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Schneider J, Harari MM, Faure N, Lacroix A, Borghini A, Tolsa JF, Horsch A. Joint observation in NICU (JOIN): A randomized controlled trial testing an early, one-session intervention during preterm care to improve perceived maternal self-efficacy and other mental health outcomes. PLoS One 2024; 19:e0301594. [PMID: 38662661 PMCID: PMC11045081 DOI: 10.1371/journal.pone.0301594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Parents of preterm infants in the Neonatal Intensive Care Unit (NICU) environment may experience psychological distress, decreased perceived self-efficacy, and/or difficulties in establishing an adaptive parent-infant relationship. Early developmental care interventions to support the parental role and infant development are essential and their impact can be assessed by an improvement of parental self-efficacy perception. The aims were to assess the effects of an early intervention provided in the NICU (the Joint Observation) on maternal perceived self-efficacy compared to controls (primary outcome) and to compare maternal mental health measures (perceived stress, anxiety, and depression), perception of the parent-infant relationship, and maternal responsiveness (secondary outcomes). METHODS This study was a monocentric randomized controlled trial registered in clinicatrials.gov (NCT02736136), which aimed at testing a behavioural intervention compared with treatment-as-usual. Mothers of preterm neonates born 28 to 32 6/7 weeks gestation were randomly allocated to either the intervention or the control groups. Outcome measures consisted of self-report questionnaires completed by the mothers at 1 and 6 months after enrollment and assessing perceived self-efficacy, mental health, perception of the parent-infant relationship and responsiveness, as well as satisfaction with the intervention. RESULTS No statistically significant group effects were observed for perceived maternal self-efficacy or the secondary outcomes. Over time, perceived maternal self-efficacy increased for mothers in both groups, while anxiety and depression symptoms decreased. High satisfaction with the intervention was reported. CONCLUSIONS The joint observation was not associated with improved perceived maternal self-efficacy or other mental health outcomes, but may constitute an additional supportive measure offered to parents in a vulnerable situation during the NICU stay.
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Affiliation(s)
- Juliane Schneider
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense, Innovation, and Research Center, Lausanne, Switzerland
| | - Mathilde Morisod Harari
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Noémie Faure
- Centre Sages-Femmes, Vevey, Switzerland
- UniVers Famille, Châtel-St-Denis, Switzerland
| | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | | | - Jean-François Tolsa
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Demir E, Öz S, Aral N, Gürsoy F. A Reliability Generalization Meta-Analysis of the Mother-To-Infant Bonding Scale. Psychol Rep 2024; 127:447-464. [PMID: 35815798 DOI: 10.1177/00332941221114413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Mother-to-Infant Bonding Scale (MIBS) is among the most popular measurement tools to evaluate caregiver-infant attachment. We carried out a meta-analysis study to explore the generalizability of the reliability coefficients for the MIBS in different studies. The literature review yielded a total of 702 studies investigating caregiver-infant attachment. After removing duplicate studies, we also excluded compilations, meta-analyses, qualitative studies, those using different measurement tools, studies published in a language other than English, citations, and those whose full texts could not be accessed. Eventually, we considered a total of 26 studies with 33 Cronbach's alpha coefficients that satisfied the inclusion criteria. We normalized the alpha coefficients using Bonett's transformation, and the analyses were performed using a 95% confidence interval. The findings revealed a Cronbach's alpha (n = 33) coefficient of 0.73 (CI = 0.68-0.77); hence, the present reliability generalization study provides evidence that the reliability scores produced after measurements with the MIBS in previous studies are acceptable across samples. Overall, further studies may reliably utilize the MIBS to evaluate mother-infant attachment.
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Affiliation(s)
- Emin Demir
- Faculty of Health Sciences, Department of Child Development, Tarsus University, Tarsus, Turkey
| | - Sena Öz
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
| | - Neriman Aral
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
| | - Figen Gürsoy
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
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Maiwald CA, Rovers C, Janvier A, Sturm H, Michaelis M, Marckmann G, Ehni HJ, Poets CF, Rüdiger M, Franz AR. Parental perspectives about information and deferred versus two-stage consent in studies of neonatal asphyxia. Arch Dis Child Fetal Neonatal Ed 2023; 109:106-111. [PMID: 37648417 PMCID: PMC10804040 DOI: 10.1136/archdischild-2023-325900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The ALBINO Trial (NCT03162653) investigates effects of very early postnatal allopurinol on neurocognitive outcome following perinatal asphyxia where prenatal informed consent (IC) is impossible. Ethically and legally, waiver of consent and/or deferred consent (DC) is acceptable in such an emergency. Short oral/two-step consent (SOC, brief information and oral consent followed by IC) has recently been investigated. METHODS Mixed-methods analysis of parental opinions on DC versus SOC in the context of neonatal asphyxia in a survey at two German centres. Prospective parents (ProP), parents of healthy newborns (PNeo) and parents of asphyxiated infants (PAx) born between 2006 and 2016 were invited. RESULTS 108 of 422 parents participated (ProP:43; PNeo:35; PAx:30). Most parents trusted physicians, wanted preinterventional information and agreed that in emergencies interventions should begin immediately. Intergroup and intragroup variability existed for questions about DC and SOC. In the ALBINO Trial situation, 55% preferred SOC, and 26% reported DC without information might adversely affect their trust. Only 3% reported to potentially take legal action after DC. PAx were significantly more likely to support DC. PAx more frequently expressed positive emotions and appreciation for neonatal research. In open-ended questions, parents gave many constructive recommendations. CONCLUSION In this survey, parents expressed diverse opinions on consent, but the majority preferred SOC over DC. Parents who had experienced emergency admission of their asphyxiated neonates were more trusting. Obtaining parental perspectives is essential when designing studies, while being cognisant that these groups of parents may not represent the opinion of all parents.
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Affiliation(s)
- Christian A Maiwald
- Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
- Center for Pediatric Clinical Studies (CPCS), University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Charlotte Rovers
- Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Annie Janvier
- Department of Pediatrics, Bureau de l'Éthique Clinique, Université de Montréal, Montreal, Québec, Canada
- Division of Neonatology, Research Center, Clinical Ethics Unit, Palliative Care Unit, Unité de recherche en éthique clinique et partenariat famille, CHU Sainte-Justine, Montreal, Québec, Canada
| | - Heidrun Sturm
- Centre for Public Health and Health Services Research, Faculty of Medicine, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Martina Michaelis
- Centre for Public Health and Health Services Research, Faculty of Medicine, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Georg Marckmann
- Institute of Ethics, History and Theory of Medicine, Ludwig Maximilians University (LMU) Munich, Munich, Bayern, Germany
| | - Hans-Joerg Ehni
- Institute for Ethics and History of Medicine, Medical Faculty, University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Christian F Poets
- Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Mario Rüdiger
- Clinic for Pediatrics, Department of Neonatology and Pediatric Intensive Care, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany
| | - Axel R Franz
- Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
- Center for Pediatric Clinical Studies (CPCS), University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
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Music Therapy and Family-Integrated Care in the NICU: Using Heartbeat-Music Interventions to Promote Mother-Infant Bonding. Adv Neonatal Care 2022; 22:E159-E168. [PMID: 34138791 DOI: 10.1097/anc.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Family-integrated care in the neonatal intensive care unit (NICU) is the criterion standard. Parent-infant bonding may be an indicator of successful family involvement. Music therapy (MT) is a growing service in the NICU, with interventions to support meaningful family involvement and improve bonding. PURPOSE To study the effects of heartbeat-music interventions to support mother-infant bonding in the NICU and explore experiences of mothers participating in MT. METHODS Parallel-group randomized trial (MT vs standard care) to compare Mother-to-Infant Bonding Scale (MIBS) scores from baseline to 1 week postenrollment. MT included 2 heartbeat-music interventions (recorded maternal lullaby and heartbeat for infants, and recorded infant heartbeat and preferred music for mothers). Five mothers were randomly asked to complete a survey regarding their experiences with MT services. RESULTS One hundred mothers enrolled. In total, 44.3% completed the MIBS follow-up. Covarying out baseline MIBS, one-way analysis of covariance found no statistical difference between groups for MIBS 1-week follow-up (MT: mean = 0.64, SD = 1.6; standard care: mean = 0.57, SD = 1.5; P = .60) but underpowered in post hoc. Comforting, family cohesion, and personal growth and development themes emerged in qualitative analysis of survey responses. IMPLICATIONS FOR PRACTICE MT remains a viable service for purposefully including parents in the care of their NICU infants. Nurses and music therapists must work closely to successfully implement meaningful interventions such as heartbeat-music. IMPLICATIONS FOR RESEARCH Heartbeat-music interventions should be further studied for diverse applications, including family integration, family coping, and bereavement.
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Determinants of birth asphyxia at public hospitals in Ilu Aba Bor zone southwest, Ethiopia: a case control study. Sci Rep 2022; 12:10705. [PMID: 35739178 PMCID: PMC9226011 DOI: 10.1038/s41598-022-15006-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Birth asphyxia is a leading cause of neonatal deaths, which accounts for about 31.6% of all neonatal deaths in Ethiopia. Despite its being one of the important causes of morbidity and mortality in newborns, its determinants were not investigated according to local context. So, this study was aimed at investigating the determinants of asphyxia at Illu Aba Bor zone public health facilities. An institution-based case–control study was employed. A pre-tested, structured and adapted interviewer administered questionnaire for mothers of newborn interviews and a data extraction tool for chart review were used. The collected data were entered into Epi-data version 3.1 and exported to SPSS version 24 for further analysis. A binary logistic regression was employed, and variables with a p-value < 0.25 were taken to a multi-variable logistic regression. Finally, a Bonferroni correction was used and variables with a p-value < 0.0038 at 95% CI were declared statistically significant. A total of 308 (103 cases vs 205 controls) mothers of newborns were interviewed, yielding a response rate of 100%. The mean age (SD) of mothers for the cases and the controls were (25.97 ± 4.47) and (25.52 ± 4.17) respectively. Prolonged duration of labor [AOR 4.12; 95% CI 1.78, 9.50], non-cephalic fetal presentation [AOR 4.35; 95% CI 1.77, 10.67], being preterm [AOR 5.77; l95% CI 2.62, 12.69] and low birth weight [AOR 4.43; (95% CI 1.94, 10.13) were found to be the determinants of birth asphyxia. Prolonged duration of labor, non-cephalic presentation, prim parous, preterm, and low birth weight were the independent determinants of birth asphyxia. Hence, improving the utilization of parthograph during labor and interventions focusing on this area should give priority to reducing the risk of morbidity and mortality.
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Odd D, Okano S, Ingram J, Blair PS, Billietop A, Fleming PJ, Thoresen M, Chakkarapani E. Physiological responses to cuddling babies with hypoxic-ischaemic encephalopathy during therapeutic hypothermia: an observational study. BMJ Paediatr Open 2021; 5:10.1136/bmjpo-2021-001280. [PMID: 35510511 PMCID: PMC8679081 DOI: 10.1136/bmjpo-2021-001280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/14/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To determine whether parents cuddling infants during therapeutic hypothermia (TH) would affect cooling therapy, cardiorespiratory or neurophysiological measures. The secondary aim was to explore parent-infant bonding, maternal postnatal depression and breastfeeding. DESIGN Prospective observational study. SETTING Two tertiary neonatal intensive care units (NICU). PARTICIPANTS Parents and their term-born infants (n=27) receiving TH and intensive care for neonatal hypoxic-ischaemic encephalopathy. INTERVENTIONS Cuddling up to 2 hours during TH using a standard operating procedure developed in the study (CoolCuddle). MAIN OUTCOME MEASURES Mean difference in temperature, cardiorespiratory and neurophysiological variables before, during and after the cuddle. Secondary outcomes were parental bonding, maternal postnatal depression and breastfeeding. RESULTS During 70 CoolCuddles (115 cumulative hours), there were measurable increases in rectal temperature (0.07°C (0.03 to 0.10)) and upper margin of amplitude-integrated electroencephalogram (1.80 µV (0.83 to 2.72)) and decreases in oxygen saturations (-0.57% (-1.08 to -0.05)) compared with the precuddle period. After the cuddle, there was an increase in end-tidal CO2 (0.25 kPa (95% CI 0.14 to 0.35)) and mean blood pressure (4.09 mm Hg (95% CI 0.96 to 7.21)) compared with the precuddle period. From discharge to 8 weeks postpartum, maternal postnatal depression declined (13 (56.5%) vs 5 (23.8%), p=0.007); breastfeeding rate differed (71% vs 50%, p=0.043), but was higher than national average at discharge (70% vs 54.6%) and mother-infant bonding (median (IQR): 3 (0-6) vs 3 (1-4)) remained stable. CONCLUSION In this small study, CoolCuddle was associated with clinically non-significant, but measurable, changes in temperature, cardiorespiration and neurophysiology. No infant met the criteria to stop the cuddles or had any predefined adverse events. CoolCuddle may improve breastfeeding and requires investigation in different NICU settings.
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Affiliation(s)
- David Odd
- Population Medicine, Cardiff University, School of Medicine, Cardiff, UK
| | - Satomi Okano
- Neonatology, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.,Translational Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Jenny Ingram
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
| | - Peter S Blair
- Centre for Child and Adolescent Health, University of Bristol Medical School, Bristol, UK
| | - Amiel Billietop
- Neonatal Intensive Care Unit, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
| | - Peter J Fleming
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
| | - Marianne Thoresen
- Translational Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Ela Chakkarapani
- Neonatology, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK .,Translational Health Sciences, University of Bristol Medical School, Bristol, UK
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Webb R, Smith AM, Ayers S, Wright DB, Thornton A. Development and Validation of a Measure of Birth-Related PTSD for Fathers and Birth Partners: The City Birth Trauma Scale (Partner Version). Front Psychol 2021; 12:596779. [PMID: 33746826 PMCID: PMC7966709 DOI: 10.3389/fpsyg.2021.596779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/08/2021] [Indexed: 12/02/2022] Open
Abstract
Research suggests that some fathers and birth partners can experience post-traumatic stress disorder (PTSD) after witnessing a traumatic birth. Birth-related PTSD may impact on many aspects of fathers’ and birth partners’ life, including relationship breakdown, self-blame and reducing plans for future children. Despite the potential impact on birth partners’ lives there is currently no measure of birth-related PTSD validated for use with birth partners. The current study therefore adapted the City Birth Trauma Scale for use with birth partners. The City Birth Trauma Scale (Partner version) is a 29-item questionnaire developed to measure birth-related PTSD according to DSM-5 criteria: stressor criteria (A), symptoms of re-experiencing (B), avoidance (C), negative cognitions and mood (D), and hyperarousal (E), as well as duration of symptoms (F), significant distress or impairment (G), and exclusion criteria or other causes (H). A sample of 301 fathers/birth partners was recruited online and completed measures of birth-related PTSD, bonding, and demographic details. Results showed the City Birth Trauma Scale (Partner version) had good reliability (α = 0.94) and psychometric and construct validity. The fathers/birth partners version has the same two-factor structure as the original scale: (1) general symptoms and (2) birth-related symptoms, which accounted for 51% of the variance. PTSD symptoms were associated with preterm birth and maternal and infant complications. Overall, the City Birth Trauma Scale (Partner version) provides a promising measure of PTSD following childbirth that can be used in research and clinical practice.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Ann M Smith
- Neonatal Intensive Care Unit, Homerton University Hospital NHS Foundation Trust, London, United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Daniel B Wright
- Department of Educational Psychology and Higher Education, University of Nevada, Las Vegas, NV, United States
| | - Alexandra Thornton
- Perinatal Mental Health Service, West London NHS Trust, St Bernard's Hospital, London, United Kingdom
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Ertan D, Hingray C, Burlacu E, Sterlé A, El-Hage W. Post-traumatic stress disorder following childbirth. BMC Psychiatry 2021; 21:155. [PMID: 33726703 PMCID: PMC7962315 DOI: 10.1186/s12888-021-03158-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/04/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Childbirth experience could be complicated and even traumatic. This study explored the possible risk factors for post-traumatic stress disorder following childbirth (PTSD-FC) in mothers and partners. METHODS Through a cross-sectional online survey biographical, medical, psychological, obstetrical and trauma history data were collected. The PTSD-FC, postnatal depression, social support, and perceived mother-infant bond in 916 mothers and 64 partners were measured through self-reported psychometric assessments. RESULTS Our findings highlight the possible impact of several risk factors such as emergency childbirth, past traumatic experiences and distressing events during childbirth on PTSD-FC. The difficulties in mother-infant bond and the postpartum depression were highly associated with the total score of PTSD-FC symptoms for mothers. While for partners, post-partum depression was highly associated with the total score of PTSD-FC. CONCLUSIONS Our study demonstrated significant links between psychological, traumatic and birth-related risk factors as well as the perceived social support and the possible PTSD following childbirth in mothers and partners. Given that, a specific attention to PTSD-FC and psychological distress following childbirth should be given to mothers and their partners following childbirth.
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Affiliation(s)
- Deniz Ertan
- Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France
- La Teppe, Tain l'Hermitage, France
| | - Coraline Hingray
- Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Elena Burlacu
- CHRU de Tours, Centre Régional de Psychotraumatologie CVL, Tours, France
| | - Aude Sterlé
- CHRU de Tours, Centre Régional de Psychotraumatologie CVL, Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Centre Régional de Psychotraumatologie CVL, Tours, France.
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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Kune G, Oljira H, Wakgari N, Zerihun E, Aboma M. Determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, Central Ethiopia: A case-control study. PLoS One 2021; 16:e0248504. [PMID: 33725001 PMCID: PMC7963050 DOI: 10.1371/journal.pone.0248504] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
Birth asphyxia is one of the leading causes of death in low and middle-income countries and the prominent cause of neonatal mortality in Ethiopia. Early detection and managing its determinants would change the burden of birth asphyxia. Thus, this study identified determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, central Ethiopia. A hospital-based unmatched case-control study was conducted from May to July 2020. Cases were newborns with APGAR (appearance, pulse, grimaces, activity, and respiration) score of <7 at first and fifth minute of birth and controls were newborns with APGAR score of ≥ 7 at first and fifth minute of birth. All newborns with birth asphyxia during the study period were included in the study while; two comparable controls were selected consecutively after each birth asphyxia case. A pre-tested and structured questionnaire was used to collect maternal socio-demographic and antepartum characteristics. The pre-tested checklist was used to retrieve intrapartum and fetal related factors from both cases and controls. The collected data were entered using Epi-Info and analyzed by SPSS. Bi-variable logistic regression analysis was done to identify the association between each independent variable with the outcome variable. Adjusted odds ratio (AOR) with a 95% CI and a p-value of <0.05 was used to identify determinants of birth asphyxia. In this study, prolonged labor (AOR = 4.15, 95% CI: 1.55, 11.06), breech presentation (AOR = 5.13, 95% CI: 1.99, 13.21), caesarean section delivery (AOR = 3.67, 95% CI: 1.31, 10.23), vaginal assisted delivery (AOR = 5.69, 95% CI: 2.17, 14.91), not use partograph (AOR = 3.36, 95% CI: 1.45, 7.84), and low birth weight (AOR = 3.74, 95% CI:1.49, 9.38) had higher odds of birth asphyxia. Prolonged labor, breech presentation, caesarean and vaginal assisted delivery, fails to use partograph and low birth weights were the determinants of birth asphyxia. Thus, health care providers should follow the progress of labor with partograph to early identify prolonged labor, breech presentation and determine the mode of delivery that would lower the burden of birth asphyxia.
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Affiliation(s)
- Guta Kune
- Ambo University Referral Hospital, Ambo, Ethiopia
| | - Habtamu Oljira
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Negash Wakgari
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | | | - Mecha Aboma
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Mulugeta T, Sebsibe G, Fenta FA, Sibhat M. Risk Factors of Perinatal Asphyxia Among Newborns Delivered at Public Hospitals in Addis Ababa, Ethiopia: Case-Control Study. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2020; 11:297-306. [PMID: 32922119 PMCID: PMC7457880 DOI: 10.2147/phmt.s260788] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/09/2020] [Indexed: 12/22/2022]
Abstract
Background Perinatal asphyxia determines the newborn’s future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. Methods An unmatched case–control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P<0.05 and findings were presented using texts and tables. Results A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73–29.72], low birth weight [AOR=2.87; 95% CI 1.01–8.13], preterm birth [AOR=3.4; 95% CI 1.04–11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01–7.42], instrumental delivery [AOR=4.88; 95% CI 1.35–17.61], fetal distress [AOR=4.77; 95% CI 1.52–14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96–30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.
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Affiliation(s)
- Tewodros Mulugeta
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Girum Sebsibe
- School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fikirtemariam Abebe Fenta
- School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Migbar Sibhat
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
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Horsch A, Stuijfzand S. Intergenerational transfer of perinatal trauma-related consequences. J Reprod Infant Psychol 2020; 37:221-223. [PMID: 31219345 DOI: 10.1080/02646838.2019.1629190] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Antje Horsch
- b Department Woman-Mother-Child , Lausanne University Hospital , Lausanne , Switzerland
| | - Suzannah Stuijfzand
- a Institute of Higher Education and Research in Healthcare (IUFRS) , University of Lausanne and Lausanne University Hospital , Lausanne , Switzerland
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Laborie S, Denis A, Horsch A, Occelli P, Margier J, Morisod Harari M, Claris O, Touzet S, Fischer Fumeaux CJ. Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial. BMJ Open 2020; 10:e032910. [PMID: 32005780 PMCID: PMC7045006 DOI: 10.1136/bmjopen-2019-032910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Among preterm infants, mother's own milk feeding reduces neonatal morbidity and decreases the length of hospital stay. However, breastfeeding rates and duration are lower than among term infants. It is reported that peer counselling is effective in increasing breast feeding in term infants in low-income and middle-income countries, but results are mixed in high-income countries. We aim to investigate herein whether peer counselling may be a feasible and effective breastfeeding support among preterm infants in French-speaking high-income countries. METHODS AND ANALYSIS Eight European centres will participate in this stepped-wedge cluster randomised controlled trial. We plan to include 2400 hospitalised neonates born before 35 gestational weeks. Each centre will begin with an observational period. Every 3 months, a randomised cluster (centre) will begin the interventional period with peer counsellors until the end of the study. The counsellors will be trained and supervised by the trained nurses. They will have a weekly contact with participating mothers, with a face-to-face meeting at least once every fortnight. During these meetings, peer counsellors will listen to mothers' concerns, share experiences and help the mother with their own knowledge of breast feeding. The main outcome is breastfeeding rate at 2 months corrected age. Secondary outcomes are breastfeeding rates at hospital discharge and at 6 months, breastfeeding duration and severe neonatal morbidity and mortality. The mental health of the mother, mother-infant bonding and infant behaviour will be assessed using self-report questionnaires. A neurodevelopmental follow-up, a cost-effectiveness analysis and a cost-consequence at 2 years corrected age will be performed among infants in a French subgroup. ETHICS AND DISSEMINATION French, Belgian and Swiss ethics committees gave their agreement. Publications in peer-reviewed journals are planned on breast feeding, mental health and economic outcomes. TRIAL REGISTRATION NUMBER NCT03156946.
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Affiliation(s)
- Sophie Laborie
- Hopital Femme Mère Enfant, Neonatology, Hospices Civils de Lyon, Bron, France
| | - Angelique Denis
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Pauline Occelli
- Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université Lyon 1, Villeurbanne, France
| | | | - Mathilde Morisod Harari
- Child and Adolescent Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Olivier Claris
- Hopital Femme Mère Enfant, Neonatology, Hospices Civils de Lyon, Bron, Auvergne-Rhône-Alpes, France
- Equipe P2S4129, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Sandrine Touzet
- Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire Health Services and Performance Research (HESPER) EA 7425, Université de Lyon 1, Villeurbanne, France
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Yoshimasu K, Miyauchi N, Sato A, Yaegashi N, Nakai K, Hattori H, Arima T. Assisted reproductive technologies are slightly associated with maternal lack of affection toward the newborn: The Japan Environment and Children's Study. J Obstet Gynaecol Res 2020; 46:434-444. [PMID: 31944470 DOI: 10.1111/jog.14189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/13/2019] [Indexed: 12/26/2022]
Abstract
AIM To evaluate the association between use of assisted reproductive technology (ART) and mother-to-infant bonding. METHODS Using nationwide birth cohort study with periodical follow-ups for mothers and children during pregnancy and at 1 year after delivery, mothers were classified following three groups; infertility group with ART: 2792 mothers; infertility group with non-ART treatment (ovulation induction and intrauterine insemination): 3835 mothers and unaided pregnancy group: 78 726 mothers. Data on maternal and child health as well as basic characteristics were collected via medical records and self-administered questionnaires. The Japanese version of Mother-to-Infant Bonding Scale was used to evaluate maternal bonding style. To evaluate the association between ART and maternal bonding toward babies, multivariate analysis was used with adjustment for potential confounders such as babies' sex, socio-economic status and history of maternal mental disorders. RESULTS Multivariate logistic regression analysis indicated that ART was slightly but significantly associated with an increased risk of maternal lack of affection toward their newborn (adjusted odds ratio 1.10, 95% confidence interval 1.02-1.20), while non-ART was significantly associated with both maternal lack of affection and anger/rejection toward the newborn. No substantial association was observed between ART and overall Mother-to-Infant Bonding Scale score (adjusted odds ratio 1.03, 95% confidence interval 0.94-1.12). Very slight negative correlations were observed between poor mother-to-infant bonding and good infant mental and physical development at both 6 months and 1 year. CONCLUSION ART may exert a negative influence on maternal emotion after delivery, but this does not have strong correlation with child development evaluated by mothers.
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Affiliation(s)
- Kouichi Yoshimasu
- Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoko Miyauchi
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Sato
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiromitsu Hattori
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
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Stuijfzand S, Garthus-Niegel S, Horsch A. Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study. Front Psychiatry 2020; 11:570727. [PMID: 33173518 PMCID: PMC7540215 DOI: 10.3389/fpsyt.2020.570727] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/21/2020] [Indexed: 12/03/2022] Open
Abstract
The parent-infant bond following childbirth is an important facilitator of optimal infant development. So far, research has mainly focused on mother-infant bonding. Data on fathers are still sparse. Parental mental health, such as posttraumatic stress symptoms (PTSD), may influence mother-infant relations and/or interactions. There is evidence that both parents can experience PTSD symptoms following childbirth (PTSD-CB). The aim of this study is to investigate the prospective relationship between parental PTSD-CB symptoms at 1 month postpartum and perceived parent-infant bonding at 3 months postpartum, while adjusting for antenatal confounders. A subsample was used for this study (n Totalsample 488, n mothers = 356, n fathers = 132) of an ongoing prospective cohort study. Future parents awaiting their third trimester antenatal appointments at a Swiss university hospital were recruited. Self-report questionnaires assessed PTSD-CB symptoms and psychological distress at 1 month postpartum, and parent-infant bonding at 3 months postpartum. Confounders included antenatal PTSD symptoms and social support measured via self-report questionnaires, and gestity and gestational age, extracted from medical records. Using structural equation modeling, the predictive ability of PTSD-CB symptoms at 1 month postpartum on parent-infant bonding at 3 months postpartum was assessed for both parents respectively. Maternal PTSD-CB symptoms at 1 month postpartum were found to be negatively prospectively associated with mother-infant bonding at 3 months postpartum; however, this effect disappeared after adjusting for psychological distress at 1 month postpartum. No such effects were found for fathers. There was no evidence of mediation of the relationship between parental PTSD-CB symptoms at 1 month postpartum and parental-infant bonding at 3 months postpartum via psychological distress at 1 month postpartum. However, such a mediation was found for maternal intrusion and hyperarousal symptom subscales. Results expand the current literature on the impact of PTSD-CB on parent-child relations to also include fathers, and to a community sample. Any adverse effects of mental health symptoms on parent-infant bonding were evidenced by 3 months postpartum only for mothers, not fathers. Our results may inform the development of prevention/intervention strategies.
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Affiliation(s)
- Suzannah Stuijfzand
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Department of Medicine, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Dresden University of Technology, Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Antje Horsch
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Lausanne, Switzerland
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Sandoz V, Deforges C, Stuijfzand S, Epiney M, Vial Y, Sekarski N, Messerli-Bürgy N, Ehlert U, Bickle-Graz M, Morisod Harari M, Porcheret K, Schechter DS, Ayers S, Holmes EA, Horsch A. Improving mental health and physiological stress responses in mothers following traumatic childbirth and in their infants: study protocol for the Swiss TrAumatic biRth Trial (START). BMJ Open 2019; 9:e032469. [PMID: 31892657 PMCID: PMC6955544 DOI: 10.1136/bmjopen-2019-032469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother-infant interactions, but also on long-term infant development. The partner's mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma. METHODS AND ANALYSIS This study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game 'Tetris' on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit.The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother-infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event. ETHICS AND DISSEMINATION Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017-02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT03576586.
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Affiliation(s)
- Vania Sandoz
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Manuella Epiney
- Department Woman-Child-Adolescent, Geneva University Hospital and University of Geneva, Geneva, GE, Switzerland
| | - Yvan Vial
- Obstetrics and Gynecology Service, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Nicole Sekarski
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Nadine Messerli-Bürgy
- Clinical Child Psychology & Biological Psychology, University of Fribourg, Fribourg, FR, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, ZH, Switzerland
| | - Myriam Bickle-Graz
- Neonatology Service, Woman-Mother-Child Department, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Mathilde Morisod Harari
- Service of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Kate Porcheret
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Daniel S Schechter
- Service of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
- Department of Psychiatry, University of Geneva Faculty of Medicine, Geneve, GE, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City University of London, London, London, UK
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
- Neonatology Service, Woman-Mother-Child Department, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
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Schneider J, Borghini A, Morisod Harari M, Faure N, Tenthorey C, Le Berre A, Tolsa JF, Horsch A. Joint observation in NICU (JOIN): study protocol of a clinical randomised controlled trial examining an early intervention during preterm care. BMJ Open 2019; 9:e026484. [PMID: 30928952 PMCID: PMC6475149 DOI: 10.1136/bmjopen-2018-026484] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Preterm birth may generate significant distress among the parents, who often present with difficulties in appropriating their parental role. Parental stress and low perceived parental self-efficacy may interfere with the infant's socioemotional and cognitive development, particularly through disrupted parent-infant interactions. Perceived parental self-efficacy represents the belief of efficacy in caring for one's own infant and successful incarnation of the parental role, as well as the perception of one's own abilities to complete a specified task. Interventions to support parental role, as well as infant development, are needed, and parental self-efficacy represents a useful indicator to measure the effects of such early interventions. METHODS AND ANALYSIS This study protocol describes a randomised controlled trial that will test an early intervention in the neonatal intensive care unit (NICU) (JOIN: Joint Observation In Neonatology) carried out by an interdisciplinary staff team. Mothers of preterm neonates born between 28 and 32 6/7 weeks of gestational age are eligible for the study. The intervention consists of a videotaped observation by a clinical child psychologist or child psychiatrist and a study nurse of a period of care delivered to the neonate by the mother and a NICU nurse. The care procedure is followed by an interactive video guidance intended to demonstrate the neonate's abilities and resources to his parents. The primary outcome will be the difference in the perceived maternal self-efficacy between the intervention and control groups assessed by self-report questionnaires. Secondary outcomes will be maternal mental health, the perception of the parent- infant relationship, maternal responsiveness and the neurodevelopment of the infant at 6 months corrected age. ETHICS AND DISSEMINATION Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 496/12). Results from this study will be disseminated at national and international conferences, and in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02736136, Pre-results.
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Affiliation(s)
- Juliane Schneider
- Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ayala Borghini
- Child and Adolescent Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Psychomotricity Institute, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Mathilde Morisod Harari
- Child and Adolescent Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Noemie Faure
- Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Chloé Tenthorey
- Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Aurélie Le Berre
- Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-François Tolsa
- Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital, Lausanne, Switzerland
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Determinants of birth asphyxia among live birth newborns in University of Gondar referral hospital, northwest Ethiopia: A case-control study. PLoS One 2018; 13:e0203763. [PMID: 30192884 PMCID: PMC6128623 DOI: 10.1371/journal.pone.0203763] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022] Open
Abstract
Background Birth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the leading causes of such mortality in Ethiopia. Early recognition and management of its contributing factors would modify the problem. Thus, this study aimed to identify the determinants of birth asphyxia among live births at the University of Gondar Referral Hospital, northwest Ethiopia. Methods A hospital-based unmatched case-control study was conducted from April to July 2017.Cases were newborn babies with an APGAR score of < 7at 5 minutes of birth; controls were newborn babies with an APGAR score of ≥7 at 5 minutes of birth. Every other asphyxiated baby was selected as a case and every 6th non-asphyxiated baby as a control. A pretested structured questionnaire was used to collect data on maternal sociodemographic characteristics. A pretested structured checklist was used to retrieve data on ante-partum, intra-partum, and neonatal factors of both cases and controls. Data were entered using Epi Info 7 and analyzed using SPSS 20. The bivariate logistic regression analysis was used to identify the relation of each independent variable to the outcome variable. Variables with p values of up to 0.2 in the bivariate analysis were considered for the multiple logistic regression analysis. An adjusted odds ratio (AOR) with a 95% CI and p-value of <0.05 was used to identify significant variables associated with birth asphyxia. Results In this study, prolonged labor (AOR = 2.75, 95% CI: 1.18, 6.94), cesarean section delivery (AOR = 3.58, 95% CI: 1.13, 11.31), meconium stained amniotic fluid (AOR = 7.69, 95% CI: 2.99, 17.70), fetal distress (AOR = 5.74, 95% CI: 1.53, 21.55), and low birth weight (AOR = 7.72, 95% CI: 1.88, 31.68) were factors which significantly increased the odds of birth asphyxia. Conclusion Prolonged labor, cesarean section (CS) delivery, meconium stained amniotic fluid (AF), fetal distress, and low birth weight were the determinants of birth asphyxia. Thus, efforts should be made to improve the quality of intra-partum care services in order to prevent prolonged labor and fetal complications, and to identify and make a strict follow up on mothers with meconium stained amniotic fluid.
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