Midwifery Department, Faculty of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, Iran.
Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran.
Sci Rep. 2024 Oct 1;14(1):22819. doi: 10.1038/s41598-024-73751-8.
Midwife-led continuity of care models have been linked to better clinical outcomes in certain developed countries. However, there is a paucity of research on these models in developing nations. This quasi-experimental study was conducted on primiparous women who referred to one private midwifery center and two public hospitals in Ahvaz, Iran to evaluate the effect of team midwifery care on maternal and neonatal outcomes of pregnant women in Iran. Two hundred women were allocated either into the experimental (n = 100) or control (n = 100) groups. Women in the experimental group, received team midwifery care, while women in the control group, received routine care. Data were collected using a demographic questionnaire, Mackey questionnaire, and a checklist. Women in the team midwifery care group experienced significantly higher rates of normal vaginal birth and exclusive breastfeeding compared to women in the control group. No statistically significant difference was observed between the two groups in terms of the rate of induction of labor and postpartum hemorrhage. The duration of labor was longer in the team midwifery care compared to the control group. Women in the team midwifery care group had a significantly higher rate of exclusive breastfeeding at six weeks postpartum compared to the control group (80 vs. 61%, p = 0.001). After excluding women with ruptured membranes and prolonged pregnancies, neonates in the intervention group had significantly higher first- and fifth-minute Apgar scores (p < 0.0001), and a lower rate of admission to intensive care unit in the intervention group compared to the control group (1 vs. 9%, p = 0.04). Also, women in the team midwifery group had skin-to-skin contact significantly earlier than those in the control group (33.87 ± 66.26 min vs. 111.98 ± 247.31 min, p = 0.578). Given the positive impact of continuous team midwifery care on maternal and neonatal outcomes, its implementation in maternity care systems, particularly in countries like Iran with high cesarean section rates, is strongly recommended.
导乐连续护理模式已被证明与某些发达国家的更好的临床结果相关。然而,在发展中国家,针对这些模式的研究相对较少。本研究是在伊朗阿瓦士的一家私立助产士中心和两家公立医院就诊的初产妇中进行的,旨在评估团队助产护理对伊朗孕妇的母婴结局的影响。将 200 名女性随机分配到实验组(n=100)或对照组(n=100)。实验组的女性接受团队助产护理,而对照组的女性接受常规护理。使用人口统计学问卷、Mackey 问卷和检查表收集数据。与对照组相比,接受团队助产护理的女性阴道分娩和纯母乳喂养的比例显著更高。两组间引产和产后出血的发生率无统计学差异。与对照组相比,团队助产护理组的产程时间更长。与对照组相比,接受团队助产护理的女性在产后 6 周时纯母乳喂养的比例显著更高(80% vs. 61%,p=0.001)。排除胎膜早破和延长妊娠的女性后,干预组新生儿的第一分钟和第五分钟 Apgar 评分显著更高(p<0.0001),干预组新生儿入住重症监护病房的比例显著更低(1% vs. 9%,p=0.04)。此外,与对照组相比,接受团队助产护理的女性更早开始皮肤接触(33.87±66.26 min vs. 111.98±247.31 min,p=0.578)。鉴于连续团队助产护理对母婴结局的积极影响,强烈建议在产妇护理系统中实施该模式,特别是在剖宫产率较高的伊朗等国家。