Dani Carlo, Papini Sofia, Iannuzzi Laura, Pratesi Simone
Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
Margherita Birth Center, Careggi University Hospital of Florence, Florence, Italy.
Acta Paediatr. 2020 Sep;109(9):1787-1790. doi: 10.1111/apa.15180. Epub 2020 Feb 11.
To assess the effect of midwife-to-infant ratio on healthy term infant outcome.
Infants were enrolled in an inhospital midwife-led centre and an obstetrician-led centre with different midwife-to-infant ratios (1:2.5-1:5 vs 1:7-1:15). The primary endpoint was exclusive breastfeeding rate; secondary endpoints were neonatal admission in neonatal care unit rate and length of hospital stay.
One hundred and ten infants were enrolled in both midwife- and obstetrician-led centre. Exclusive breastfeeding rate at discharge was higher (88% vs 78%, P = .048) in infants born in the midwife- than in the obstetrician-led centre. Admission rate in neonatal care units (9% vs 2%, P = .017) and stay in hospital duration (3.1 ± 1.8 vs 2.6 ± 0.8 days, P = .008) were higher in the obstetrician- than in the midwife-led centre. Birth in the midwife-led centre increased the likelihood of exclusive breastfeeding (OR: 2.04, 1.07-3.92), while newborns' admission in neonatal care units decreased it (OR : 0.17, 0.07-0.43).
Healthy term infants' neonatal outcome is negatively associated with a low midwife-to-infant ratio which decreases exclusive breastfeeding rate and is associated with a higher likelihood of admission in neonatal care units and longer stay in hospital.
评估助产士与婴儿比例对足月健康婴儿结局的影响。
将婴儿纳入由助产士主导的住院中心和由产科医生主导的中心，这两个中心的助产士与婴儿比例不同（1:2.5 - 1:5 对比 1:7 - 1:15）。主要终点是纯母乳喂养率；次要终点是新生儿重症监护病房的入院率和住院时间。
110名婴儿被纳入助产士主导中心和产科医生主导中心。在助产士主导中心出生的婴儿出院时的纯母乳喂养率更高（88% 对比 78%，P = 0.048）。产科医生主导中心的新生儿重症监护病房入院率（9% 对比 2%，P = 0.017）和住院时间（3.1 ± 1.8天对比2.6 ± 0.8天，P = 0.008）高于助产士主导中心。在助产士主导中心出生增加了纯母乳喂养的可能性（比值比：2.04，1.07 - 3.92），而新生儿重症监护病房的入院则降低了这种可能性（比值比：0.17，0.07 - 0.43）。
足月健康婴儿的新生儿结局与低助产士与婴儿比例呈负相关，低比例会降低纯母乳喂养率，并与新生儿重症监护病房入院可能性增加及住院时间延长相关。
