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Rodríguez-Gallego I, Vila-Candel R, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial. Nutrients 2024; 16:227. [PMID: 38257120 PMCID: PMC10821517 DOI: 10.3390/nu16020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth.
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Affiliation(s)
- Isabel Rodríguez-Gallego
- Foetal Medicine, Genetics and Reproduction Unit, Virgen del Rocío University Hospital, 41009 Seville, Spain;
- Red Cross Nursing University Centre, University of Seville, 41013 Seville, Spain
| | - Rafael Vila-Candel
- Faculty of Health Sciences, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain
- La Ribera Primary Health Department, 46600 Alzira, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
| | - Isabel Corrales-Gutierrez
- Surgery Department, Faculty of Medicine, University of Seville, 41009 Seville, Spain
- Foetal Medicine Unit, Virgen Macarena University Hospital, 41009 Seville, Spain
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain;
| | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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Nejsum FM, Måstrup R, Torp-Pedersen C, Løkkegaard ECL, Wiingreen R, Hansen BM. Exclusive breastfeeding: Relation to gestational age, birth weight, and early neonatal ward admission. A nationwide cohort study of children born after 35 weeks of gestation. PLoS One 2023; 18:e0285476. [PMID: 37224110 DOI: 10.1371/journal.pone.0285476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/22/2023] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVES Prematurity, being small for gestational age and early neonatal ward admission are the major neonatal conditions that may interfere with breastfeeding supportive practices in infants born at gestational age ≥35+0 weeks. We aimed to investigate the associations between gestational age, small for gestational age, early neonatal ward admission and exclusive breastfeeding at one and four months. METHODS A register-based cohort-study of all Danish singletons with gestational age ≥35+0 weeks born in 2014-2015. In Denmark, health visitors routinely conduct free home visits throughout infants' first year and thereby report breastfeeding data to The Danish National Child Health Register. These data were linked with data from other national registers. Logistic regression models estimated the odds ratio for exclusive breastfeeding at one and four months, adjusted for confounding variables. RESULTS The study population comprised 106,670 infants. Compared to gestational age 40 weeks, the adjusted odds ratio for exclusive breastfeeding at one month showed a decreasing tendency from gestational age ≥42 (n = 2,282) (1.07; 95% confidence interval (CI) 0.97-1.17) to 36 weeks (n = 2,062) (0.80; 95% CI 0.73-0.88). Small for gestational age (n = 2,342) was associated with decreased adjusted odds ratio for exclusive breastfeeding at one month (0.84; 95% CI 0.77-0.92). Neonatal ward admission was associated with increased adjusted odds ratio for exclusive breastfeeding at one month among late preterm infants (gestational age 35-36 weeks; n = 3,139) (1.31; 95% CI 1.12-1.54), as opposed to among early term (gestational age 37-38 weeks; n = 19,171) (0.84; 95% CI 0.77-0.92) and term infants (gestational age >38 weeks; n = 84,360) (0.89; 95% CI 0.83-0.94). The associations seemed to persist at four months. CONCLUSIONS Decreasing gestational age and small for gestational age were associated with decreased exclusive breastfeeding rates. Neonatal ward admission was associated with increased exclusive breastfeeding rates among late preterm infants, whereas the opposite was observed among early term and term infants.
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Affiliation(s)
- Freja Marie Nejsum
- Department of Pediatrics, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
| | - Ragnhild Måstrup
- Department of Neonatology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Christine Leth Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Wiingreen
- Department of Pediatrics, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bo Mølholm Hansen
- Department of Pediatrics, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Galvão da Silva M, Mattiello R, Del Ponte B, Matijasevich A, Silveira MF, Bertoldi AD, Domingues M, Barros F, Santos IS. Breastfeeding Duration and Exclusivity Among Early-Term and Full-Term Infants: A Cohort Study. Curr Dev Nutr 2023; 7:100050. [PMID: 37181939 PMCID: PMC10111589 DOI: 10.1016/j.cdnut.2023.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/27/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Background As compared to full-term infants (39-41 weeks of gestation), early-term infants (37-38 wk) are at increased risk of adverse outcomes, including shorter exclusive breastfeeding (EB) duration and continued breastfeeding. Objectives To compare early-term with full- and late-term infants regarding the prevalence of EB at 3 mo and any breastfeeding at 12 mo. Methods Data sets from two population-based birth cohorts conducted in the city of Pelotas, Brazil, were combined. Only term infants (37 0/7 through 41 6/7 weeks of gestation) were included in the analyses. Early-term infants (37 0/7 through 38 6/7 wk) were compared to the remaining term infants (39 0/7 through 41 6/7 wk). Information on breastfeeding was gathered through maternal interviews at the 3-mo and 12-mo follow-ups. The prevalence of EB at 3 mo and any breastfeeding at 12 mo with 95% CIs were calculated. Crude and adjusted prevalence ratios (PRs) were obtained through Poisson regression. Results A total of 6395 infants with information on gestational age and EB at 3 mo and 6401 infants with information on gestational age and any breastfeeding at 12 mo were analyzed. There was no difference between early-term infants and the remaining term infants regarding the prevalence of EB at 3 mo (29.2% and 27.9%, respectively) (P = 0.248). Prevalence of any breastfeeding at 12 mo was lower in early-term infants than among those born between 39 0/7 and 41 6/7 weeks of gestation (38.2% compared with 42.4%) (P = 0.001). In the adjusted analysis, the PR for any breastfeeding at 12 mo was 15% lower in the early-term group than in the remaining term infants (PR = 0.85; 95% CI: 0.76-0.95) (P = 0.004). Conclusions The prevalence of EB at 3 mo was similar among term infants. Nonetheless, in comparison with the remaining infants born at term, early-term infants were at increased risk of having been weaned before reaching 12 mo of age. Curr Dev Nutr 2023;xx:xx.
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Affiliation(s)
- Michele Galvão da Silva
- Postgraduate Program in Pediatrics and Child Health, Medical School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rita Mattiello
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Del Ponte
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Mariangela F. Silveira
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Andrea D. Bertoldi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Marlos Domingues
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
- Postgraduate Program in Health and Behaviour, Universidade Católica de Pelotas, Rio Grande do Sul, Brazil
| | - Ina S. Santos
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
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López-Fernández G, Barrios M, Gómez-Benito J. Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior. J Pediatr Nurs 2022; 69:e80-e87. [PMID: 36529595 DOI: 10.1016/j.pedn.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years. DESIGN AND METHODS A total of 432 mothers participated in a cross-sectional online survey. A three-way interaction model was used to test the moderating role of maternal stress and child behavioral problems in the relationship between breastfeeding and maternal attachment. RESULTS The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attachment. CONCLUSIONS This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attachment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship. PRACTICE IMPLICATIONS Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.
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Affiliation(s)
- Gemma López-Fernández
- Department of gynecology and obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain.
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Hanin EA, Rayan H, Hani T, Taleb J, Dany AH, Lama C. Breastfeeding and Readmission for Hyperbilirubinemia in Late Preterm and Term Infants in Beirut, Lebanon. Indian Pediatr 2021. [DOI: 10.1007/s13312-022-2472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chooniedass R, Tarrant M, Turner S, Lok Fan HS, Del Buono K, Masina S, Becker AB, Mandhane P, Turvey SE, Moraes T, Sears MR, Subbarao P, Azad MB. Factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women: a multi-centre study. Public Health Nutr 2021; 25:1-12. [PMID: 34859767 PMCID: PMC9991853 DOI: 10.1017/s1368980021004699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women. DESIGN Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. SETTING General community setting in four Canadian provinces. PARTICIPANTS In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012. RESULTS Of 3010 participants included in the current study, the majority were Canadian-born (75·5 %). Breast-feeding initiation rates were high in both non-Canadian-born (95·5 %) and Canadian-born participants (92·7 %). The median breast-feeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breast-feeding initiation and continuation were older maternal age, higher maternal education, living with their partner and recruitment site. Rooming-in during the hospital stay was also associated with higher rates of breast-feeding initiation, but not continuation at 6-month postpartum. Factors associated with non-initiation of breast-feeding and cessation at 6-month postpartum were maternal smoking, living with a current smoker, caesarean birth and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breast-feeding initiation and lower odds of breast-feeding continuation at 6 months, and older maternal age and recruitment site were associated with breast-feeding continuation at 6 months. CONCLUSIONS Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breast-feeding initiation rates, breast-feeding initiation and continuation are more strongly associated with socio-demographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breast-feeding continuation in both groups and may indicate geographic disparities in breast-feeding rates nationally.
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Affiliation(s)
- Rishma Chooniedass
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Sarah Turner
- Manitoba Interdisciplinary Lactation Centre, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, People’s Republic of China
| | - Katie Del Buono
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Stephanie Masina
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Allan B Becker
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Piushkumar Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Theo Moraes
- Department of Paediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Padmaja Subbarao
- Department of Paediatrics, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Ahmed AH, Rojjanasrirat W. Breastfeeding Outcomes, Self-Efficacy, and Satisfaction Among Low-Income Women With Late-Preterm, Early-Term, and Full-Term Infants. J Obstet Gynecol Neonatal Nurs 2021; 50:583-596. [PMID: 34390676 DOI: 10.1016/j.jogn.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess breastfeeding exclusivity and rate of breastfeeding, breastfeeding self-efficacy, and satisfaction with breastfeeding after hospital discharge among low-income women with late-preterm and early-term infants compared with women with full-term infants. DESIGN Prospective, comparative, with repeated measures. SETTING Four Midwestern U.S. Special Supplemental Nutrition Program for Women, Infants, and Children offices. PARTICIPANTS Participants included 270 mother-infant dyads. METHODS We assessed breastfeeding exclusivity, rate of breastfeeding, and breastfeeding self-efficacy at 2 weeks, 2 months, and 5 months and satisfaction with breastfeeding at 5 months after birth or when participants stopped breastfeeding. RESULTS More than 50% of women in each subgroup were non-Hispanic White. Late-preterm and early-term infants had lower breastfeeding exclusivity rates than full-term infants across the three time points (40%, 51%, and 65% at 2 weeks, p = .029; 22.5%, 34%, and 58% at 2 months, p < .001; and 7%, 15%, and 28.46% at 5 months, p < .001, respectively). The overall exclusive breastfeeding rate for all groups was 55.93% at 2 weeks, 44.07% at 2 months, and 20.37% at 5 months; 55.56% continued any breastfeeding at 5 months. Breastfeeding self-efficacy during the first 5 months after birth, satisfaction with breastfeeding, level of education, and attending breastfeeding classes were positively correlated with breastfeeding exclusivity. We found significantly less exclusive breastfeeding, lower breastfeeding self-efficacy, and lower satisfaction with breastfeeding among participants with late-preterm and early-term infants compared to those with full-term infants. CONCLUSION Ongoing professional breastfeeding support for women is needed to improve and promote breastfeeding exclusivity and continuation among their late-preterm and early-term infants.
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Hensman AM, Erickson-Owens DA, Sullivan MC, Quilliam BJ. Determinants of Neonatal Readmission in Healthy Term Infants: Results from a Nested Case-Control Study. Am J Perinatol 2021; 38:1078-1087. [PMID: 32120422 DOI: 10.1055/s-0040-1702936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the incidence and identify the factors associated with neonatal readmission among healthy term infants. STUDY DESIGN A nested case-control study with matching was conducted at a large level III perinatal hospital with approximately 8,700 deliveries each year. Each case infant (n = 130) was matched to two control infants (n = 260) on the case infant's date of birth (±7 days) and the mother's maternal age (<20 years, 20-29, 30-39, and >39 years). All infants were selected from a cohort of eligible term, healthy, in-state infants admitted to the newborn unit postdelivery from January 1, 2016 to May 8, 2017. Data were analyzed using hierarchical conditional logistic regression. RESULTS The incidence of neonatal readmission was 2.2%, and all readmissions occurred within 8.6 days of birth. Earlier gestational age (37 weeks; odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.79-9.45; 38 weeks OR: 1.29, CI 0.60-2.75; [ref] 39 weeks), jaundice on day two of life (OR: 2.45; CI: 1.40-4.30), maternal group B streptococcus chemoprophylaxis (OR: 2.55; CI: 1.23-5.28 [Ref N/A]) were associated with readmission. Delivery by cesarean section (OR: 0.31, CI: 0.12-0.79) and each milliliter of formula [first three days] (OR: 0.96; CI: 0.993-0.999) were protective. CONCLUSION Neonatal readmission in healthy term infants may potentially be reduced with identification of modifiable determinants of readmission prior to discharge. Policies to capture the true incidence of neonatal readmissions should include admissions to hospitals other than the birth hospital.
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Affiliation(s)
- Angelita M Hensman
- Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island.,Bio Med Pediatric Department, Brown University, Providence, Rhode Island.,College of Nursing, University of Rhode Island, Kingston, Rhode Island
| | - Debra A Erickson-Owens
- Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island.,College of Nursing, University of Rhode Island, Kingston, Rhode Island
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Kingston, Rhode Island
| | - Brian J Quilliam
- College of Health Sciences, University of Rhode Island, Kingston, Rhode Island
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:116-124. [DOI: 10.1016/j.jogn.2019.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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