Banca de QUALIFICAÇÃO: JOSILENE MARIA FERREIRA PINHEIRO

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : JOSILENE MARIA FERREIRA PINHEIRO
DATE: 06/10/2020
TIME: 09:00
LOCAL: REMOTO-VIDEOCONFERÊNCIA
TITLE:

EVALUATION OF NEONATAL CARE AND ASSOCIATED FACTORS

KEY WORDS:

Newborn. Children's Health. Maternal and Child Health Services. Health Care.

PAGES: 161
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

The neonatal period requires qualified attention, given the newborn's susceptibility to adversity. This study aimed to evaluate the fulfillment of the assistance actions recommended by the Ministry of Health for the neonatal period and associations. A longitudinal study was carried out in four public maternity hospitals in the city of Natal/RN, Brazil. The sample consisted of 415 mother and child, being term newborns, weight ≥ 2.5kg and Apgar ≥ 7.0. The data collection was carried out 48 hours after birth (in person), with seven days and 28 days of life (by telegonic call). Based on the data collected, five studies were developed, three cross-sectional, one longitudinal, and in the current context, a reflective study. The studies addressed the following questions: (1) Prevalence of the five neonatal screening tests. (2) Determinants of breast milk supplementation supply in the first 48 hours of life. (3) Newborn feeding practices; (4) Challenges to maintain exclusive breastfeeding in face of the measures imposed to avoid transmissibility by the SARS-CoV-2 coronavirus. (5) Evaluation of neonatal care actions. Statistical analysis included applications of Pearson's Chi-square and multiple Poison regression, with 95% Confidence Interval (95%CI). Of the 415 binomials initially evaluated, there was a loss of 13.7% in the second period and 16.6% in the third period. The mothers, majority, were in the age group of 20 to 29 years (46.5%), were married or lived in stable union (79.0%) and had high school or higher education (65.3%). As for the newborn, the majority were male (52.5%), with an average gestational age of 39.2 weeks and birth weight of 3,310g. The main results of the studies stand out: (1) The prevalence of the five tests (36.6%) was associated to mothers living in the state capital (PR=1.36; 95%CI=1.18-1.56) and to those who received guidance in the maternity wards (PR=1.30; 95%CI=1.08-1.67). (2) Half of newborns received breast milk complement, 57.6% in the first hour of life and 92% with artificial formula, being associated with maternal age ≤ 20 years (RP=0.64; 95%CI=0.47-0.86), primiparity (RP=1.37; 95%CI=1.11-1.60) and cesarean section (RP=1.2; 95%CI=1.00-1.45). (3) Regarding feeding practices, the prevalence of exclusive breastfeeding was 48.7%, 91.6% and 83.3% at 48 hours, seven and 28 days, respectively. Early weaning was associated with the absence of paternal support (RR:4.98; CI:2.54-9.79) and with the use of soother (RR= 3.2, CI:1.63-6.32) at seven days, and only with the use of soother (RR=2.48, CI:1.53-4.02) at 28 days. (4) Mother and baby transmissibility by the new coronavirus are still a controversial issue that, given the uncertainties, may compromise team/family/mother/baby interaction and breastfeeding in the first hours of life. (5) Only 10% of the recommended actions in the neonatal period had a prevalence greater than or equal to 70%, being associated with maternal schooling, place of residence, degree of complexity of the maternity wards, non-credentiality of the Child Friendly Hospital Initiative, and low ratio of professionals per bed. The results point to the need to restructure assistance and readjust good practices that favor integral and longitudinal care for the newborn.

BANKING MEMBERS:
Interna - 2149611 - CLELIA DE OLIVEIRA LYRA
Presidente - 1879353 - FABIA BARBOSA DE ANDRADE
Externo à Instituição - RODRIGO PINHEIRO DE TOLEDO VIANNA - UFPB