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Effects of early essential newborn care after elective caesarean section on maternal and neonatal outcomes: a
Xiaojin Zhang1, Li Ding1, Mei He1
1Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University Yiwu 322000, Zhejiang, China.
Objective:
Early essential newborn care (EENC) is a World Health Organization (WHO)-recommended package of evidence-based perinatal interventions, but evidence regarding its effects after elective caesarean section (CS) remains limited. We evaluated the effects of EENC on maternal and neonatal outcomes following elective CS.
Methods:
In this retrospective observational study, 590 patients who underwent CS from November 2021 to October 2022 were screened; after applying eligibility criteria, 282 were included for analysis: 125 in the EENC group (E group) and 157 in the routine care group (R group). Outcomes included intraoperative and 24-h postpartum blood loss, postoperative pain (visual analogue scale [VAS] at 2/24/48/72 h), exclusive breastfeeding rate, neonatal hospitalization, neonatal intensive care unit (NICU) admission and transcutaneous bilirubin (TcB). Continuous data were compared with the independent t-test or Mann-Whitney U test and categorical data with the chi-square or Fisher's exact test.
Results:
Intraoperative blood loss (239.20±74.21 vs. 259.87±85.37 mL, t=2.14, P=0.033) and 24-h postpartum blood loss (47.01±20.71 vs. 54.71±26.64 mL, t=2.66, P=0.008) were lower in the E group. The 2-h VAS score was lower in the E group (1.88 [1, 3] vs. 2.48 [1, 4], Z=3.32, P<0.001). The exclusive breastfeeding rate was higher (78.4% vs. 63.7%, χ2=7.20, P=0.005) and neonatal hospitalization shorter (4.04 [3, 5] vs. 4.20 [3, 6] days, P=0.021) in the E group. NICU admission, TcB and VAS at 24-72 h did not differ.
Conclusion:
EENC after elective CS was associated with reduced intraoperative and 24-h postpartum blood loss, lower early postoperative pain, higher exclusive breastfeeding rates and shorter neonatal hospitalization, supporting broader implementation of EENC in CS deliveries.
