneity of the studies was calculated by I2 Index. Results: Of 2306 studies, 35 studies which met the inclusion criteria from 1986 to 2018 entered to the meta-analysis. The results of this meta-analysis showed that the total prevalence of congenital anomalies in Iran is 2.6%. The prevalence of abnormalities in boys is 2.8% and in girls is 2%. Also, the most common congenital anomalies were skeletal abnormalities (29.1%) and genitourinary system abnormalities (23.2%), respectively. Conclusion: The results of this study indicate a high prevalence of congenital anomalies in Iran. Further studies are needed to more identify this issue and plan to prevent congenital anomalies.

Background & aim: Marital satisfaction during pregnancy is one of the factors affecting marital affectional bond. This study was performed to evaluate the effect of paternal-fetal attachment training on marital satisfaction during pregnancy. Methods: This clinical trial was conducted on 60 couples referring to two health centers of Mashhad, Iran, in 2015. The couples were randomly divided into intervention and control groups (n=30 couples in each group). The fathers in the intervention group participated in three 120-minute sessions of paternal-fetal attachment training and the mothers in both groups (intervention and control) received the routine prenatal care. Both groups were evaluated using Marital Satisfaction questionnaire of Nathan H Azarin before and three weeks after the intervention. To analyze the data, descriptive statistics, t-test, Chi-square test, Wilcoxon, Mann-Whitney U test, and analysis of covariance were performed using SPSS, version 22. Results: The mean score of marital satisfaction in men was significantly higher in the intervention group than the control group (P=0.003). The mean score of women's marital satisfaction in the intervention group increased after training from 62.63±2.58 to 66.50±2.43. However, there was no significant difference between two groups in terms of women’s mean score of marital satisfaction (P=0.083). Conclusion: Paternal-fetal attachment training promoted marital satisfaction in men during pregnancy, so it is suggested to hold training programs for couples during pregnancy to enhance their marital satisfaction.

Background: The inadequate reporting of cross-sectional studies, as in the case of the prevalence of Congenital Anomaly, could cause challenges in the synthesis of new evidence and make possible mistakes in the creation of public policies. This study was conducted to critically appraise the quality of the articles involving congenital anomaly prevalence in Iranian infants with the STROBE recommendations. Methods: We performed a thorough literature search using the words "congenital anomaly" "birth defect" and "Iran" in MEDLINE/PubMed, Scopus, SID, Elmnet, Magiran, IranDoc, Iranmedex, and Google Scholar until Aug 2017. In this critical appraisal we focused on cross-sectional studies that reported the prevalence of congenital anomaly in Iranian infants. Data were analyzed using the STROBE score per item and recommendation. Results: The results of 17 selected articles on Congenital Anomaly prevalence showed that the overall accordance of the cross-sectional study reports with STROBE recommendations was about 63%. All articles met the recommendations associated with the report of the study’s rationale, objectives, setting, key results and provision of summary measures. Methods and results were the weakest part of the articles, in which recommendations associated with the participant flowchart and missing data analysis were not reported. The recommendations with the lowest scores were those related to the sensitivity analysis (6%, n=1/17), bias (6%, n=1/17), and funding (41%, n=7/17). Conclusion: Cross-sectional studies about the prevalence of congenital anomaly in Iranian infants have an insufficient reporting on the methods and results parts. We recognized a clear need to increase the quality of such studies.

INTRODUCTION: An appropriate exchange of information between the health-care provider and the family is an important component of coping with stress following the prenatal diagnosis of fetal anomalies. Therefore, this study was conducted to explore the informational needs of pregnant women following a prenatal diagnosis of fetal anomalies in Mashhad, Iran. SUBJECTS AND METHODS: This qualitative, conventional, content analysis study was designed through two referral centers for fetal anomaly. The data were collected from April 2017 to January 2018 in Mashhad (Iran) through individual semi-structured in-depth interviews, from 25 pregnant women with a prenatal diagnosis of fetal anomalies. RESULTS: Three categories and nine subcategories emerged. Category 1, information needed for clarifying the diagnosed anomaly and making a decision, containing four subcategories: The need to know the reasons of doing more diagnostic tests; The need to know the facts regarding the anomaly and its cause; The need for more information to gain control over the situation; and The need to know about legal permission for therapeutic abortion. Category 2, Information needed for preparing to the future, containing three subcategories: Practical and economic issues; The delivery and postnatal situation; and Future mortality and morbidity of especial anomaly. Category 3, the adequacy of the information provided, containing two subcategories: Information overload and Inadequate information. CONCLUSIONS: Pregnant women receiving a prenatal diagnosis of fetal anomaly have a variety of information needs that are not adequately met by the health-care providers. Further research is required for finding a means to meeting this information need.

چکیده مقدمه: اُتيسم اختلال عصب شناختي رو به گسترشي است كه ابعاد مختلف عملكرد كودك و خانواده را تحت تاثير قرار مي‌دهد و نيازمند ارايه خدمات توانبخشي و درماني چند بعدي و گاه مادام‌العمر است لذا پژوهش حاضر با هدف بررسی نیازهای مادران کودکان اتیستیک انجام شده است. مواد و روش‌ها:این پژوهش از نوع نیازسنجی است. گروه نمونه، والدین 41 نفر از کودکان اتیسم را شامل می‌شود که به صورت نمونه‌گیری در دسترس از سه کلینیک اتیسم شهرستان مشهد، انتخاب شدند. شرکت‌کنندگان، پرسش‌نامه پژوهشگرساخته، شامل نُه مقوله آموزشی- توانبخشی را کامل کردند. پایایی کل پرسش‌نامه (نُه مقوله) به شیوه ضریب آلفای کرونباخ 94/0= a محاسبه شد. يافته‌ها: نتایج تی تک نمونه‌ای نشان داد که والدین کودکان اتیسم، همه مقوله‌های آموزشی- توانبخشی را مورد نیاز ارزیابی کردند و چهار مقوله آشنایی با مسایل خودیاری کودک، آشنایی با مهارت‌های بازی کودک و بازی کردن والدین با کودک، آشنایی با مشکلات شناختی و ذهنی کودک و آموزش مهارت‌های ارتباطی را بسیار مورد نیاز ارزیابی کردند. همچنین، نتایج تحلیل واریانس چند متغیره نشان داد که سن کودک، ترتیب تولد کودک، سن مادر و میزان تحصیلات والدین، در اولویت بندی نیازها، تأثیری نداشته است. نتيجه‌گيري: به كارگيري نتايج و اولويت‌هاي مستخرج از نيازسنجي حاضر مي‌تواند متخصصان و درمانگران را جهت ارايه خدمات توان‌بخشي و روانشناختي از اولويت بالا يا در حد بسيار مورد نياز تا اولويت‌هاي بعدي يا در حد مورد نياز ياري رسانند. . کلیدواژه‌ها: کودکان اتستیک، نیازهای آموزشی توانبخشی، نیازسنجی