Banca de DEFESA: JOSILENE MARIA FERREIRA PINHEIRO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : JOSILENE MARIA FERREIRA PINHEIRO
DATE: 26/02/2021
TIME: 14:00
LOCAL: REMOTO-VIDEOCONFERÊNCIA
TITLE:

EVALUATION OF ASSISTANCE ACTIONS IN THE NEONATAL PERIOD

KEY WORDS:

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

PAGES: 178
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

The neonatal period requires qualified attention, given the newborn’s susceptibility to adversities. This study was intended to assess the accomplishment of the care actions recommended by the Brazilian Ministry of Health for the neonatal period and its associations with institutional characteristics and demographic partners. A longitudinal study was held in four public maternity hospitals in the city of Natal/RN, Brazil. The sample consisted of 415 mother/child binomials, being full-term newborns, weight ≥ 2.5 kg and Apgar ≥ 7.0. Data collection took place 48 hours after birth (in person), with seven days and 28 days of life (by telephone call). From the obtained data, five studies were developed, three cross-sectional, one longitudinal; and, in view of the current context of Covid-19, a reflective study. The studies addressed the following issues: (1) Care actions for the newborn and the continuity of care in the neonatal period; (2) Prevalence of the five neonatal screening tests; (3) Determinants of the supply of complement to breast milk in the first 48 hours of life; (4) Feeding practices in the neonatal period; (5) Challenges to maintain exclusive breastfeeding in view of the measures imposed to prevent transmissibility by the SARS-CoV-2 coronavirus. The statistical analysis included applications of Pearson’s chi-square and multiple Poisson regression, with a 95% confidence interval (95% CI). Of the 415 binomials initially assessed, there was a loss of 13.7% in the second period and 16.6% in the third period. The mothers, mostly, were in the age group of 20 to 29 years (46.5%), were married or lived in a stable relationship (79.0%) and had high school or higher education (65.3%). As for the newborn, most (52.5%) were male, with an average gestational age of 39.2 weeks and birth weight of 3.310g. The main results of the studies should be highlighted: (1) Of the 29 actions performed in the maternity ward and 11 in Primary Health Care, 22.5% were classified as satisfactory, 45% partial and 32.5% unsatisfactory. The adequacy of composite care indicators was associated with multiparous women undergoing vaginal delivery, and low complexity risk maternity hospitals. (2) The prevalence of the five tests (36.6%) was associated with mothers living in the state capital (PR = 1.36; 95% CI = 1.18-1.56) and with those who received guidance at the maternity hospitals (PR = 1.30; 95% CI = 1.08-1.67). (3) Half of the newborns received complementary breast milk, being 57.6% in the first hour of life and 92% with artificial formula, which was associated with maternal age ≤ 20 years (PR = 0.64; 95% CI = 0.47-0.86), primiparity (PR=1.37; 95% CI=1.11-1.60) and cesarean delivery (PR = 1.2; 95% CI = 1.00-1.45). (4) Regarding feeding practices, the prevalence of EBF 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 the use of a pacifier (RR = 3.2, CI: 1.63-6.32) seven days, and only using a pacifier (RR = 2.48, CI: 1.53-4.02) at 28 days. (5) The mother/baby transmissibility by the new coronavirus is still a controversial issue that, given the uncertainties, may compromise team/family/mother/newborn interaction, as well as breastfeeding, in the first hours of life. The results underline the need to restructure care and readjust good practices that favor comprehensive and longitudinal care of the newborn.  

BANKING MEMBERS:
Presidente - 1879353 - FABIA BARBOSA DE ANDRADE
Interna - 2149611 - CLELIA DE OLIVEIRA LYRA
Externa ao Programa - 2444410 - FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
Externo à Instituição - KENYA DE LIMA SILVA - UFPB
Externo à Instituição - RODRIGO PINHEIRO DE TOLEDO VIANNA - UFPB