Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial

IF 2.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Breastfeeding Journal Pub Date : 2024-05-03 DOI:10.1186/s13006-024-00635-y

Jianping Xu, Min Zhang, Yi Li, Shuiqin Gu

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引用次数: 0

Abstract

As an essential part of Early Essential Newborn Care, 90 minutes of mother-infant skin-to-skin contact is significant in improving maternal and infant outcomes. However, due to human resource constraints and the consideration of maternal and infant safety, it is difficult to achieve continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean delivery. The aim of this study was to investigate the efficacy and safety of the continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean section for exclusive breastfeeding rate during hospitalization and maternal and infant health indicators during and after cesarean delivery. This is a single-center, prospective randomized controlled trial conducted in one tertiary care hospital in China. We selected 280 cases of elective cesarean delivery in a tertiary maternal and child specialty hospital in Zhejiang Province from September 2018 to August 2022, which were randomly divided into two groups: in the conventional group, doulas performed at least 30 minutes for early continuous SSC within 10–30 minutes during and after cesarean delivery. In the EENC group, with immediate continuous SSC within 5–10 minutes of neonatal delivery until surgery is completed and continued SSC after returning to the ward. Exclusive breastfeeding rate during hospitalization and maternal and infant health indicators were compared between the groups. A total of 258 cases were analyzed. Compared with the control group, the EENC group had earlier first breastfeeding initiation (13.7 ± 3.6 vs 62.8 ± 6.5 minutes, P < 0.001), longer duration of first breastfeeding (42.6 ± 9.0 vs 17.9 ± 7.5 minutes, P < 0.001), earlier onset of lactogenesis II (73.7 ± 3.6 vs 82.5 ± 7.4 hours, P < 0.001), higher breastfeeding self-efficacy score (128.6 ± 8.9 vs 104.4 ± 8.5, P < 0.001), higher Exclusive breastfeeding rate during hospitalization (88% vs 81%, P = 0.018), higher maternal satisfaction scores (18.9 ± 1.1 vs 14.0 ± 2.7, P < 0.001). Meanwhile the EENC group showed lower incidence of neonatal hypothermia (0% vs 4.6%, P = 0.014), lower neonatal hypoglycemia (0% vs 5.4%, P = 0.007) and less cumulative blood loss within 24 hours postpartum (254.2 ± 43.6 vs 282.8 ± 63.8 ml, P < 0.001). The implementation of EENC up to 90 minutes by caesarean doula company nurses is feasible and beneficial to maternal and infant health. ChiCTR1800018195(2018-09-04).

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在嘉兴实施剖宫产新生儿早期基本护理：单中心前瞻性随机对照试验

作为新生儿早期基本护理的重要组成部分，90 分钟的母婴皮肤接触对改善母婴预后意义重大。然而，由于人力资源的限制和对母婴安全的考虑，在剖宫产过程中和剖宫产后很难实现至少 90 分钟连续不间断的皮肤接触。本研究旨在探讨剖宫产术中和术后至少 90 分钟连续不间断的皮肤接触对住院期间纯母乳喂养率以及剖宫产术中和术后母婴健康指标的有效性和安全性。这是一项在中国一家三级甲等医院进行的单中心、前瞻性随机对照试验。我们选取了2018年9月至2022年8月浙江省某三级妇幼专科医院的280例择期剖宫产产妇，将其随机分为两组：常规组，朵拉在剖宫产术中、术后10-30分钟内进行至少30分钟的早期持续SSC。EENC组，在新生儿娩出后5-10分钟内立即持续SSC，直至手术结束，返回病房后继续SSC。比较了各组住院期间的纯母乳喂养率和母婴健康指标。共分析了 258 个病例。与对照组相比，EENC 组首次母乳喂养开始时间更早（13.7 ± 3.6 vs 62.8 ± 6.5 分钟，P < 0.001），首次母乳喂养持续时间更长（42.6 ± 9.0 vs 17.9 ± 7.5 分钟，P < 0.001），泌乳期 II 开始时间更早（73.7 ± 3.6 vs 82.5 ± 7.4 小时，P < 0.001），母乳喂养自我效能评分更高（128.6 ± 8.9 vs 104.4 ± 8.5，P < 0.001），住院期间纯母乳喂养率更高（88% vs 81%，P = 0.018），产妇满意度评分更高（18.9 ± 1.1 vs 14.0 ± 2.7，P < 0.001）。同时，EENC 组的新生儿低体温发生率较低（0% vs 4.6%，P = 0.014），新生儿低血糖发生率较低（0% vs 5.4%，P = 0.007），产后 24 小时内累计失血量较少（254.2 ± 43.6 vs 282.8 ± 63.8 ml，P < 0.001）。由剖腹产助产公司的护士实施长达90分钟的EENC是可行的，并且有益于母婴健康。ChiCTR1800018195(2018-09-04).

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来源期刊

International Breastfeeding Journal Medicine-Obstetrics and Gynecology

CiteScore

6.30

自引率

11.40%

发文量

审稿时长

32 weeks

期刊介绍： Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.