Influence of social determinants of health on skin to skin contact between mother and newborn

Uchoa, Janaiana Lemos; Barbosa, Lorena Pinheiro; Mendonça, Larissa Bento de Araújo; Lima, Francisca Elisângela Teixeira; Almeida, Paulo César de; Rocha, Silvana Santiago da

doi:10.1590/0034-7167-2020-0138

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Brasil

Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. bras. enferm. 74 (suppl 4) • 2021 • https://doi.org/10.1590/0034-7167-2020-0138 copy

Influence of social determinants of health on skin to skin contact between mother and newborn

Influencia de los determinantes sociales de la salud en el contacto piel a piel entre la madre y el recién nacido

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the association of skin-to-skin contact and social determinants of health.

Methods:

this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval.

Results:

62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1^st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines.

Conclusion:

skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.

Descriptors:
Breast Feeding; Maternal-Child Health Services; Social Determinants of Health; Newborn; Public Health Policy.

	Conducting skin-to-skin contact				Mean ± SD
	Yes, n=116		No, n=71
	n°	%	n	%
1. Individual determinants
Age group (year) of mothers					26.2±7.3
20 - 34	74	39.6	48	25.7
11 - 19	27	14.4	11	5.9
35 - 46	15	8.0	12	6.4
Weight (gram) of newborns					3112±444
2,500 - 3,999	108	57.8	60	32.1
<2,500	5	2.7	9	4.7
<4,000	3	1.6	2	1.1
Gestational age classification of newborns
Full-term	110	58.8	51	27.3
Preterm	6	3.2	20	10.7
1st minute APGAR of newborns					8.3±1.1
7 - 9	116	62.0	56	29.9
3 - 6			11	5.9
Unregistered			4	2.2
2. Proximal determinants of mothers:
Education
Higher education	5	2.7	4	2.1
Elementary education	48	25.7	31	16.5
High school	63	33.7	36	19.3
Marital status
Married/common-law marriage	93	49.7	57	30.5
Single/widowed/divorced	23	12.3	13	7.0
Unregistered			1	0.5
3. Influence of mothers' social relations:
Number of living children					0.9±1.2
0	53	28.3	37	19.8
1	37	19.8	13	7.0
≥2	26	13.9	21	11.2
4. Intermediate determinants of pregnancy and current childbirth:
Prenatal care
Underwent prenatal consultations	114	61.0	69	36.8
Did not undergo prenatal consultations	2	1.1	2	1.1
Number of prenatal care consultations					7.3±2.7
6 - 14	93	49.7	52	27.8
≥ 5	23	12.3	19	10.2
Childbirth type
Vaginal	93	49.7	23	12.3
C-section	23	12.3	48	25.7
Gestational history
1 pregnancy	50	26.7	32	17.1
Multiple pregnancies	66	35.3	39	20.9
Parity history					1.8±1.1
Muliple pregnancies (1 - 6)	62	33.7	34	18.2
Primiparous	54	28.9	37	19.2
Abortion					0.23±0.5
No	97	51.9	53	28.3
Yes (1 - 3)	19	10.2	18	9.6
Health of newborns at birth
Healthy-transferred to rooming-in	110	58.8	42	22.5
Need complementary care in a Neonatal Intermediate Care	6	3.2	29	15.5

	RC	(95%) CI			ρ
1. Individual determinants
Age group (year) of mothers
20 - 34	1
11 - 19	1.6	0.72	-	3.51	0.246
35 - 46	2.0	0.70	-	5.52	0.198
Weight (gram) of newborns
2,500 - 3,999	1
<2,500	3.2	1.04	-	10.11	0.034
<4,000	1.2	0.20	-	7.38	0.845
Gestational age classification of newborns
Full-term	1
Preterm	7.2	2.72	-	18.98	<0.001
1st minute APGAR of newborns
7 - 9	1
3 - 6	2.9	2.38	-	3.06	<0.001
2. Proximal determinants of mothers
Education
High education	1
Elementary education	1.1	0.61	-	2.08	0.694
Higher education	1.4	0.35	-	5.55	0.631
Marital status
Single/widowed/divorced	1
Married/common-law marriage	1.1	0.51	-	2.31	0.834
3. Influence of mothers' social relations
Number of living children
0	2.0	0.93	-	4.24	0.074
1	1
≥2	2.3	0.98	-	5.40	0.054
4. Intermediate determinants of pregnancy and current childbirth
Prenatal care
Underwent prenatal consultations	1
Did not undergo prenatal consultations	1.7	0.22	-	11.99	0.616
Number of prenatal care consultations
6 - 14	1
≥ 5	1.5	0.73	-	2.96	0.270
Childbirth type
Vaginal	1
C-section	8.4	4.29	-	16.57	<0.001
Abortion
No	1
Yes (1 - 3)	1.7	0.96	-	4.48	0.060
Health of newborns at birth
Healthy-transferred to rooming-in	1
Need complementary care in Neonatal Intermediate Care	12.7	4.90	-	32.67	<0.001

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[1] Corresponding author: Janaiana Lemos Uchoa janaiana@hotmail.com