Influence of social determinants of health on skin to skin contact between mother and newborn

Elements that influenced immediate mother-neonate contact during the golden hour

OBJECTIVE

To characterize the elements that influenced the immediate mother-neonate contact during the golden hour.

METHOD

A cross-sectional observational study with a quantitative approach. A total of 105 parturient women hospitalized in two maternity hospitals with usual risk were observed. The instrument was based on Brazilian National Normal Childbirth Care Guidelines and World Health Organization good obstetric practices, totaling 36 questions. The analysis took place in a descriptive way using the Chi-Square Test for proportion comparison.

RESULTS

Of the parturient women, 2.8% (n = 3) experienced the golden hour, and 82.9% (n = 87), immediate contact between 1 and 5 minutes. In 85.7% (n = 90) of the group, there were no causes that contraindicated immediate contact. For 48.0% (n = 49) of participants, contact was re-established by the nursing staff within 31-60 minutes.

CONCLUSION

Immediate contact during the golden hour had low hospital care compliance. Neonatal procedures that can be postponed predominated as influencing elements of the golden hour. The assistance observed in the birth rooms investigated reflects the need to reduce interventions in labor and birth.

Practicing Level and Determinants of Safe Cord Care and Skin-To-Skin Contact Among Post-partum Women in Public Hospitals of Eastern Ethiopia

BACKGROUND

Even though practicing levels of safe cord care and skin-to-skin contact among post-partum women are critical to reducing neonatal deaths, limited data revealed the low practice. Thus, the purpose of this study was to determine the level of practice and determinants of safe cord care and skin-to-skin contact among post-partum women in public hospitals of Eastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted at the public hospitals of Harari reginal state, eastern Ethiopia. A random sample of 820 post-partum women was included in the study. A pre-tested and structured questionnaire was used to collect data through a face-to-face interview. STATA version 14 was used for data analysis. Bivariable and multivariable logistic regression analyses were employed to determine the association between independent and outcome variables.

RESULTS

The practicing level of safe cord care was 71.7% (95% Confidence Interval (CI): 64.5, 81.7). While the practicing level of Skin-To-Skin contact was 53.2% (95% CI: 43.6, 58.8). Being in age of 20-29 [adjusted odds ratio (AOR) = 2.93, 95% CI: 1.24, 6.96], attending tertiary education [AOR = 1.83, 95% CI (1.08, 3.13)], and having good knowledge about safe cord care [AOR = 11.3, 95% CI: (7.49, 17.18)] were determinants of safe cord care practice. While mothers aged 20-29, 30-39, and above 40 [(AOR = 11.17, 95% CI: 4.71, 26.5; AOR = 4.1, 95% CI: 1.77, 9.55, and AOR = 14.3, 95% CI: 7.2, 28.6), respectively], Being married [AOR = 3.70, 95% CI (1.58, 8.70)], being a merchant and self-employed ([AOR = 0.55, 95% CI: 0.34,0.87] and [AOR = 0.49, 95% CI: 0.27, 0.86], respectively), having good knowledge about SSC [AOR = 2.11, 95% CI: (1.53, 2.92)], giving birth at gestational age of 37-42 weeks [AOR = 1.82, 95% CI (1.31, 2.5)], and multigravidity (AOR = 2.83, 95% CI (1.90,4.21) were significantly associated with skin to skin contact.

CONCLUSIONS

The practicing level of safe cord care and skin-to-skin contact was high. In this study, the age of mothers, educational status, and knowledge of post-partum women on safe cord care were determinants of a safe cord care practice. While the age of mothers, marital status, occupational status, knowledge of mother, and gestational age at birth were significantly associated with skin-to-skin contact practice. Safe cord care should be strengthened and intensified to reduce neonatal mortality due to avoidable umbilical cord infections. Furthermore, skin-to-skin contact practice should be strengthened to enhance the survival of at-risk neonates.

Elementos Que Influenciaram No Contato Imediato Entre Mãe E Bebê Na hora dourada

RESUMO Objetivo: Caracterizar os elementos que influenciaram no contato imediato entre mãe e bebê na hora dourada. Método: Estudo observacional transversal, com abordagem quantitativa. Foram observadas 105 parturientes internadas em duas maternidades de risco habitual. O instrumento teve como base as Diretrizes Nacionais de Assistência ao Parto Normal e as boas práticas obstétricas da Organização Mundial da Saúde, totalizando 36 questões. A análise ocorreu de forma descritiva mediante o Teste do Qui-Quadrado para comparação de proporção. Resultados: Das parturientes, 2,8% (n = 3) vivenciaram a hora dourada, e 82,9% (n = 87), o contato imediato entre 1 e 5 minutos. Em 85,7% (n = 90) do grupo, não houve causas que contraindicassem o contato imediato. Para 48,0% (n = 49) das participantes, o contato foi restabelecido pela enfermagem entre 31–60 minutos. Conclusão O contato imediato na hora dourada teve baixa adesão na assistência hospitalar. Os procedimentos neonatais passíveis de serem adiados predominaram como elementos influenciadores da hora dourada. A assistência observada nas salas de parto investigadas reflete a necessidade de reduzir as intervenções no parto e nascimento.