皮肤接触和产房实践：皮埃蒙特和奥斯塔谷的纵向调查。
Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley.
机构信息
Struttura Complessa Pediatria, Ospedale Castelli, Azienda Sanitaria Locale VCO, Verbania, Italy.
Dipartimento Materno Infantile VCO, Ospedale Castelli, Verbania, Italy.
出版信息
Ital J Pediatr. 2019 Aug 2;45(1):95. doi: 10.1186/s13052-019-0688-9.
BACKGROUND
Sudden unexpected postnatal collapse of presumably healthy neonates during early skin-to-skin contact is a rare, yet recognized occurrence, associated with a high risk of mortality and morbidity. A survey was conducted in 2012 in 30 delivery wards throughout Piedmont and the Aosta Valley to evaluate the environmental and logistical aspects that could be linked to SUPC. The survey was again conducted in 2016 in 28 delivery wards in Piedmont and the Aosta Valley in order to evaluate organizational improvements introduced after ministerial indications and recommendations by the Italian Society of Neonatology were published in 2014, in light of new findings regarding the phenomenon.
METHODS
A questionnaire specifically asking about the organization of delivery wards, and surveillance or supervision during early skin-to-skin contact, was sent to all of the hospitals taking part in the survey in both 2012 and 2016. The collected data were elaborated anonymously and the statistical analysis was performed by using the two by two table.
RESULTS
In 2012, 28 out of 30 delivery wards in Piedmont and Aosta, with a total of 31,074 newborns out of 35,435, were evaluated in all of the environmental and logistical aspects that might be cause for SUPC to occur. An identical survey was taken again in 2016; 26 out of 28 wards participated with a total of 27,484 newborns out of 30,339. In 2012, early skin-to-skin contact took place immediately in all the delivery rooms in 27 wards, and soon after in the post-partum room in one; in 11 out of 28 wards there was early skin-to-skin contact in the operating theater itself, following caesarean sections (11/26 in 2016). Routine newborn care was given after 3 h in 8 delivery wards (7/26 in 2016); after 2 h in 12 (7/26 in 2016); after 1 h in 2 (4/26 in 2016); after 30 min in 3 (2/26 in 2016); after 10 min in 1 (0/26 in 2016); after 1 or 2 min in 1 (0/26 in 2016) and at any time in one ward (6/26 in 2016).
CONCLUSION
Periodic surveys of delivery wards are useful for the assessment of all the aspects and risk factors that need to be changed in order to implement safe early skin-to-skin contact.
背景
在早期母婴皮肤接触期间，健康新生儿突然、意外的产后崩溃是一种罕见但已被认识到的情况，与高死亡率和发病率相关。2012 年，在皮埃蒙特和奥斯塔谷的 30 个分娩病房进行了一项调查，以评估可能与 SUPC 相关的环境和后勤方面。2016 年，皮埃蒙特和奥斯塔谷的 28 个分娩病房再次进行了调查，以评估 2014 年意大利新生儿学会发布部长指示和建议后引入的组织改进措施，以及针对该现象的新发现。
方法
向所有参与 2012 年和 2016 年调查的医院发送了一份专门询问分娩病房组织以及早期母婴皮肤接触时的监测或监督情况的问卷。匿名收集数据，并使用四格表进行统计分析。
结果
2012 年，皮埃蒙特和奥斯塔谷的 30 个分娩病房中的 28 个（共 31074 名新生儿，占 35435 名新生儿的 88%）对所有可能导致 SUPC 发生的环境和后勤方面进行了评估。2016 年再次进行了相同的调查；26 个病房参与了调查，共有 27484 名新生儿，占 30339 名新生儿的 90%。2012 年，27 个病房的所有分娩室都立即进行了早期母婴皮肤接触，1 个病房在产后室很快进行了接触；28 个病房中的 11 个在剖宫产术后的手术室进行了早期母婴皮肤接触（2016 年为 11/26）。8 个分娩病房在 3 小时后进行常规新生儿护理（2016 年为 7/26）；12 个在 2 小时后（2016 年为 7/26）；2 个在 1 小时后（2016 年为 4/26）；3 个在 30 分钟后（2016 年为 2/26）；1 个在 10 分钟后（2016 年为 0/26）；1 个在 1 分钟后（2016 年为 0/26）；1 个在任何时间（2016 年为 1/26）。
结论
定期对分娩病房进行调查有助于评估需要改变的所有方面和危险因素，以实施安全的早期母婴皮肤接触。
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