Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions

Objective To explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).Design A pre-comparison and post-comparison study.Setting The study was conducted in December 2016 and December 2018 in 18 counties in four west...

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Autores principales:	Yan Wang, Qing Yue, Xi Jin, Xiaona Huang, Wen Qu, Jin Liuxing Yang, Xiaobo Tian, Kathryn Martin, Anuradha Narayan
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2020
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/4ab6e9af368345ea8f621781124f5cd0
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spelling	oai:doaj.org-article:4ab6e9af368345ea8f621781124f5cd02021-11-20T13:30:06ZAssessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions10.1136/bmjopen-2020-0418292044-6055https://doaj.org/article/4ab6e9af368345ea8f621781124f5cd02020-12-01T00:00:00Zhttps://bmjopen.bmj.com/content/10/12/e041829.fullhttps://doaj.org/toc/2044-6055Objective To explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).Design A pre-comparison and post-comparison study.Setting The study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.Participants 46 hospitals that provide delivery services participated in the study.Interventions EENC practices were introduced and implemented in the 46 hospitals.Outcome measures The changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).Results 54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.Conclusions The introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.Yan WangQing YueXi JinXiaona HuangWen QuJin Liuxing YangXiaobo TianKathryn MartinAnuradha NarayanBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 10, Iss 12 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Yan Wang Qing Yue Xi Jin Xiaona Huang Wen Qu Jin Liuxing Yang Xiaobo Tian Kathryn Martin Anuradha Narayan Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
description	Objective To explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).Design A pre-comparison and post-comparison study.Setting The study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.Participants 46 hospitals that provide delivery services participated in the study.Interventions EENC practices were introduced and implemented in the 46 hospitals.Outcome measures The changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).Results 54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.Conclusions The introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.
format	article
author	Yan Wang Qing Yue Xi Jin Xiaona Huang Wen Qu Jin Liuxing Yang Xiaobo Tian Kathryn Martin Anuradha Narayan
author_facet	Yan Wang Qing Yue Xi Jin Xiaona Huang Wen Qu Jin Liuxing Yang Xiaobo Tian Kathryn Martin Anuradha Narayan
author_sort	Yan Wang
title	Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
title_short	Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
title_full	Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
title_fullStr	Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
title_full_unstemmed	Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
title_sort	assessing the changes in childbirth care practices and neonatal outcomes in western china: pre-comparison and post-comparison study on early essential newborn care interventions
publisher	BMJ Publishing Group
publishDate	2020
url	https://doaj.org/article/4ab6e9af368345ea8f621781124f5cd0
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Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions

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