Background and objectives: Maternal anemia pose significant challenges to perinatal health globally. The current study was conducted to investigate the association between severity of anemia in pregnant women and adverse perinatal outcomes. Methods: A comparative descriptive study was conducted in Zakho Maternity Hospital, Zakho City, Kurdistan Region, Iraq from May 2022 to May 2023 involving 500 women during labor. The sample size included 253 anemic (Hemoglobin <11 g/dl) and 247 non-anemic pregnant women (Hemoglobin ≥11 g/dl). Demographic character, mode of delivery and perinatal outcomes were compared between both groups. Results: Among the 253 anemic women during labor involved in the study, 56.0% had mild, 42.4% had moderate, and 1.6% had severe anemia. Higher parity increased anemia risk (P<0.000), Among mothers with moderate anemia, 47.2% were multiparous compared to 26.4% primigravida. Similarly, among those with severe anemia, 42.8% were multiparous compared to 0% primigravida. Anemia was associated with extreme maternal age (<20 and >35 years) and rural housing (p<0.001), although work status had no significant impact (p=0.292). Maternal anemia correlated with poorer Apgar scores, with rates of (75.0%, 9.3%, and 1.4% for severe, moderate, and mild anemia, respectively). More NICU admissions were observed for babies born to mothers with severe anemia (100.0%), followed by moderate (17.8%) and mild (4.9%) anemia. Additionally, more low birth weight cases were observed, with a prevalence of 75.0% in severe anemia followed by moderate (7.5%) and mild anemia (2.1%).

Background and objectives: Maternal anemia pose significant challenges to perinatal health globally. The current study was conducted to investigate the association between severity of anemia in pregnant women and adverse perinatal outcomes. Methods: A comparative descriptive study was conducted in Zakho Maternity Hospital, Zakho City, Kurdistan Region, Iraq from May 2022 to May 2023 involving 500 women during labor. The sample size included 253 anemic (Hemoglobin <11 g/dl) and 247 non-anemic pregnant women (Hemoglobin ≥11 g/dl). Demographic character, mode of delivery and perinatal outcomes were compared between both groups. Results: Among the 253 anemic women during labor involved in the study, 56.0% had mild, 42.4% had moderate, and 1.6% had severe anemia. Higher parity increased anemia risk (P<0.000), Among mothers with moderate anemia, 47.2% were multiparous compared to 26.4% primigravida. Similarly, among those with severe anemia, 42.8% were multiparous compared to 0% primigravida. Anemia was associated with extreme maternal age (<20 and >35 years) and rural housing (p<0.001), although work status had no significant impact (p=0.292). Maternal anemia correlated with poorer Apgar scores, with rates of (75.0%, 9.3%, and 1.4% for severe, moderate, and mild anemia, respectively). More NICU admissions were observed for babies born to mothers with severe anemia (100.0%), followed by moderate (17.8%) and mild (4.9%) anemia. Additionally, more low birth weight cases were observed, with a prevalence of 75.0% in severe anemia followed by moderate (7.5%) and mild anemia (2.1%). Conclusion: A substantial link is there between anemia during pregnancy and maternal characteristics of parity and rural residence. Furthermore, poor perinatal outcomes had significant relation with anemia. Keywords: Anemia, Perinatal outcomes, Pregnancy, Risk factors

The purpose of this investigation is to conduct a comprehensive analysis of the association between prenatal exposure to valproate and its potential correlation with an 3 elevated risk of ASD in offspring. Researchers explore the underlying biological mechanisms and systematically review existing epidemiological data to clarify the relationship between maternal valproate usage during pregnancy and subsequent neurodevelopmental outcomes. By examining various parameters, including dosage, timing of exposure, and genetic predispositions, they aspire to enhance understanding of the implications related to valproate administration during the perinatal period (16,17,18)

Viral hepatitis is a major public health challenge as dictated by the World Health Organization (WHO), with a figure of 254 million people living with hepatitis B infection. It is one of the communicable diseases for which mortality is increasing. In 2022, an estimated 1.2 million new people contracted the infection, and 1.1 million patients died of hepatitis B and related complications, including liver cirrhosis, liver failure, and hepatocellular carcinoma. This datum makes it the second leading infectious cause of death, superseded only by tuberculosis (TB).1 Hepatitis B infection is caused by hepatitis B virus (HBV), an enveloped DNA virus that is primarily transmitted by exposure to infected body fluids (mainly blood and mucosal secretions). The methods of transmission include unprotected sexual intercourse, intravenous drug injections, transfusion of blood products, dialysis, tattooing, needle-stick injury, and vertical transmission.2 Despite having both active and passive immunization by an effective vaccine and hepatitis B immunoglobulin, respectively, it has been difficult to control the spread of hepatitis B in developing countries because of the lack of a standardized program to deliver and supervise these immunizations.3,4 Imperative to any intention of public health authorities fighting against hepatitis B is a set of data on the prevalence and risk factors associated with the disease in order to develop an effective and targeted plan. WHO data clearly show that the worldwide distribution of hepatitis B varies by region, ranging from a prevalence of 0.5% in North and South America to 5.8% in Africa.1,5 It is also expected that the contribution of each risk factor associated with hepatitis B varies depending on cultural trends, which is extremely important to consider when planning to limit the spread of infections in general and hepatitis B in particular.6,7 Therefore, we present this study to investigate various risk factors associated with hepatitis B in the Kurdistan region of Iraq.

Preeclampsia is an illness of long-established consequences which can extends to the post-partum period. It is estimated to complicate 2-8% of pregnancies worldwide. During this study we concentrated on the main risk factors related to the development of preeclampsia in Maternity Hospital of Zakho, in order to evaluate the main elements correlated to increase the risk of the development of preeclampsia and its related complications. The pregnant ladies who were diagnosed with preeclampsia, conducted under a hospital-based case control study, from 1 August 2023 to 1 April 2024 at Zakho Maternity Hospital, Kurdistan region, Iraq. A total of 300 cases collected with 0% of missing data. The study contained two thematic blocks, the first thematic block with its two main domains, included patient demographic data, past medical history and family history related to increase the risk of PE. The second thematic block included patient information of current pregnancy phase. Logistic analysis using SPSS 26th edition performed to estimate and analyze the most evident risk factors related to preeclampsia. Vancouver citation style used to describe the references related to the study. From a total of 300 cases with variable gestational age and 0% missing data, aged between 16 and 45 years old. Preeclampsia is increasing among the mothers aged less than 20 and above 40 years old as correlated to other studies. During the analysis, our study focused on the past medical history of the pregnant females, DM and hypertension show the greatest effect to enhance PE development. The ones with a previous history of preeclampsia as expected to have the probability to develop it again, our results showed the adverse of this thesis. The study highlighted the family history to be a significant risk to develop PE. Sedentary lifestyle and obesity were major risks for the condition. Regular BP monitoring and prenatal care were good parameters for early PE identification, as they decreased the circumstances of bad PET prognosis.

Background: Cervical intraepithelial neoplasia (CIN) refers to abnormal changes in the squamous cells of the cervix, with more significant changes known as high-grade squamous intraepithelial lesions (HSIL) in grades II and III. Aim: The aims of the present study were to estimate the prevalence of cervical neoplasia and explore potential risk factors for HSIL among women living in the Kurdistan region. Materials and Methods: The study included 1300 women who underwent Papanicolaou (PAP) smears for the conclusion of cervical infection and who attended several parts and hospitals in the Kurdistan region. As this is a multi-center study for the determination of pap smears and the relationship between cervical cancer and those women, only 120 of those 1300 women suffer from cervical and vaginal problems. The study was done from January 2021 to the end of December 2021. A Pap smear, also known as a Pap test, is a routine screening procedure used to detect abnormal cervical cells that may indicate the presence of cervical cancer or precancerous conditions. The procedure involves collecting a sample of cells from the cervix, which is the lower part of the uterus that extends into the vagina.

Background: Incidence and mortality rates for cervical cancer have dropped primarily as a result of pap smear-based screening programs. Screening and treatment recommendations for cervical intraepithelial neoplasia (CIN) have changed as more outcome data have become available. Aim: The aims of the present study were to study relation of cervical cancer with grading of cervical intraepithelial neoplasia in women who underwent PAP smear Materials and methods: Study included 1300 women underwent PAP smear for concluded of cervical infection who's attended several part and hospital in Kurdistan region as this study is multicenter study for determination of pap smear and the relation of cervical cancer and those women, from those 1300 women only 120 women were suffered from cervical and vaginal problem. The study was done from the period starting from one January 2021 to the end of December 2021, women who underwent the procedure in various healthcare centers and hospitals across the Kurdistan region of cervical cancer with grading of cervical intraepithelial neoplasia in women who underwent PAP smear. The findings of this multicenter study can provide valuable information regarding the relationship between ASC-US and CIN in the context of cervical health among women in the Kurdistan region. The findings may have implications for cervical cancer prevention and control strategies, improving healthcare practices, and promoting women's health in the Kurdistan region.

ABSTRACT Background: Neural tube defects are a common congenital disorder. The complex etiology of Neural tube defects involve both genetic and environmental factors, thus investigating gene-environment interactions is critical to understanding how it occur or how it may be prevented. Published literatures also have indicated that viral illness during early pregnancy and several antiviral drugs are associated with an increased risk for neurodevelopmental congenital anomalies of new-born. Aim of the study: To evaluate the prevalence of Neural tube defects among pregnant women suffered from COVID 19 infection Patients and methods: This study is a case control study had done in Zakho Maternity Hospital. The data collected during the period of 1st Ja. 2020-1st Ja 2022, the total 90 cases that reported in the obstetrics and gynecology department with neural tube defects was enrolled in the study, and compared with control group of 90 pregnancies without Neural tube defects. The information collected through direct interview with the mothers through questionnaire includes the information about the socio-demographic, obstetrical history and history of COVID 19 infection, severity, presence of fever, trimester of infection. The laboratory investigations of hemoglobin and PCR to confirm COVID 19 infection was done. Results: COVID infection during pregnancy was significantly higher among those with Neural tube defects 68 (75.6%), in comparison to 30 (33.3%) of those without NTD. Anemia was significantly higher among those with Neural tube defects 69 (67.7%) in comparison to 15 (16.7%). Fever in 1st trimester was significantly higher among those with NTD 70 (77.8%) in comparison to 28 (31.1%). Alcohol intake was significantly lower among those with NTD 2(2.2%) in comparison to 10(11.1%). Polyhydramnios was significantly higher among those with NTD 72 (80%) in comparison to 11(12.2%). Conclusions: COVID infection during pregnancy was significantly higher among those with neural tube defects and this alarming. Key words: Risk factors, Neural tube defect, COVID, Zakho

Introduction: Documented articles have determined that viral illness during early pregnancy and several antiviral drugs are associated with an increased risk for neurodevelopmental congenital anomalies of the newborn. These include NTDs, the most common and severe malformations of spinal cord (spina bifida) or brain (anencephaly, encephalocele, hydrocephalus), which develop within 6 weeks of pregnancy with an incidence of one in 1000 neonates worldwide and they cause lifelong neurological complications. The aim of this study is to describe the clinical characteristics of simultaneous cases of COVID 19 in pregnant women with neural tube defects in their newborns. Patient and methods: This is descriptive study case series including cases of Neural Tube Defects when their mothers were affected with COVID-19 infection that was reported in Zahko Maternity hospital. Those in the labour unit were enrolled in this study and the cases was collected during the period 1st January 2020 and 1st January 2022. The information collected through direct interview with the mothers through questionnaire includes the information about the socio-demographic, obstetrical history and history of COVID 19 infection, severity presence of fever and type of medication received.

Background Despite vaccine and antiviral treatment availability, hepatitis B virus (HBV) continues to circulate among pregnant women in Iraq. HBV spread is due to many factors. This study evaluated HBV prevalence among pregnant women and Syrian refugees residing in Zakho city, Iraq, and identified risk factors associated with infection. Materials and methods Demographic data were collected from 2,054 pregnant women via a questionnaire assessing risk factors associated with HBV infection. Blood samples were collected for hepatitis B surface antigen (HBsAg) and were screened using an enzyme-linked immunosorbent assay.

many studies reported the association between NTDs and maternal fever, , infection like toxoplasma, rubella and cytomegalovirus, this study aimed to give the trend of the NTDs in Zakho and find if it was related to new epidemic of COVID19. Patient and method: This is study have two lines 1 st studying the trend of the prevalence of NTDs depending on the health directorate statistics from Jan. 2013 to December 2021. The 2 nd is a case series of 18 case of NTDs with COVID19 infection that reported in Zakho Maternity hospital labour unit.