Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2021 Mar;26(3):859-874. doi: 10.1590/1413-81232021263.26032020. Epub 2020 Aug 21.
This paper aims to compare best practices for healthy newborns in public and mixed hospitals affiliated with SUS, according to type of birth, between "Nascer no Brasil/2011" (NB - Birth in Brazil) and in the last assessment cycle of Rede Cegonha, here called "Avaliação da Rede Cegonha/2017" (ARC - Stork Network Assessment). NB included a sample with national representativeness of 266 hospitals, and ARC was conducted in 606 maternity hospitals included in the Rede Cegonha strategy, totaling 15,994 and 8,047 pairs of healthy mothers and newborns, respectively.Between the two studies, NB-2011 and ARC-2017, although the proportion of cesarean sections remained around 44%, the prevalence of skin-to-skin contact with newborns, breastfeeding in the delivery room and breastfeeding in the first 24h of life increased by 140%, 82% and 6%, respectively. The proportion of upper airway aspiration of newborns dropped 65%. The results indicate that the use of evidence-based guidelines for the care of healthy newborns has increased in clinical practice, considering the six-year period between the compared studies. Despite the progress, important challenges remain to ensure best practices for all women and newborns, especially in relation to cesarean births.
本文旨在比较隶属于 SUS 的公立和混合医院中，根据分娩类型，“巴西新生儿（Nascer no Brasil/2011，NB）”与“鹳鸟网络评估（Avaliação da Rede Cegonha/2017，ARC）”最后评估周期中健康新生儿的最佳实践。NB 包含了一个具有全国代表性的 266 家医院的样本，ARC 在鹳鸟网络策略中包含的 606 家产科医院进行，分别有 15994 对和 8047 对健康母亲和新生儿。在这两项研究中，尽管剖宫产率仍保持在 44%左右，但与新生儿的皮肤接触、在分娩室进行母乳喂养以及在生命的头 24 小时内进行母乳喂养的比例分别增加了 140%、82%和 6%。新生儿上呼吸道抽吸的比例下降了 65%。结果表明，考虑到比较研究之间的六年时间，基于循证指南的健康新生儿护理在临床实践中有所增加。尽管取得了进展，但仍存在重要挑战，特别是在剖宫产方面，以确保所有妇女和新生儿都能获得最佳实践。
