Masumeh Saeidi Health Providers 2820-9192 3 1 2023 06 01 To Breastfeed or not to Breastfeed? An Overview in the Time of the COVID-19 Pandemic 1 9 160044 10.22034/hp.2022.368456.1026 EN Nafiseh Pourbadakhshan Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-3494-2085 Fatemeh Vafi Sani MSc of Operating Room, Department of Operative Room and Anesthetics, School of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran. 0000-0001-9711-4714 Iman Nosratabadi Student Research Committee, School of Nursing and Midwifery, Sirjan University of Medical Sciences, Sirjan, Iran. 0000-0003-0185-4377 Masumeh Ghazanfarpour Department of Midwifery, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran. 0000-0003-4639-3711 Sara Saadat MD, Pediatric Nephrologist, Assistant Professor, Department of Pediatrics, Division of Nephrology, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0001-9802-1667 Adeleh Khodabakhshi Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran. 0000-0002-2666-9795 Journal Article 2022 11 04 Background: Despite the recognized benefits of breastfeeding for both mothers and infants, many women opt not to breastfeed due to insufficient knowledge regarding the transmission of COVID-19 through breast milk. This study aims to summarize the most recent evidence concerning breastfeeding during the COVID-19 pandemic. Materials and Methods: In this overview, two independent researchers screened all reviews, systematic reviews, meta-analyses, and scoping reviews that addressed breastfeeding in the context of the COVID-19 pandemic. They searched the Scopus, EMBASE, Web of Science, Medline, CIVILICA, and CINAHL databases for full-text articles available in Persian or English, without any time restrictions up to November 2022. Results: Vertical transmission of COVID-19 from a mother to her child cannot be confirmed or denied. Currently, there is no evidence of the virus being present in the amniotic fluid at the time of birth or in breast milk, indicating that breastfeeding should continue with strict adherence to safety and hygiene measures. The World Health Organization advises mothers suspected of or infected with COVID-19 to continue breastfeeding, considering the significant benefits of breastfeeding in relation to the potential risks. Conclusion: Breastfeeding is the most effective protective measure for both healthy and at-risk infants, as well as their mothers, during the COVID-19 pandemic. Adhering to health protocols can mitigate the risk of COVID-19 transmission from mother to baby through breastfeeding.

https://www.health-providers.ir/article_160044_71ffc9e7b3c0b60f2e27d85924faef85.pdf

Masumeh Saeidi Health Providers 2820-9192 3 1 2023 06 01 Breakfast and Snack Patterns among Iranian Children and Adolescents: A Systematic Review 11 27 162304 10.22034/hp.2022.375576.1029 EN Farzane Rouhani Pediatric Endocrinologist, Aliasghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 0000-0002-2277-4862 Hamidreza Alidoost Pediatric Endocrinologist, Aliasghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 0000-0002-5371-8580 Journal Article 2022 12 05 Background: Breakfast is often considered the most important meal of the day; however, many children and adolescents regularly skip this morning meal. This study aims to investigate breakfast and snack consumption patterns, as well as the factors influencing these behaviors among primary and high school students in Iran. Materials and Methods: In this systematic review, two independent researchers selected articles that reported on the status of breakfast and snacks among students from the Scopus, EMBASE, Cochrane Library, Web of Science, CINAHL, Medline, CIVILICA databases, and the Google Scholar search engine, without any time restrictions up to December 2022. Results: A total of 21 studies involving 45,778 children and adolescents were included. The results indicated that 20.75% (9.3–32.2) of school children and 17.09% (2.1–32.08) of high school students skipped breakfast. Additionally, 54.1% (10.5–97.7) of children and 55.05% (17.3–92.8) of adolescents reported consuming breakfast regularly. Midmorning snack intake was observed in 55.35% (13–97.7) of children and 72.4% (48.6–96.2) of adolescents. The primary reasons for skipping breakfast included low appetite, waking up late, unappetizing foods, and lack of attention from mothers. A significant relationship was found between snack consumption and various factors, including maternal age, maternal educational level, gender, urban residency, and the students’ birth order (p < 0.045). An inverse relationship was identified between students’ age and economic situation and breakfast consumption (p = 0.01, r = -0.143). Conclusion: Breakfast skipping and snack consumption were common among children and adolescents. The primary reasons for missing breakfast included low appetite, waking up late in the morning, unappetizing foods, and a lack of attention from mothers. It is essential to develop school health promotion programs for parents and students to encourage healthy eating habits, including nutritious breakfasts and snacks.

https://www.health-providers.ir/article_162304_34a58dcf1975437c9083a03535d940a3.pdf

Masumeh Saeidi Health Providers 2820-9192 3 1 2023 06 01 Effects of Immunosuppressive Treatments on Pregnancy Outcomes in Infertile Women: A Systematic Review of Clinical Trials 29 40 166773 10.22034/hp.2023.385697.1031 EN Parisa Taheri Obstetrics and Gynecology Specialist, Infertility Fellowship, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0001-8094-7066 Journal Article 2023 02 14 Background: Despite advancements in in-vitro fertilization (IVF), repeated implantation failure (RIF) remains a significant obstacle to fertility. Immunomodulation and immunosuppression are key strategies to address RIF. This study reviews the literature on the effects of immunosuppressive drugs on pregnancy outcomes in infertile women with RIF. Materials and Methods: For this systematic review, two independent reviewers selected relevant articles from Scopus, EMBASE, the Cochrane Central Register of Controlled Trials, the International Registry Platform for ongoing trials, ClinicalTrials.gov, Web of Science, CINAHL, Medline, and Google Scholar. The search covered all available literature up to January 2023, without time restrictions. Results: Combining prednisone and hydroxychloroquine (HCQ) significantly improves fertilization, implantation, and clinical pregnancy rates compared to prednisone alone, offering a promising immunomodulatory approach for women facing fertility challenges. HCQ modulates immune responses by reducing Th17-related cytokines and increasing T-reg-related cytokines, while also decreasing TNF-α and increasing IL-10 levels. Although abortion rates remain similar, adding cyclosporine to the regimen does not significantly improve outcomes. These findings suggest that prednisone with HCQ may be more effective than prednisone alone for specific patient populations. Conclusion: Combining prednisone and HCQ significantly improves fertility outcomes by enhancing immune modulation. This combination offers a promising approach for women facing specific fertility challenges, although adding cyclosporine does not yield additional benefits in certain outcomes. Overall, HCQ's immunomodulatory effects support its potential in enhancing reproductive health.

https://www.health-providers.ir/article_166773_5cd1937ed44a81ae519c8a42e8f4d28f.pdf

Masumeh Saeidi Health Providers 2820-9192 3 1 2023 06 01 Pregnant Women’s Knowledge, Attitudes, Practices, and Barriers Associated with Influenza Vaccination Uptake: A Systematic Review 41 59 162011 10.22034/hp.2022.375002.1028 EN Shima Payandeh Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-5983-1277 Nima Nabavi Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-1054-0284 Samaneh Movahedinia Kerman University Of Medical Sciences, Kerman, Iran. 0000-0003-4236-8463 Vahid Poudineh Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0009-0008-3615-688X Sina Afzoon Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-1982-219X Narges Malakoti Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran. 0000-0003-2006-8240 Journal Article 2022 12 01 Background: Vaccination is the most effective method for preventing influenza during pregnancy. This study aims to determine the knowledge, attitudes, and practices (KAP), as well as barriers associated with the uptake of influenza vaccination among pregnant women worldwide. Materials and Methods: In this systematic review, a comprehensive search of online databases (Medline, EMBASE, Scopus, Web of Science, ProQuest, CINAHL, and Google Scholar) was conducted to identify all studies examining knowledge, attitudes, practices (KAP), and barriers related to vaccination among pregnant women up to December 2022. Results: A total of 24 studies from 22 countries were analyzed to assess knowledge, attitudes, and practices regarding influenza vaccination among pregnant women. The mean correct knowledge score was 50.75% (ranging from 5.5% to 96%), with the highest score reported in Thailand and the lowest in Iran. The mean positive attitude score was 57.05% (ranging from 34.6% to 79.5%), with Iranian women showing more positive attitudes than Italian women, who had less favorable views. The mean practice score related to vaccination was 37·45% (ranging from 1·1% to 73·8%), with the best performance observed in the UK and the poorest in Turkey. The primary barrier to vaccination was concern over side effects, cited by approximately 80·9% of participants as a major deterrent. Other significant barriers included a lack of awareness about vaccine safety, insufficient endorsement or recommendation from healthcare providers, unawareness of the benefits that vaccination provides for both mothers and infants, and negative attitudes towards vaccination among pregnant women. Conclusion: The findings indicate that pregnant women generally possess limited knowledge and exhibit low vaccination practices regarding influenza, despite holding moderate positive attitudes. The widespread concern about vaccine side effects highlights the urgent need for targeted educational interventions to enhance understanding and boost vaccination uptake.

https://www.health-providers.ir/article_162011_c7212b80dbd7630a33fa30e5f5a9928a.pdf

Masumeh Saeidi Health Providers 2820-9192 3 1 2023 06 01 Pandemic Inﬂuenza and Pregnant Women: An Overview of Influenza Vaccination during Pregnancy and its Impact on Pregnancy Outcomes 61 72 160812 10.22034/hp.2022.370519.1027 EN Aida Tafazoli Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 0000-0002-9234-0330 Shahabaldin Sorouri Assistant Professor of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-4847-557x Fatemeh Vafi Sani MSc of Operating Room, Department of Operative Room and Anesthetics, School of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran. 0000-0001-9711-4714 Maryam Soleimani Houni Nursing Research Center, Department of Community Health Nursing, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran. 0000-0001-9249-0454 Iman Nosratabadi Student Research Committee, School of Nursing and Midwifery, Sirjan University of Medical Sciences, Sirjan, Iran. 0000-0003-0185-4377 Sara Saadat MD, Pediatric Nephrologist, Assistant Professor, Department of Pediatrics, Division of Nephrology, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0001-9802-1667 Journal Article 2022 11 16 Background: Evidence regarding the effectiveness and safety of the influenza vaccine during pregnancy is crucial for healthcare providers' decision-making processes. This study aims to review the existing evidence on the effectiveness and safety of influenza vaccination in pregnant women and its impact on pregnancy outcomes. Materials and Methods: In this overview, two independent researchers selected articles reporting on the effectiveness and safety of influenza vaccination for pregnant women and their fetuses. The search was conducted across multiple databases, including Scopus, EMBASE, Cochrane Library, Web of Science, CINAHL, Medline, and Google Scholar, without any time restrictions up to January 2023. Results: Based on the available evidence, pregnant women are at a higher risk of serious illness from influenza compared to non-pregnant women. The influenza vaccine is the most effective way to protect both pregnant women and their infants against influenza, as well as to prevent potential complications associated with the virus during pregnancy. Vaccination during pregnancy is safe, cost-effective, and provides neonatal protection against influenza through the partial transplacental transfer of protective antibodies. There is no evidence linking influenza vaccination administered at any stage of pregnancy to adverse outcomes such as premature birth, spontaneous abortion, congenital anomalies, shortened gestation, gestational diabetes, chorioamnionitis, gestational hypertensive disorders, or fetal death. Furthermore, influenza vaccination during pregnancy has been shown to reduce the risk of pre-delivery hospitalization due to influenza-like illness by approximately 39%. Conclusion: The administration of an inactivated influenza vaccine during pregnancy is safe for both the mother and the fetus and is recommended for all pregnant women. There is no evidence linking influenza vaccination to maternal complications or adverse fetal outcomes.

https://www.health-providers.ir/article_160812_a11802b13d77fb299f6eb5f42e149102.pdf