Shahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260701Breast Milk Stem Cells and Maternal Microchimerism: Mechanisms and Clinical Implications677351210.18502/wjpn.v8i2.22102ENSadeghSafaeiMonoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, IranDepartment of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, IranJournal Article20260720Human breast milk is recognized as a living, cell-rich fluid that provides viable maternal cells along with supplementary nutrients and soluble immunomodulators. It contains heterogeneous populations of mesenchymal, hematopoietic, epithelial and pluripotent-like stem/progenitor cells that can differentiate into derivatives of all three germ layers in vitro. Preclinical studies have shown that milk-derived cells can survive gastrointestinal passage, enter the neonatal circulation, and reside in multiple organs, such as the brain, liver, and immune tissues. These cells express organ-specific markers and contribute to maternal microchimerism. Studies on the neonatal gut and blood-brain barrier show that a narrow early-life window exists in which breast milk stem cells can access systemic and, in experimental models, central nervous system compartments. This window is established by immature intestinal barrier properties, age-dependent differences in neurovascular interfaces, and homing cues induced by injury or inflammation. It has been suggested that these cells may contribute to organ maturation and tissue repair. Maternal cell transfer during lactation has been associated with the expansion of regulatory T cells, tolerance to non-inherited maternal antigens, stronger vaccine-induced T-cell responses, and, in certain circumstances, improved infection control. These results collectively support the idea that maternal cellular transfer contributes to the development of infant immunity during the early stages of life. This review provides a concise summary of the phenotype and origin of breast milk stem cells, their trafficking and contribution to maternal microchimerism, and neonatal immune development, and the clinical implications for the health of both infants and mothers.https://wjpn.ssu.ac.ir/article_512_a8f652c662c5a113543ad3286ab639d2.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260901Integration of Artificial Intelligence, Multi-Omics, and Digital Health for Precision Prevention of Preterm Birth: A Structured Narrative Review748151110.18502/wjpn.v8i2.22103ENMahshidBokaieResearch Center for Nursing and Midwifery Care, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranSchool of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, IranRoghayehIjabiStudent research committee, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260720<strong>Background:</strong> Preterm birth (PTB) remains a leading cause of neonatal morbidity and mortality worldwide. Conventional prediction methods have limited accuracy, highlighting the need for precision prevention strategies that integrate molecular, clinical, and digital health data.<br /><strong>Methods:</strong> A structured narrative review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between 2010 and 2024. A total of 21 relevant studies were included and narratively synthesized into three thematic areas: multi-omics technologies, artificial intelligence (AI)-based prediction models, and digital health approaches for PTB prevention.<br /><strong>Results:</strong> Multi-omics technologies, including genomics, transcriptomics, proteomics, metabolomics, and microbiome profiling, improved understanding of PTB pathophysiology and identified biomarkers associated with inflammation, immune dysregulation, oxidative stress, extracellular matrix remodeling, and placental dysfunction. AI models integrating clinical, imaging, laboratory, and molecular data demonstrated promising predictive performance, with reported area under the receiver operating characteristic curve (AUC) values ranging from approximately 0.61 to 0.94 where available. Ensemble machine learning and deep learning algorithms generally outperformed conventional statistical approaches. Digital health technologies, including wearable devices and remote monitoring systems, supported continuous maternal assessment and facilitated earlier identification of women at increased risk. However, limited external validation, heterogeneous datasets, model interpretability, and data privacy remain important challenges to clinical implementation. <strong>Conclusion:</strong> The integration of multi-omics technologies, AI, and digital health represents a promising strategy for precision prevention of PTB. Future research should prioritize multicenter validation, standardized data integration, and the development of transparent and clinically applicable AI models to facilitate translation into routine obstetric care.https://wjpn.ssu.ac.ir/article_511_cef00e4cbea40ad0fe336db5cf16f67b.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260601The Role of Prevention Programs in Reducing Unsafe Abortions: A Narrative Review829051310.18502/wjpn.v8i2.22104ENZahraRezaeikoopaeiStudent Research Committee, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences,Yazd, Iran0009-0001-2794-5309TahminehFarajkhodaResearch Center for Nursing and Midwifery Care, Comprehensive Research Institute for Maternal and Child Health, Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260720Unsafe abortion remains one of the major challenges facing health systems worldwide, and unintended pregnancy is a common precursor to unsafe abortion. One of the most important and serious consequences of unsafe abortion is the increased maternal morbidity and mortality. Evidence indicates that in developing countries, approximately 13% of maternal deaths are attributable annually to unsafe abortion, and in Iran, more than 5% of maternal deaths have been reported to be related to abortion and its complications. Given that one of the major goals of reproductive health is to prevent complications and promote women’s health, it is essential to consider preventive interventions and programs at both individual and societal levels as important global strategies. Studies have shown that women’s knowledge and awareness are important factors, alongside access to reproductive health services, contraception counseling, and supportive social policies. In this regard, commonly reported interventions include: awareness programs (including counseling approaches such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)), I-change model-based program, school- and college-based educational programs, peer education, youth-friendly services, premarital education programs, preconception care program, male participation, greater couple responsibility regarding pregnancy, self-care program, social support, social networks and mass media, non-governmental organizations (NGOs), prenatal genetic counseling program, and interpersonal communication. Therefore, health policymakers should scale up these programs to effectively prevent unsafe abortions and enhance women’s health at individual, societal, and global levels. Although prevention programs are effective in reducing unsafe abortions, their implementation remains limited and demands specialized expertise.https://wjpn.ssu.ac.ir/article_513_61cc579dc8b39d5aa8642f97c5d3f340.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260701Clinicopathological Characteristics and Outcomes of Pediatric Retroperitoneal Lesions: A Retrospective Study919751910.18502/wjpn.v8i2.22105ENSaadatEslamiDepartment of Pathology, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMaryamVajihinejadDepartment of Pathology, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahmood RezaRoknaldiniFaculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260722<strong>Background:</strong> Pediatric retroperitoneal lesions are rare and heterogeneous, often presenting with nonspecific symptoms that complicate early diagnosis. Understanding their clinical and pathological characteristics is essential for improving their management and outcomes. This study evaluated the clinical, pathological, and survival features of pediatric retroperitoneal lesions.<br /><strong>Methods:</strong> This retrospective cross-sectional study evaluated 14 patients younger than 18 years with histologically confirmed retroperitoneal lesions treated at Shahid Sadoughi Hospital, Yazd, Iran, from 2016 to 2021. The research data collected included demographics, clinical presentation, tumor origin, pathological diagnosis, metastasis, recurrence, and survival. The statistical analyses included descriptive statistics, Chi-square tests, and Kaplan-Meier survival analysis.<br /><strong>Results:</strong> The patients’ mean age was 13.9 ± 3.38 years, with an equal sex distribution. Secondary tumors were the most common lesions (64.3%), followed by primary malignant tumors (21.4%) and primary benign tumors (14.3%). The retroperitoneum was the most frequent site of origin (50%). Common presentations included nausea and vomiting (64.3%), abdominal pain (50%), and urinary symptoms (50%). Recurrence was observed in 21.4% of the patients. Five-year survival rates were 100% for primary benign tumors, 73.9% for primary malignant tumors, and 67.5% for secondary tumors. Recurrence was significantly associated with poorer survival (P = 0.027).<br /><strong>Conclusion:</strong> In this small cohort, pediatric retroperitoneal lesions were predominantly secondary tumors, while lymphoma was the most common primary malignancy. Their nonspecific presentation highlights the importance of imaging and pathological evaluation. Tumor recurrence was associated with reduced survival, suggesting prognostic significance and emphasizing the need for long-term follow-up. These findings are preliminary and require validation in larger studies.https://wjpn.ssu.ac.ir/article_519_aea3fa7b0905ffd3cd7141b3a2f5445d.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260601Chest Radiographic Findings in Hospitalized Children with COVID-19: A Cross-Sectional Study in Yazd, Iran9810751610.18502/wjpn.v8i2.22106ENAhmadShajariDepartment of Medical Sciences, Ali-Ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd, IranSaeidehDayaDepartment of Medical Sciences, Ali-Ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd, IranMehranKarimiChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranAmir PashaAmel ShahbazDepartment of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranFarimahShamsiCenter for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranRezaNafisi MoghadamDepartment of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranElaheAkbarianChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260721<strong>Background: </strong>Chest X‑ray (CXR) patterns in pediatric COVID‑19 are not well described. We aimed to characterize CXR findings in hospitalized children and to examine their associations with clinical and laboratory features.<br /><strong>Methods: </strong>This cross‑sectional study included all children (<18 years) with PCR‑confirmed or clinically/radiologically diagnosed COVID‑19 admitted to Shahid Sadoughi Hospital, Yazd, Iran, between February 2020 and March 2021. Admission CXRs were interpreted by a single radiologist and scored (0–18) across six lung zones. Clinical, laboratory, and outcome data were retrieved from a registry. Associations were tested with Chi‑square, Mann–Whitney U, or Kruskal–Wallis tests.<br /><strong>Results: </strong>Among 108 children (61.1% male; mean age 5.7 ± 4.8 years), 68 (62.9%) had an abnormal CXR. The most frequent patterns were ground‑glass opacity (86.8%), peribronchial thickening (54.4%), and consolidation (45.6%). Lesions were predominantly peripheral (50.0%), bilateral (82.4%), and involved the right lower zone (52.2%). Pleural effusion (14.7%) strongly predicted mortality (risk difference 32.5%, P<0.001). Consolidation was more common with shortness of breath (68.0% vs. 20.0%, P=0.001) but less common in respiratory distress (36.7% vs. 64.7%, P=0.045). Higher CXR severity scores were associated with underlying comorbidities, hypoxia, PICU admission, and critical illness in previously healthy children (P=0.002).<br /><strong>Conclusion: </strong>Bilateral peripheral ground‑glass opacity and peribronchial thickening are common in pediatric COVID‑19. Consolidation, pleural effusion, and high radiographic scores correlate with severe disease and poor outcomes, supporting CXR as a useful adjunct for risk stratification in moderate‑to‑severe cases, rather than universal screening.https://wjpn.ssu.ac.ir/article_516_8251e0928dbcd1eb9b5dd0977f6dbfea.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260601Clinical Manifestations, Treatment and Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Single-Center Experience from Iran10812451810.18502/wjpn.v8i2.22107ENFarzadFerdosianChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Pediatrics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMohammad EmadSharifiSchool of Dentistry, Tehran University of Medical Sciences, Tehran, IranMother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranMehranKarimiChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Pediatrics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranNaeimehNaserzadehChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Pediatrics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranZahraNafeiChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Pediatrics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranNiloufarVaziri BozorgSchool of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranShekoofehSavabiehDepartment of Pediatrics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260722<strong>Background:</strong> Multisystem inflammatory syndrome in children (MIS-C) is a documented complication arising from SARS-CoV-2 infection. Even pediatric patients who present with mild initial COVID-19 symptoms may subsequently experience severe morbidity or mortality due to MIS-C; therefore, early identification and prompt clinical management are essential for achieving favorable outcomes. This study aimed to assess the clinical characteristics, therapeutic strategies, and patient outcomes among children diagnosed with MIS-C in Yazd, Iran.<br /><strong>Methods:</strong> This study included all pediatric patients admitted to Shahid Sadoughi Hospital in Yazd, Iran, who presented with either suspected or confirmed MIS-C between March 2020 and March 2021. Comprehensive data were extracted from medical records, including demographics, clinical symptoms, laboratory biomarkers, imaging results, and treatment modalities.<br /><strong>Results:</strong> The study included 40 children (52.5% males, 47.5% females, median age 7.3 years). Fever was the predominant symptom (87.5%), followed by gastrointestinal complaints (57.5%) and mucocutaneous abnormalities (20%). The digestive, respiratory, and neurological systems were most frequently involved. Hospitalisation lasted 1–7 days in 75% and 8–14 days in 22.5% of patients. Disease severity was severe in 25%, moderate in 47.5%, and mild in 27.5%. Remdesivir (40%), corticosteroids (52.5%), and intravenous immunoglobulin (47.5%) were used as treatment. Notably, the overall mortality rate was 22.5% (9/40), substantially higher than the rates reported in most international studies. <strong>Conclusion:</strong> This elevated mortality underscores the urgent need for enhanced early detection, rapid referral systems, and timely immunomodulatory therapy. Previous studies have reported that COVID-19 vaccination is associated with a reduced incidence of MIS-C. https://wjpn.ssu.ac.ir/article_518_c72cdff35d58dcfd082640e8363edacf.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07928220260601Prevalence of Gastrointestinal Symptoms in Children with COVID-19 Hospitalized at Shahid Sadoughi Hospital in Yazd12513352010.18502/wjpn.v8i2.22108ENMajidAflatoonianChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranMehranKarimiMother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranFarzadFerdosianChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranRoohollahEdalatkhahChildren Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranShivaRezaeiMother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20260722<strong>Background: </strong>COVID-19 affects the respiratory system, but GI manifestations are recognized in children. These symptoms may precede or accompany respiratory manifestations, making their recognition important for diagnosis. This study aimed to investigate the frequency of GI manifestations and their association with characteristics and disease severity among hospitalized children with COVID-19.<br /><strong>Methods:</strong> This retrospective cross-sectional study included 191 children <18 years with COVID-19 hospitalized at a referral hospital in Yazd, between 2020 and 2021. Demographic, laboratory, radiological, and GI data were extracted from the COVID-19 registry and medical records. Disease severity was classified per WHO criteria. Statistical analysis was performed using the Chi-square test.<br /><strong>Results:</strong> Among 191 children, 78 (40.8%) had ≥1 GI manifestation. Common symptoms were diarrhea (26.5%), vomiting (25.4%), and abdominal pain (13.6%). No significant associations were found between GI manifestations and sex, underlying conditions, ALT levels, prognosis, ICU admission, or hospitalization length (p > 0.05). Nausea showed a significant association with age (p = 0.01), being prevalent among adolescents aged 13–16 years (16.7%), while weight loss was associated with elevated AST (p = 0.04). Diarrhea was the only GI symptom associated with severity, occurring more frequently in non-severe vs. severe disease (34.4% vs. 18.7%, p = 0.01). <br /><strong>Conclusion:</strong> GI manifestations are common in hospitalized children with COVID-19 and may facilitate early recognition. Although diarrhea was associated with severity, it was more frequent in non-severe cases and should not be considered an independent marker of severe illness. Severity assessment should be based on clinical presentation rather than GI manifestations alone. https://wjpn.ssu.ac.ir/article_520_f0fbe3e0267bbf6b7a6f8a62c9e3a095.pdf