Effects of early essential newborn care after elective caesarean section on maternal and neonatal outcomes: a retrospective study.

Abstract

Objective: Early essential newborn care (EENC) is a World Health Organization (WHO)-recommended package of evidence-based perinatal interventions, but evidence regarding its effects after elective caesarean section (CS) remains limited. We evaluated the effects of EENC on maternal and neonatal outcomes following elective CS.

Methods: In this retrospective observational study, 590 patients who underwent CS from November 2021 to October 2022 were screened; after applying eligibility criteria, 282 were included for analysis: 125 in the EENC group (E group) and 157 in the routine care group (R group). Outcomes included intraoperative and 24-h postpartum blood loss, postoperative pain (visual analogue scale [VAS] at 2/24/48/72 h), exclusive breastfeeding rate, neonatal hospitalization, neonatal intensive care unit (NICU) admission and transcutaneous bilirubin (TcB). Continuous data were compared with the independent t-test or Mann-Whitney U test and categorical data with the chi-square or Fisher's exact test.

Results: Intraoperative blood loss (239.20±74.21 vs. 259.87±85.37 mL, t=2.14, P=0.033) and 24-h postpartum blood loss (47.01±20.71 vs. 54.71±26.64 mL, t=2.66, P=0.008) were lower in the E group. The 2-h VAS score was lower in the E group (1.88 [1, 3] vs. 2.48 [1, 4], Z=3.32, P<0.001). The exclusive breastfeeding rate was higher (78.4% vs. 63.7%, χ²=7.20, P=0.005) and neonatal hospitalization shorter (4.04 [3, 5] vs. 4.20 [3, 6] days, P=0.021) in the E group. NICU admission, TcB and VAS at 24-72 h did not differ.

Conclusion: EENC after elective CS was associated with reduced intraoperative and 24-h postpartum blood loss, lower early postoperative pain, higher exclusive breastfeeding rates and shorter neonatal hospitalization, supporting broader implementation of EENC in CS deliveries.