15 research outputs found
Relationship between the Duration of the Second Stage of Labour and Neonatal Morbidity
(1) Background: To assess the relationship between the duration of the second stage of
labour and the neonatal morbidity risk; (2) Methods: An observational, analytical, retrospective cohort
study was performed at the “Mancha-Centro” Hospital (Spain) during the 2013–2016 period.
Data were collected from 3863 women who gave a vaginal birth. The studied neonatal morbidity
variables were umbilical cord arterial pH, 5-min Apgar score, need for advanced neonatal
resuscitation, and a composite neonatal morbidity variable on which the multivariate analysis
was done. A univariate analysis was used for the potential risk factors and a multivariate analysis
with binary logistic regression to control for possible confounding factors; (3) Results: The univariate
analysis showed a statistically significant relationship between the duration of the second stage
of labour and a high risk of advanced neonatal resuscitation and composite neonatal morbidity in
multiparous women. However, after performing the multivariate analysis for the variable “composite
neonatal morbidity”, we observed no relationship with the duration of the second stage of labour
in either nulliparous or multiparous women; (4) Conclusions: The duration of the second stage of
labour was not related to an increased risk of neonatal morbidity in our study population
Food Preferences in Undergraduate Nursing Students and Its Relationship with Food Addiction and Physical Activity
The transition to college is a decisive stage for the acquisition of eating habits that continue into adulthood. The aim of this study is to assess the consumption of healthy elements of the Mediterranean diet in a group of university students and to evaluate whether the consumption pattern was related to sex, Body Mass Index (BMI), food addiction or the amount of physical activity performed. A total of 515 nursing students participated. The Mediterranean diet adherence questionnaire (PREDIMED), the food addiction scale (YFAS 2.0) and the International Physical Activity Questionnaire (IPAQ) were completed. For data analysis, multivariate analysis was performed with multiple linear regression and adjusted for sex, age, and BMI. The results showed that females consumed various types of meats (white/red, processed) in a healthier proportion (p < 0.05). Students that consumed more than one per day (unhealthy) of red/processed meats (mean difference (MD) = −0.49; 95% CI: −0.83; −0.15), soft drinks (MD = −0.82; 95% CI: 82–1.36; −0.27) and pastries (MD = −0.63; 95% CI: −0.97; −0.30) displayed higher food addiction scores. In addition, students who skipped breakfast also scored higher on food addiction (MD = 0.75; 95% CI: 0.31–1.19). Higher values of physical activity were observed in those who presented a healthy consumption of vegetables (MD = 140.86; 95% CI: 72.71–209.02), fruit (MD = 145.78; 95% CI: 69.35–222.21), legumes (MD = 136.46; 95% CI: 60.43–212.50) and nuts (MD = 74.36; 95% CI: 14.23–134.49). Students who consumed more red or processed meats, more pastries and more soft drinks had higher values of food addiction, while those who consumed more vegetables, fruits, legumes, and nuts had more minutes of physical activity per week. These findings invite us to insist on expanding knowledge regarding the health benefits of consuming a Mediterranean-type diet as a whole. The healthy consumption of fish, fruit and legumes should also be emphasized, especially among university students
Physical Activity and Sedentary Lifestyle in University Students: Changes during Confinement Due to the COVID-19 Pandemic
Regular physical activity is related to many factors in a university student’s environment. The coronavirus pandemic and the resulting lockdown have restricted many elements of our environment. The aim of this study was to evaluate students’ physical activity and sedentary behaviour at two points in time: before and during the coronavirus lockdown. As a secondary aim, we also wanted to look at changes resulting from other factors (alcohol, tobacco, diet, stages of change, symptoms of anxiety/depression and sociodemographic characteristics). We conducted an observational, cross-sectional, pre-post study with two cut-off points. Two hundred and thirteen students took part in the study. The main dependent variables were physical activity and sitting time, measured using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Parametric and non-parametric tests were used for paired and unpaired data, as well as group-stratified analysis. During lockdown, both weekly physical activity (MD: −159.87; CI: −100.44, −219.31) and weekly sitting time increased (MD: −106.76; CI: −71.85, −141.67). In the group analysis, differences were observed in relation to gender, year of study, BMI, alcohol consumption, tobacco use, symptoms of anxiety/depression, Mediterranean diet, living situation and stage of change. The results showed an increase in both physical activity and sitting time globally and by group.La actividad física regular está relacionada con muchos factores en el entorno del estudiante universitario. La pandemia de coronavirus y el confinamiento resultante han restringido muchos elementos de nuestro entorno. El objetivo de este estudio fue evaluar la actividad física y el comportamiento sedentario de los estudiantes en dos momentos: antes y durante el confinamiento por el coronavirus. Como objetivo secundario, también queríamos observar los cambios resultantes de otros factores (alcohol, tabaco, dieta, etapas de cambio, síntomas de ansiedad/depresión y características sociodemográficas). Realizamos un estudio observacional, transversal, pre-post con dos puntos de corte. Doscientos trece estudiantes participaron en el estudio. Las principales variables dependientes fueron la actividad física y el tiempo sentado, medidos mediante el Cuestionario Internacional de Actividad Física—Forma Corta (IPAQ-SF). Se utilizaron pruebas paramétricas y no paramétricas para datos apareados y no apareados, así como análisis estratificado por grupos. Durante el confinamiento aumentó tanto la actividad física semanal (DM: −159,87; IC: −100,44, −219,31) como el tiempo de sedestación semanal (DM: −106,76; IC: −71,85, −141,67). En el análisis de grupos se observaron diferencias en relación al sexo, año de estudio, IMC, consumo de alcohol, tabaquismo, síntomas de ansiedad/depresión, dieta mediterránea, situación de vida y etapa de cambio. Los resultados mostraron un aumento tanto en la actividad física como en el tiempo sentado a nivel mundial y por grupo. En el análisis de grupos se observaron diferencias en relación al sexo, año de estudio, IMC, consumo de alcohol, tabaquismo, síntomas de ansiedad/depresión, dieta mediterránea, situación de vida y etapa de cambio. Los resultados mostraron un aumento tanto en la actividad física como en el tiempo sentado a nivel mundial y por grupo. En el análisis de grupos se observaron diferencias en relación al sexo, año de estudio, IMC, consumo de alcohol, tabaquismo, síntomas de ansiedad/depresión, dieta mediterránea, situación de vida y etapa de cambio. Los resultados mostraron un aumento tanto en la actividad física como en el tiempo sentado a nivel mundial y por grupo
Effects of cord milking in late preterm infants and full-term infants: A systematic review and meta-analysis
Background: Umbilical cord milking (UCM) consists of performing several milkings
of the cord from the placenta to the newborn. The objective was to evaluate the
effects of UCM on newborns ≥34 weeks’ gestation.
Methods: Searches were conducted in MEDLINE, EMBASE, CINAHL, the
Cochrane Database of Clinical Trials, and the clinicaltrails.gov database for randomized
clinical trials (RCT), with no time or language restrictions, and for articles
that compared UCM with other strategies. The main results were initial hemoglobin
and hemoglobin after 6 weeks. The data were collected by two reviewers and the
quality of the studies was assessed using the Cochrane Manual methodology.
Results: The sample included 1845 newborns in 10 RCTs. The use of UCM
in ≥34 weeks’ gestation newborns was not related to initial hemoglobin levels
(pooled weighted mean difference: (PWMD = 0.40 g/L [−0.16 to 0.95]) or after
6 weeks (PWMD = 0.07 g/L [−0.29 to 0.27]). A reduction in hemoglobin levels
was also observed at 6 weeks when the control group had undergone late clamping
(PWDM = 0.16g/L [−0.26 to −0.06]).
Conclusions: UCM produced no differences in hematologic variables for newborns
with ≥34 weeks of gestation relative to controls. However, a slight decrease in hemoglobin
levels is observed at 6 weeks when the control group is made up of newborns
with late clamping
Influence of Family Income Level on Obstetric and Perinatal Outcomes in Spain
For pregnant women, having a low family income status is associated with late prenatal
attendance and an increased risk of adverse outcomes during pregnancy, delivery, and immediately
after delivery. However, the influence of the socioeconomic level on maternal and child health may
be minimal as long as the health system model is able to neutralise health inequity. For this reason,
the objective of this study is to determine the relationship between the socioeconomic level assessed
through monthly household income and obstetric and perinatal outcomes in the Spanish Health
System, where midwives play a relevant role. To meet this objective, a cross-sectional observational
study aimed at women who have been mothers between 2013 and 2018 in Spain was developed.
The final study population was 5942 women. No statistically significant differences with linear
trend were found between income level and obstetric and perinatal outcomes after the adjustment
by confounding factors (pregnancy composite morbidity, p = 0.447; delivery composite morbidity,
p = 0.590; perinatal composite morbidity, p = 0.082; postpartum composite morbidity, p = 0.407).
The main conclusion is that, in the current Spanish health system, household income as an indicator
of socioeconomic status is not related to perinatal outcomes after the adjustment by confounding
factors. These results are likely due to the public model of our health system that serves all citizens
on equal footing, although other social and individual factors may have influenced these results
Relationship between parity and the problems that appear in the postpartum period
Parity is associated with the incidence of problems in pregnancy, delivery and the puerperium. The
influence of parity in the postpartum period has been poorly studied and the results are incongruous.
The objective of this study was to identify the association between parity and the existence of distinct
discomfort and problems during the postpartum period. Cross-sectional study with puerperal women
in Spain. Data was collected on demographic and obstetric variables and maternal manifestations of
discomfort and problems during the postpartum period. An ad hoc online questionnaire was used. Crude
odds ratios (ORs) and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were estimated by
conditional logistic regression. 1503 primiparous and 1487 multiparous participated in the study. 53.4%
(803) of the primiparous women affirmed to have feelings of sadness, as opposed to 36.2% (539) of
multiparous women (aOR: 1.60; 95% CI: 1.35–1.89). 48.3% (726) of primiparous had lactation problems
vs 24.7% (367) of multiparous (aOR: 2.46; 95% CI: 2.05–2.94). 37.2% (559) of primiparous reported
anxiety, while the percentage in multiparous was 25.7% (382) (aOR: 1.34; 95% CI: 1.12–1.61). 22.2%
(333) of primiparous had depressive symptoms, and 11.6% (172) of multiparous (aOR: 1.65; CI 95%:
1.31–2.06). Faecal incontinence was more present in primiparous than in multiparous, 6.5% (97) and
3.3% (49) respectively (aOR: 1.60; 95% CI: 1.07–2.38). Parity is associated with the presence of certain
problems in the postpartum period. Thus, primiparous are more likely to have lactation problems,
depressive symptoms, anxiety, sadness, and faecal incontinence
Quality of Childbirth Care in Women Undergoing Labour: Satisfaction with Care Received and How It Changes over Time
Background: To evaluate women’s satisfaction with the care received during childbirth
undergoing labour and how this changes over time. (2) Methods: An observational, multicentre
and longitudinal study in two public hospitals of Spain with a convenience sample of 248 women
during the post-partum period. Satisfaction was evaluated using the Intrapartal-Specific Quality from
the Patient’s Perspective questionnaire. Socio-demographic and clinical variables were considered.
A bivariate analysis evaluated the relationship between satisfaction and the recorded variables to
compare the hypotheses, and also to know if there were any significant differences between the
scores obtained at the various evaluated time points (three days, 15 days, one year postpartum).
The multivariate analysis by binary logistic regression helped complete the study about the variables
related to the level of satisfaction; (3) Results: The mean scores for satisfaction at each time point
were high, and they lowered with time. The bivariate analysis showed an association between
satisfaction and the following variables: ‘mother’s place of birth’, ‘level of education’, ‘type of labour
onset’, ‘type of birth’ and ‘type of perineal trauma’. For the multivariate analysis, women who gave
birth vaginally, began labour spontaneously and had an epidural were more satisfied than those
who did not; (4) Conclusions: Women seemed to obtain good levels of satisfaction with the care
they received. Even so, based on continuously improved quality, we proposed some improvement
measures, particularly regarding the physical environment and the information offered to patients.
It is important to know at what time experience while giving birth should be evaluated as scores can
lower with time as part of its normal evolution
Factors that influence mothers’ prenatal decision to breastfeed in Spain
Background: Parents’ decisions about how to feed their newborns are influenced by multiple factors. Our objective
was to identify the factors that can influence the decision to breastfeed.
Methods: Cross-sectional observational online study was conducted in Spain on women who gave birth between
2013 and 2018. The total number of participants was 5671. Data collection was after approval by the ethics
committee in 2019. The data were collected retrospectively because the information was obtained from women
who were mothers during the years 2013–2018. An online survey was distributed to breastfeeding associations and
postpartum groups. Multivariate analysis with binary logistic regression was done to calculate the Adjusted Odds
Ratios (aOR). The main result variable was “intention to breastfeed”.
Results: Ninety-seven percent (n = 5531) of women made the decision to breastfeed prior to giving birth. The
internet played a role in deciding to breastfeed in 33.7% (n = 2047) of women, while 20.1% (n = 1110) said the same
thing about their midwife. We identified five significant factors associated with the mother’s prenatal decision to
breastfeed: attending maternal education (aOR 2.10; 95% CI 1.32, 3.34), having two (aOR 0.52; 95% CI 0.28, 0.99) and
three children (aOR 0.24; 95% CI 0.10, 0.59), previous breastfeeding experience (aOR 6.99; 95% CI 3.46, 14.10), support
from partner (aOR 1.58; 95% CI 1.09,2.28) and having a condition during pregnancy (aOR 0.62; 95% CI 0.43, 0.91).
Conclusions: Factors related with previous breastfeeding experience and education for mothers are decisive when it
comes to making the decision to breastfeed. Given the proven influence that partners have in decision-making, it is
important for them to be fully involved in the process
Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey
Background: Obesity is a worldwide public health problem that demands significant attention. Several studies have
found that maternal obesity has a negative effect on the duration of breastfeeding and delayed lactogenesis. The
World Health Organization has classified Body Max Index (BMI) as normal weight (normoweight) (BMI:18.5–24.9),
overweight (BMI:25–29.9), obesity grade I (30.0–34.9), obesity grade II (BMI: 35.0–39.9) and obesity grade III (BMI 40.0).
The objective of this study is to describe the relationship between maternal BMI and breastfeeding rates, as well as
breastfeeding-associated problems and discomfort in women assisted by the Spanish Health System.
Methods: To this end, a cross-sectional observational study aimed at women who have been mothers between 2013
and 2018 in Spain was developed. The data was collected through an online survey of 54 items that was distributed
through lactation associations and postpartum support groups between March and June 2019. Five thousand eight
hundred seventy one women answered the survey. In the data analysis, Crude Odds Ratios (OR) and Adjusted Odds
Ratios (AOR) were calculated through a multivariate analysis through binary and multinomial regression.
Results: A linear relationship was observed between the highest BMI figures and the reduction of the probability of
starting skin-to-skin contact (AOR for obesity type III of 0.51 [95% CI 0.32, 0.83]), breastfeeding in the first hour (AOR for
obesity type III of 0.58 [95% CI 0.36, 0.94]), and exclusive breastfeeding to hospital discharge (AOR for obesity type III of
0.57 [95% CI 0.35, 0.94]), as compared to women with normoweight.
Conclusions: Women with higher BMI are less likely to develop successful breastfeeding than women with normoweight
Women’s Perceptions of Living a Traumatic Childbirth Experience and Factors Related to a Birth Experience
Although identified by theWorld Health Organization (WHO) as a global health priority,
maternal mental health does not receive much attention even in the health systems of developed
countries. With pregnancy monitoring protocols placing priority on the physical health of the mother,
there is a paucity of literature documenting the traumatising e ects of the birth process. To address
this knowledge gap, this qualitative descriptive study aimed to investigate women perceptions of
living a traumatic childbirth experience and the factors related to it. Qualitative data, collected via
semi-structured interviews with 32 participants recruited from parent support groups and social media
in Spain, were analyzed through a six-phase inductive thematic analysis. Data analysis revealed five
major themes—“Birth Plan Compliance”, “Obstetric Problems”, “Mother-Infant Bond”, “Emotional
Wounds” and “Perinatal Experiences”—and 13 subthemes. The majority of responses mentioned
feelings of being un/misinformed by healthcare personnel, being disrespected and objectified, lack of
support, and various problems during childbirth and postpartum. Fear, loneliness, traumatic stress,
and depression were recurrent themes in participants’ responses. As the actions of healthcare personnel
can substantially impact a birth experience, the study findings strongly suggest the need for proper
policies, procedures, training, and support to minimise negative consequences of childbirth