The Influence of Perinatal Education on Breastfeeding Decision and Duration

Objectives: to evaluate factors influencing breastfeeding duration in an integrative model, considering both the organization of medical care and the perinatal education.Methods: We conducted a cross sectional study with data collected in a face to face interview of 1,008 mothers with children aged between 9 and 14 months The questionnaire focused on the main characteristics of a Mother-Baby Friendly Hospital initiative and the type of perinatal education received by pregnant women. Correlation and partial correlation tests, non-parametric tests and classification tests were applied. Data were processed in SPSS 12.0 software.Results: The positive effects of Mother Baby Friendly Hospitals Organization initiative organization were confirmed. However, the main differentiator for breastfeeding duration was the level of formal education of pregnant mothers and the active seeking of perinatal education (r = 0.22, p< 0.001). The perinatal counseling was correlated with breastfeeding duration only for the subgroup participating to structured, dedicated time slot apart from the regular medical consultation (r = 0.079; p = 0.014), independently of mother’s age, education, residence, time to first breastfeeding contact, type of birth delivery and rooming in. Our results support a broader approach to perinatal education than medical counseling during pregnancy to increase the voluntary participation of future mothers to the perinatal educational programs.Conclusion: As mothers’ motivation to maintain the optimum duration of breastfeeding is a determinant factor, an earlier and sustained educational process, before pregnancy and after birth delivery, is necessary in order to create a general favorability for exclusive breastfeeding

Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic : Results from the IMAgiNE EURO study

Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336

Regulatory landscape of providing information on newborn screening to parents across Europe

Newborn screening (NBS) is an important part of public healthcare systems in many countries. The provision of information to parents about NBS is now recognised as an integral part of the screening process. Informing parents on all aspects of screening helps to achieve the benefits, promote trust and foster support for NBS. Therefore, policies and guidelines should exist to govern how the information about NBS is provided to parents, taking into account evidence-based best practices. The purpose of our survey was to explore whether any legally binding provisions, guidelines or recommendations existed pertaining to the provision of information about NBS to parents across Europe. Questions were designed to determine the regulatory process of when, by whom and how parents should be informed about screening. Twenty-seven countries participated in the survey. The results indicated that most countries had some sort of legal framework or guidelines for the provision of information to parents. However, only 37% indicated that the provision of information was required prenatally. The majority of countries were verbally informing parents with the aid of written materials postnatally, just prior to sample collection. Information was provided by a neonatologist, midwife or nurse. A website dedicated to NBS was available for 67% of countries and 89% had written materials about NBS for parents. The survey showed that there is a lack of harmonisation among European countries in the provision of information about NBS and emphasised the need for more comprehensive guidelines at the European level.Institutional support was provided by projects LM2018132 from the Large Infrastructure Projects of the Czech Ministry of Education, PROGRES Q26 from Charles University and RVO VFN 64165 from the Ministry of Health, Czech Republic. Several authors of this publication are members of the European Reference Network for Rare Hereditary Metabolic Disorders (MetabERN)—Project ID No. 739543.info:eu-repo/semantics/publishedVersio

Global impact of COVID-19 on newborn screening programmes

Introduction The global COVID-19 pandemic has presented extraordinary disruption to healthcare services and exposed them to numerous challenges. Newborn screening (NBS) programmes were also affected; however, scarce data exist on the impact of COVID-19 on NBS. Methods We conducted an international survey to assess the global impact of COVID-19 on NBS, with the main aim of gathering the experiences of the COVID-19 pandemic from a large and representative number of NBS centres worldwide. Results The results of our study showed that COVID-19 impacted the NBS programmes, at least partially, in 29 out of 38 responding countries. Majority of the screening centres experienced a broad spectrum of difficulties and most were affected more in the second wave of the pandemic. Delays and unreliability with the postal service as well as flight cancellations caused delays in samples arriving to screening centres and with the provision of laboratory equipment and reagents. The availability of laboratory staff was sometimes reduced due to infection, quarantine or reassignment within the healthcare facility. Sample collection at home, second-tier tests and follow-up were also affected. Social restrictions and interruptions in public transport added to these difficulties. Only a limited number of centres managed to retain a fully functioning NBS programme. Conclusion As the pandemic might continue or could recur in future years, it would be useful to develop guidelines to protect these valuable services