Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA.
College of Nursing, University of Massachusetts, Dartmouth, MA.
J Pediatr. 2020 Mar;218:11-15. doi: 10.1016/j.jpeds.2019.09.069. Epub 2019 Nov 18.
To determine if implementation of skin-to-skin care and the Baby-Friendly Hospital Initiative (BFHI) contributes to sudden unexpected infant death (SUID) and asphyxia in the first 6 days after birth.
Survey data were used to determine a correlation between BFHI and deaths from SUID and asphyxia among infants <7 days in the US and Massachusetts. Using data from the Centers for Disease Control and Prevention, implementation of BFHI was tracked from 2004-2016 and skin-to-skin care was tracked from 2007-2015. Using data from Centers for Disease Control and Prevention WONDER and the Massachusetts Department of Public Health, SUID and asphyxia were tracked from 2004-2016.
Nationally, births in Baby-Friendly facilities rose from 1.8% to 18.3% and the percentage of facilities in which most dyads experienced skin-to-skin care rose from 40% to 83%. SUID prevalence among infants <7 days was rare (0.72% of neonatal deaths) and decreased significantly from 2004-2009 compared with 2010-2016, from 0.033 per 1000 live births to 0.028, OR 0.85 (95% CI 0.77, 0.94). In Massachusetts, births in Baby-Friendly facilities rose from 2.8% to 13.9% and skin-to-skin care rose from 50% to 97.8%. SUID prevalence decreased from 2010-2016 compared with 2004-2009: OR 0.32 (95% CI 0.13, 0.82), with 0 asphyxia deaths during the 13-year period.
Increasing rates of breastfeeding initiatives and skin-to-skin care are temporally associated with decreasing SUID prevalence in the first 6 days after birth in the US and Massachusetts.
确定皮肤接触和婴儿友好医院倡议（BFHI）的实施是否会导致婴儿出生后 6 天内的意外突发婴儿死亡（SUID）和窒息。
使用调查数据来确定 BFHI 与美国和马萨诸塞州出生后 7 天内 SUID 和窒息婴儿死亡之间的相关性。使用疾病控制和预防中心的数据，从 2004 年至 2016 年跟踪 BFHI 的实施情况，从 2007 年至 2015 年跟踪皮肤接触情况。使用疾病控制和预防中心 WONDER 和马萨诸塞州公共卫生部的数据，从 2004 年至 2016 年跟踪 SUID 和窒息情况。
在全国范围内，婴儿友好设施中的分娩率从 1.8%上升到 18.3%，大多数双胞胎经历皮肤接触的设施比例从 40%上升到 83%。出生后 7 天内的 SUID 发生率很低（新生儿死亡的 0.72%），与 2004 年至 2009 年相比，2010 年至 2016 年显著下降，从每 1000 例活产 0.033 例降至 0.028 例，比值比（OR）为 0.85（95%置信区间为 0.77，0.94）。在马萨诸塞州，婴儿友好设施中的分娩率从 2.8%上升到 13.9%，皮肤接触率从 50%上升到 97.8%。SUID 的发生率从 2010 年至 2016 年与 2004 年至 2009 年相比有所下降：OR 0.32（95%置信区间为 0.13，0.82），在 13 年期间没有窒息死亡。
在美国和马萨诸塞州，母乳喂养计划和皮肤接触率的增加与出生后 6 天内 SUID 发生率的降低有关。
