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- Title
OBSTETRIC AND NEONATAL ADVERSE EVENTS AND ASSOCIATION WITH CARE MODELS: A COHORT STUDY.
- Authors
Cavalcante Ribeiro, Kelly da Silva; Magalhães, Adriana Simão; Granja Avelino, Ana Heloíza; Silva Ramos, Matheus da Cruz; Andrade dos Santos, Paula Wendy; Gonçalves Fonseca, Rodrigo Augusto; Barros, Ângela Ferreira
- Abstract
Objective: to analyze the prevalence of practices in childbirth care, obstetric and neonatal adverse events and their association with care models in three public health services. Method: this is a prospective cohort study carried out with 548 dyads, postpartum women and their newborns, whose pregnancy was of usual risk and vaginal birth, admitted to hospital in three public services, one with an exclusive care model by nurse-midwives (service A), one with a collaborative model involving obstetric doctors and nurses (service B) and one with an exclusive medical care model (service C). Initially, an interview was carried out with participants, and a second contact was carried out 42 days after birth to complement the collection of the adverse event outcome. Results: in service A, no woman underwent the Kristeller maneuver, episiotomy, directed pushing or more than one vaginal examination per hour. Meanwhile, in service C, 19.3%, 39.9%, 77.1% and 26.3% of women underwent these interventions, respectively. Adverse events occurred in 19.2% of the dyads. Occurrence of adverse events was associated with not using partograph (p=0.001; OR: 11.03; CI: 2.64-45.99) and episiotomy (p=0.042; OR: 1.72; CI: 1. 02-2.91). The mean probability of experiencing an adverse event was 5% in service A, 21% in service B and 24% in service C. Conclusion: adverse events had a lower mean probability of occurrence in the service exclusively operated by nurse-midwives, in which greater application of recommendations for labor and birth care was identified.
- Subjects
NURSES; DELIVERY (Obstetrics); VAGINA; MEDICAL care; MIDWIVES; DESCRIPTIVE statistics; NEWBORN infants; LONGITUDINAL method; ADVERSE health care events; CONFIDENCE intervals; OBSTETRICS; CHILDBIRTH; HEALTH care teams
- Publication
Texto & Contexto Enfermagem, 2023, Vol 32, p1
- ISSN
0104-0707
- Publication type
Article
- DOI
10.1590/1980-265X-TCE-2023-0079en