Midwifery continuity of care, breastfeeding and neonatal hyperbilirubinemia: A retrospective cohort study

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2024-06-26 DOI:10.1016/j.midw.2024.104079

Mahshid Abdi Shahshahani , Xingrong Liu , Mikael Norman , Ellen L. Tilden , Mia Ahlberg

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引用次数: 0

Abstract

Aim

To examine the association between Midwifery Continuity of Care (MCoC) and exclusive breastfeeding at hospital discharge and neonatal hyperbilirubinemia.

Methods

A matched cohort design was employed using data from the Swedish Pregnancy Register. The study included 12,096 women who gave birth at a university hospital in Stockholm, Sweden from January 2019 to August 2021. Women and newborns cared for in a MCoC model were compared with a propensity-score matched set receiving standard care. Risk ratios (RR) were determined with 95 % confidence intervals (CI) based on the matched cohort through modified Poisson regressions with robust standard error. A mediation analysis assessed the direct and indirect effects of MCoC on exclusive breastfeeding at hospital discharge and neonatal hyperbilirubinemia and to what extent the association was mediated by preterm birth.

Finding

Findings showed that MCoC was associated with a higher chance of exclusive breastfeeding rate (RR: 1.06, 95 % CI: 1.01–1.12) and lower risk of neonatal hyperbilirubinemia (RR: 0.51, 95 % CI: 0.32–0.82) compared with standard care. Mediation analysis demonstrated that lower preterm birth accounted for approximately 28 % of total effect on the reduced risk of neonatal hyperbilirubinemia.

Discussion/Conclusion

This matched cohort study provided preliminary evidence that MCoC models could be an intervention for improving exclusive breastfeeding rates at hospital discharge and reducing the risk of neonatal hyperbilirubinemia.

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助产士持续护理、母乳喂养和新生儿高胆红素血症：一项回顾性队列研究。

目的：研究助产士持续护理（MCoC）与出院时纯母乳喂养和新生儿高胆红素血症之间的关系：利用瑞典妊娠登记册的数据，采用匹配队列设计。研究对象包括 2019 年 1 月至 2021 年 8 月期间在瑞典斯德哥尔摩一家大学医院分娩的 12096 名妇女。在 MCoC 模式下接受护理的妇女和新生儿与接受标准护理的倾向分数匹配组进行了比较。在匹配队列的基础上，通过带稳健标准误差的修正泊松回归确定了风险比 (RR)，并得出了 95% 的置信区间 (CI)。一项中介分析评估了 MCoC 对出院时纯母乳喂养和新生儿高胆红素血症的直接和间接影响，以及早产对这种关联的中介作用：研究结果表明，与标准护理相比，MCoC与更高的纯母乳喂养率（RR：1.06，95 % CI：1.01-1.12）和更低的新生儿高胆红素血症风险（RR：0.51，95 % CI：0.32-0.82）相关。中介分析表明，较低的早产率约占降低新生儿高胆红素血症风险总效应的 28%：这项匹配队列研究提供了初步证据，证明 MCoC 模型可作为一种干预措施，提高出院时的纯母乳喂养率，降低新生儿高胆红素血症的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.