Background & Objective : Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status.

  Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1^st, 5^th, 10^th and 15^th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA.

 Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1^st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5^th minute Propofol was 9.2 ± 0.7 and Thiopental was 9.1 ± 0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups.

  Conclusions : Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.

 Background & Objectives: Neglecting children can have irremediable and harmful effects on them concerning their growth, evolution, acquisition, and health both at present and in the future. Since lack of nutrition knowledge and failing to observe the principles of infant nutrition is one of the important causes of malnutrition and its unpleasant consequences, we decided to carry out an assessment concerning mothers’ level of awareness about infant nutrition and the factors affecting this knowledge, as well as the effect of this knowledge on growth and development of children.

 Methods: This descriptive-analytical research was conducted to evaluate mothers’ knowledge of infant and neonatal nutrition and its effect on infant growth in Hir health center. The data were collected using a questionnaire, including 20 questions, which was filled out in the health center. Moreover weight, height and head circumference of 100 infants were measured. The data were analyzed using SPSS software.

 Results: All mothers’ age ranged between15-36 and were housewives.15% were unlettered, 18% had high school education and others primary or secondary school education. 55% of children were female and 45% male. 67% of mothers had knowledge about proper neonatal and infant nutrition. 97% of them had little knowledge about when to start introducing different nutrients for infants, 3% had moderate knowledge in this regard.

 Conclusion: Regarding the findings of this study and the lower knowledge level of mothers about when to start giving different food to infants as well as the importance of proper nutrition in their growth, it is necessary to improve mothers’ knowledge and promote children’s health.

 Background & Objectives: Yogurt is recommended as a treatment for acute diarrhea. This study was conducted to determine the effect of pasteurized yogurt consumption on acute non-bloody and non-mucoid diarrhea in hospitalized 6-24 month old infants as compared with that of routine treatment.

 Methods: In a clinical trial study 80 children with 6 to 24 months of age with diarrhea for less than four days and were hospitalized in Urmia Imam Hospital, were assigned into two groups. The first group consumed yogurt containing streptococcus thermophilus and lactobacillus bullgaris 5 ml/kg per day while the second group received the routine treatment. Those suffering from malnutrition, bloody stool and diarrhea without GI source were excluded. Reduction of diarrhea frequency to half compared to admission time was regarded as response to treatment. Weight gaining, duration of admission and reduction of diarrhea frequency were compared in two groups.

 Results: The two groups were not significantly different in terms of age, weight and frequency of diarrhea at the time of admission. Mean hospitalization days, weight gaining, reduction of diarrhea frequency were 2.7±0.91 days, 435± 89.30 grams, and 4.30±1.74 times respectively for case group and, 3.1± 0.74 days, 383 ± 98.96 grams, and 3.60±1.23 times for control group respectively. No significant differences were observed between two groups regarding mean hospitalization days (P=0.035), reduction of diarrhea frequency (P=0.049) and weight gain (P= 0.017).

 Conclusion: Consuming pasteurized yogurt as a probiotic agent has a positive effect in treatment of acute nonbloody and nonmucoid diarrhea. Public use of yogurt is recommended.

  Background & Objectives: Providing, maintainance and promotion of neonatal health as a special high-risk group has a special role in heath services. According to statistics, 4 million out of 130 million neonates, born every year, die in the first week of their life. 99% of this mortality takes place in developing countries. 38% of the deaths below the age of 5 belongs to neonatal deaths. To decrease this mortality, some factors such as mother condition (including health care both before and after pregnancy), perinatal factors and life-threatening factors in the first 28 days after birth. This study was performed in hospitals under Ardabil University of Medical Sciences to determine the related factors of neonatal mortality.

  Methods: This case-control study was conducted on 160 neonatals (80 cases of neonatal deaths and 80 live births as controls). The demographic data of two groups were separately analyzed to obtain descriptive results. Also the most common causes of neonatal mortality were obtained through studying cases. Moreover, the parents of live neonates were asked questions to evaluate the effect of social factors. Finally all of these related factors were compared.

  Results: From 160 neonates under study, 71 (44.4%) were female and others were male. Neonatal mortality in males was 1.3 times as much as that in females. 16(12.1%) mothers had history of still birth. 18(11.3%) mothers were illiterate and 27 (16.9%) had college education. 31(19.4%) neonates were under 1500gr, 42 (26.3%) 1500- 2500gr and others above 2500 gr. 37 (46.3%) mothers in case group and 24(30%) in control had no access to transportation facilities. The most common causes for neonatal mortality were prematurity with 44 (55.1%) cases and aspiration, septicemia, asphyxia each one with 4 (2.5%) cases. There were statistically significant relationship between neonatal mortality rate on the one hand and birth weight, access to transportation facilities and mothers, living place (rural or urban) (p=0.023).

  Conclusion: According to the results, factors such as birth weight, access to transportation facilities as well as the mothers’ living location (rural or urban) were determining factors in the neonatal mortality. Some measures seem necessary to by taken in order to decrease the effect of thses factors.

 Background & Objectives: The incidence of neonatal hyperbilirubinemia disease is noticeable. Studying neonatal hyperbilirubinemia and its related factors is a step to reduce its incidence and remarkable treatment expenses. On the other hand, due to lack of on time recognition and suitable treatments, this disease can cause irreversible neuro-cerebral complications. This study was conducted to examine the etiology of neonatal hyperbilirubinemia and its associated signs, in order to provide on time and suitable treatment measures.

 Methods: This cross-sectional study was performed in 2003 on neonates affected by neonatal hyperbilirubinemia in Ardabil Sabalan hospital. The data obtained from their conditions, clinical examination, and measurment of total and direct bilirubine was used to fill out a questionnaire. The data were analyzed by SPSS software (release 10).

 Results: From among 132 neonates affected by neonatal hyperbilirubinemia, 50% were male and others were female. 85.6% of these subjects were fullterm births and the rest were premature. 56% of these neonates were born by C/S. 6.8% of hyperbilirubinemia cases, which were considered as “pathologic”, occurred during 24 hours after birth. 72% were related to the second to seventh days of birth, 17.2% to second week of birth, and the rest (4%) had prolonged Icter. 65% of these neonates were the first children of the family. The average time of hospitalization was 4.8 days. 34.8% of these neonates had pathologic signs beside hyperbilirubinemia and had a clinically serious condition. About 23% of these neonates were born by C/S and only 11.8% of them were vaginal births. 46 cases (34.8%) had accompaynig pathologic problems in addition to Icter, among whom 33 children (25%) had evident infection. The causes of hyperbilirubinemia were Crigler-Najjar syndrome in one case, ABO in 11 cases (8.33%) and RH discord in 4 cases (2.8%). Generally speaking the precise cause of 36.89% of Hyperbilirubinemia was determined.

 Conclusion: Some factors such as children by C/S, neonatal infection, prematurity, ABO discords and RH discords play an important role in hyperbilirubinemia incidence and severity.

 Background & Objectives: 11% of all newborns in the developing countries suffer from low birth weight (LBW). Birth weight has an important role in individual health, family and society. Lower and higher birth weight from standard rate lead to morbidity and mortality. The purpose of this study was to determine associations between some of maternal anthropometric measurements such as BMI, pre-gravida weight, height, age with birth weight.

 Methods: This is an analytical-descriptive study, in which there were 300 pregnant women who hard referred to Alavi Hospital, Ardebil for delivery. Maternal pre-gravida height, weight and birth weight were collected from their units. Body mass index (BMI) was calculated by dividing the maternal pre-gravida weight in kg by height in m squared (kg/m²). The relationship between maternal anthropometric measurements and birth weight was analyzed by t-test.

 Results: Our study showed that 32 (10.7%) women had BMI<19.8, 185 (61.7%) BMI=19.8-26 and 83 (27.7%) BMI>26. 36.3% of women were under 55 kg, 48.3% between 55 to 70 kg and 15.3% over 70 kg. The relationship between maternal pre-gravida BMI, weight and birth weight was statistically significant (p=0.001). There was no significant difference between maternal age and neonatal birth weight.

 Conclusion: Pre-gravida body mass index (BMI) and weight could be two important anthropometric measurements associated with birth weight. Thus, it is recommended that women give adequate preconceptional and prenatal care to decrease the amount of LBW and HBW in population.

  Background & Objective: Currently, migration of rural population to cities and developing slums around them are main problems in population settlement that lead to imbalance in health standards such as difference in age groups death. The aim of this study was to examine factors associated with infant mortality in slums of the Ardabil city.

  Methods: This was a case- control study. All infants’ deaths from 2008 to 2010, which occurred in slums as a case, were included. For each case, tow controls, were chosen. Controls the ones who survived and were living in non marginalized area and years of birth and sex were matched in two groups. Information collected from health centers through questionnaires, interviews with parents and child death files.

  Results: The majority of mortalities (74.6%) were in neonatal period and 25.4% was in post- neonatal period. The most important causes of deaths in neonatal were prematurity (57%), and in post neonatal period were congenital abnormality (35.4%). Analysis of effective factors showed that birth weight, parents age and education, family income and occupation and smoking of father were highly associated with mortalities.

  Conclusion: Infant mortality of the family that their father is a smoker and they have low income, and low parental education level is significantly higher and should be taken into serious consideration to reduce the mortality.

Background & objective:   One of the objectives of health reform plan in Iran is to reduce the rate of cesarean section delivery. This needs research and use of results to improve the maternal and neonatal outcomes. The aim of this study was to compare the maternal and neonatal outcomes after normal vaginal and cesarean section delivery in hospitalized low-risk mothers in Arash Hospital in Tehran, Iran.

Methods: In this prospective cohort study, 1900 low-risk pregnant women, with 37-40 weeks of gestational age, referring to the emergency department and being hospitalized for delivery were included. The data were collected from two groups of patients (normal vaginal delivery and cesarean section delivery). Data on wound infection, abnormal postpartum hemorrhage, decrease of hemoglobin, transfusion requirement, injuries to the genitourinary system, fever until 10 days after delivery, neonatal respiratory complications, NICU admission, jaundice and obstetric injuries were collected by a questionnaire.

Results: From 1900 pregnant women, 62.1% had cesarean delivery and 37.9% had normal vaginal delivery. The reasons for cesarean delivery included repeated cesarean (68%), failure to progress (18.1%), and fetal distress (13/9%). Wound infection (p=0. 004), abnormal postpartum hemorrhage (p=0.042) and low hemoglobin (p<0.001) were more frequent in cesarean delivery group than in normal vaginal delivery group. But obstetric injuries were higher in normal vaginal delivery group (p<0. 0001). There was no difference between the two groups in terms of fever ten days after delivery and blood transfusion requirement. For neonatal outcomes, transient neonatal tachypnea (p=0.032), neonatal respiratory distress syndrome (p=0.002), and NICU admission (p<0. 0001) were more frequent in cesarean delivery group than in normal vaginal delivery group. There was no difference between the two groups in neonatal jaundice rate and neonatal injuries.

Conclusion: Due to the high rate of cesarean section delivery in our country and higher rate of maternal and neonatal complications after cesarean section delivery, appropriate strategies are required to be applied to decrease unnecessary cesarean section delivery and increase normal delivery with minimum maternal and neonatal complications.