Evidence-based practices for the fetal to newborn transition
Judith S Mercer1, Debra A Erickson-Owens, Barbara Graves
1Nurse-Midwifery Program, University of Rhode Island College of Nursing, Kingston, RI 02881-2021, USA. jmercer@uri.edu
Journal of Midwifery & Women'S Health
|May 1, 2007
Summary
Newborn care practices significantly impact the fetal to neonatal transition. Evidence suggests less intervention, like delayed cord clamping and skin-to-skin care, is often better for infant health.
Area of Science:
- Neonatal care
- Perinatal medicine
- Evidence-based practice
Background:
- Common labor, birth, and postpartum care practices influence the crucial fetal to neonatal transition.
- Many standard newborn assessment and management practices lack proven efficacy.
- Existing research on maternal analgesia's neonatal effects is inconclusive.
Purpose of the Study:
- To review current evidence on newborn care practices.
- To evaluate the efficacy of interventions during the immediate postpartum period.
- To inform recommendations for optimal neonatal transition and care.
Main Methods:
- Systematic review of evidence on various newborn care interventions.
- Analysis of randomized controlled trials and other studies.
- Evaluation of practices including cord clamping, suctioning, thermoregulation, and resuscitation.
Main Results:
- Delayed cord clamping shows potential to protect against infant anemia.
- Skin-to-skin care is recommended for newborn thermoregulation.
- Routine suctioning, amnioinfusion, and 100% oxygen resuscitation lack proven benefits and may increase risks like oxidative stress.
Conclusions:
- Less intervention is frequently more beneficial for newborns.
- Current evidence supports a gentle, physiologic approach to birth.
- Family-centered care is recommended for newborns.
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