Elements that influenced immediate mother-neonate contact during the golden hour

Monteiro, Bruna Rodrigues; Silva, Valéria Gomes Fernandes da; Andrade, Anny Suelen dos Santos; Machado, Luciara Silva; Pinto, Erika Simone Galvão; Souza, Nilba Lima de

doi:10.1590/1980-220X-REEUSP-2022-0015en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0015en copy

Elements that influenced immediate mother-neonate contact during the golden hour^* * Extracted from the dissertation: “Fatores intervenientes no contato pele a pele entre mãe e bebê na hora dourada”, Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Enfermagem, 2019.

Elementos que influyeron en el contacto inmediato entre madre y bebé en la hora dorada

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To characterize the elements that influenced the immediate mother-neonate contact during the golden hour.

Method:

A cross-sectional observational study with a quantitative approach. A total of 105 parturient women hospitalized in two maternity hospitals with usual risk were observed. The instrument was based on Brazilian National Normal Childbirth Care Guidelines and World Health Organization good obstetric practices, totaling 36 questions. The analysis took place in a descriptive way using the Chi-Square Test for proportion comparison.

Results:

Of the parturient women, 2.8% (n = 3) experienced the golden hour, and 82.9% (n = 87), immediate contact between 1 and 5 minutes. In 85.7% (n = 90) of the group, there were no causes that contraindicated immediate contact. For 48.0% (n = 49) of participants, contact was re-established by the nursing staff within 31–60 minutes.

Conclusion:

Immediate contact during the golden hour had low hospital care compliance. Neonatal procedures that can be postponed predominated as influencing elements of the golden hour. The assistance observed in the birth rooms investigated reflects the need to reduce interventions in labor and birth.

DESCRIPTORS
Mother-Child Relations; Delivery of Health Care; Labor, Obstetric; Obstetric Nursing; Infant, Newborn

Variables assessed	Total
Variables assessed	n	%	p-value
Age
15 to 18 years	23	21.9	<0.001¹
19 to 30 years	66	62.9
31 to 45 years	16	15.2
Marital status
Without a partner	17	16.2	<0.001¹
With a partner	88	83.8	<0.001¹
Skin color
White	29	27.6	<0.001¹
Black	4	3.8
Brown	72	68.6
Education
Illiterate	1	1.0	<0.001¹
Elementary school	37	35.2
High school	61	58.1
Higher education	6	5.7
Origin
Host city	65	61.9	0.015¹
Adjacent city	40	38.1	0.015¹
Monthly income
None	3	2.9
Up to 1 minimum wage	83	79.0	<0.001¹
From 2 to 3 minimum wages	19	18.1
Gestational age
Term	103	98.1	<0.001¹
Post-term	2	1.9	<0.001¹
Number of prenatal consultations
Less than 6 consultations	22	21.0	<0.001¹
6 to 9 consultations	56	53.3
More than 9 consultations	27	25.7
Number of current children
No children	46	43.9	<0.001¹
One child	29	27.6
Two children	14	13.3
Three or more children	16	15.2
Desired pregnancy
No	46	43.8	0.205¹
Yes	59	56.2	0.205¹
Serological alteration during pregnancy
No serological alteration	100	95.2	<0.001¹
Toxoplasmosis	4	3.8
Syphilis	1	1.0
Initial complications in pregnancy
Absent	71	67.6	<0.001¹
Urinary tract infection	26	24.8
Depression	1	1.0
Alcohol and tobacco	2	1.9
Hemorrhage	1	1.0
Anemia	1	1.0
Arbovirus	2	1.9
Gestational hypertension	1	1.0
Location of skin-to-skin contact information
None	78	74.3	<0.001¹
Maternity	3	2.9
Prenatal care	13	12.4
Previous birth	3	2.9
Multimedia/family/company	8	7.6

Variables assessed	Total
Variables assessed	n	%	p-value
Beginning of immediate contact (minutes)			<0.001¹
Immediately	90	85.7
5–20 minutes	8	7.6
>60 minutes	7	6.7
Responsible for beginning contact
No initial contact	7	6.7	<0.001¹
Pediatrician	5	4.8
Nursing	31	29.5
Obstetrician	62	59.0
Elements that influenced the beginning of immediate contact
Absence of elements	90	85.7	<0.001¹
Maternal complications/procedures	0	0
Complications in the neonate	7	6.7
Procedures on the neonate	6	5.7
Maternal refusal	2	1.9
Immediate contact duration (minutes)
Immediate contact not performed	7	6.7	<0.001¹
1 to 5 minutes	87	82.9
6 to 59 minutes	8	7.6
60 minutes	3	2.8
Type of immediate contact			<0.001¹
Not performed	7	6.7
Skin-to-cloth contact	59	56.2
Skin-to-skin contact	39	37.1
Elements that influenced immediate contact duration
Absence of elements	11	10.5	<0.001¹
Maternal procedures	6	5.7
Procedures on the neonate	71	67.6
Complications in the neonate	16	15.2
Structural elements	1	1
Responsible for completing immediate contact
Absence of someone responsible	11	10.4	<0.001¹
Pediatrician	85	81.0
Nursing staff	3	2.9
Obstetrician	4	3.8
Companion/father	2	1.9

Variables assessed	Total
Variables assessed	n	%	p-value
Beginning of late contact (minutes)
Up to 10 min	17	16.7	<0.001¹
11 to 20 min	25	24.5
21 to 30 min	11	10.8
31 to 60 min	49	48.0
Elements responsible for the delay to return the neonate
Absence of elements	3	2.9	<0.001¹
Procedures on the mother	17	16.6
Procedures on the neonate	55	53.9
Structural elements	10	9.8
Complications in the mother	0	0.0
Complications in the neonate	14	13.7
Other causes (maternal refusal and scabies)	3	2.9
Responsible for late contact
Not applicable	34	33.3	<0.001¹
Pediatrician	16	15.7
Nursing staff	44	43.1
Companion	5	4.9
Puerperal woman	3	2.9

Maternal procedures assessed	Total
Maternal procedures assessed	n	%	p-value
Influencing procedures in immediate contact duration
Absence of influencing procedures	100	95.0	<0.001¹
Perineum repair	2	2.0
Bed hygiene	1	1.0
Exit of the stool to bed	1	1.0
Meal	1	1.0
Procedures that influenced the neonate’s return to skin-to-skin contact
Absence of influencing procedures	88	83.8	<0.001¹
Birth canal revision	5	4.8
Uterine massage	2	1.9
Bed hygiene	7	6.7
Meal	3	2.9

Neonatal procedures assessed	Total
Neonatal procedures assessed	n	%
Airway aspiration (procedure)	69	13.0
Clamping	66	12.3
Physical exam and practical class for health students	64	12.0
Vitamin K	47	8.8
Nasogastric tube passage	38	7.2
Identification wristband placement	35	6.6
Drying the neonate	35	6.6
Rectal probe passage	34	6.4
Field swap	24	4.5
Cap	21	4.0
Photography	21	4.0
Anthropometric measurements	18	3.4
Weighing	18	3.4
Plantar identification	11	2.1
Health education/navel cleansing	7	1.3
Maternal serology	6	0.9
Clothing	5	0.8
Diaper	4	0.6
Eye protection	3	0.6
Heating neonates in the crib	2	0.4
Latch on assessment	2	0.4
Butterfly touch massage	1	0.2

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
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[1] Corresponding author: Bruna Rodrigues Monteiro Rua Monsenhor José Edson Monteiro, 36, Vale do Sol 59143-042 – Parnamirim, RN, Brazil brunarenfermeira@gmail.com

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Elements that influenced immediate mother-neonate contact during the golden hour* * Extracted from the dissertation: “Fatores intervenientes no contato pele a pele entre mãe e bebê na hora dourada”, Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Enfermagem, 2019.

Elementos que influyeron en el contacto inmediato entre madre y bebé en la hora dorada

ABSTRACT

Objective:

Method:

Results:

Conclusion: