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足月儿脐带结扎的相关因素。

Factors associated with umbilical cord clamping in term newborns.

作者信息

Strada Juliana Karine Rodrigues, Vieira Leticia Becker, Gouveia Helga Geremias, Betti Thais, Wegner Wiliam, Pedron Cecília Drebes

机构信息

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.

出版信息

Rev Esc Enferm USP. 2022 Mar 28;56:e20210423. doi: 10.1590/1980-220X-REEUSP-2021-0423. eCollection 2022.

Abstract

OBJECTIVE

To identify factors associated with umbilical cord clamping in term newborns and to compare the recording of clamping time in the medical record with what was observed.

METHOD

Cross-sectional study, with 300 mothers-infants, in a university hospital. Clamping time and medical records were observed, and a structured questionnaire was applied to postpartum women for sociodemographic variables. Bivariate analysis, multivariate Poisson Regression model, and Kappa concordance test were performed.

RESULTS

The percentage of late/optimal clamping observed was 53.7%. The associated factors were skin-to-skin contact in the delivery room (PR = 0.76; 0.61-0.95; p = 0.014), position of the newborn below the vaginal canal (PR = 2.6; CI95%: 1.66-4.07; p < 0.001), position of the newborn at the vaginal level (PR = 2.03; CI95%: 1.5-2.75; p < 0.001), and need for newborn resuscitation in the delivery room (PR = 1.42; CI95%; 1.16-1.73; p = 0.001). Kappa concordance level of the professionals, records compared to the observation was: nurse 0.47, obstetrician 0.59, and pediatrician 0.86.

CONCLUSION

the identification of associated factors and the comparison between recording and observing the clamping time can help in the planning and implementation of improvements for adherence to good practices at birth.

摘要

目的

确定足月儿脐带结扎的相关因素,并比较病历中记录的结扎时间与实际观察情况。

方法

在一家大学医院对300对母婴进行横断面研究。观察结扎时间和病历情况,并对产后妇女应用结构化问卷以获取社会人口学变量信息。进行双变量分析、多变量泊松回归模型分析和kappa一致性检验。

结果

观察到的延迟/最佳结扎百分比为53.7%。相关因素包括产房内的皮肤接触(PR = 0.76;0.61 - 0.95;p = 0.014)、新生儿位于阴道管下方的位置(PR = 2.6;95%CI:1.66 - 4.07;p < 0.001)、新生儿位于阴道水平的位置(PR = 2.03;95%CI:1.5 - 2.75;p < 0.001)以及产房内新生儿复苏的需求(PR = 1.42;95%CI:1.16 - 1.73;p = 0.001)。专业人员记录与观察的kappa一致性水平为:护士0.47,产科医生0.59,儿科医生0.86。

结论

确定相关因素以及比较记录的和观察到的结扎时间有助于规划和实施改进措施,以促进出生时良好做法的遵循。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8bf/10081613/eca816dbbba7/1980-220X-reeusp-56-e20210423-gf1.jpg

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