Objective: to examinetheeffectofskin-to-skincontactandbreastfeedingwithin30minutesofbirth,on
the rateofprimarypostpartumhaemorrhage(PPH)inasampleofwomenwhowereatmixed-risk
of PPH.
Design: retrospectivecohortstudy.
Setting: two obstetricunitsplusafreestandingbirthcentreinNewSouthWales(NSW)Australia.
Participants: afterexcludingwomen(n¼3671)whodidnothaveopportunityforskintoskinandbreast
feeding, Ianalysedbirthrecords(n¼7548) forthecalendaryears2009and2010.Recordswereaccessed
via theelectronicdatabaseObstetriX.
Intervention: skin toskincontactandbreastfeedingwithin30minutesofbirth.
Measures: outcome measurewasPPHi.e.bloodlossof500mlormoreestimatedatbirth.Datawas
analysedusingdescriptivestatisticsandlogisticregression(unadjustedandadjusted).
Findings: afteradjustmentforcovariates,womenwhodidnothaveskintoskinandbreastfeedingwere
almost twiceaslikelytohaveaPPHcomparedtowomenwhohadbothskintoskincontactandbreast
feeding (aOR0.55,95%CI0.41–0.72, po0.001).Thisapparentlyprotectiveeffectofskintoskinand
breast feedingonPPHheldtrueinsub-analysesforbothwomenat ‘lower’ (OR 0.22,95%CI0.17–0.30,
po0.001)and ‘higher’ risk (OR0.3795%CI0.24–0.57), po0.001.
Keyconclusionsandimplicationforpractice: this studysuggeststhatskintoskincontactand
breastfeeding immediatelyafterbirthmaybeeffectiveinreducingPPHratesforwomenatanylevel
of riskofPPH.ThegreatesteffectwasforwomenatlowerriskofPPH.Theexplanationisthat
pronurturancepromotesendogenousoxytocinrelease.Childbearingwomenshouldbeeducatedand
supported tohavepronurturanceduringthirdandfourthstagesoflabour.
Objective: to examinetheeffectofskin-to-skincontactandbreastfeedingwithin30minutesofbirth,onthe rateofprimarypostpartumhaemorrhage(PPH)inasampleofwomenwhowereatmixed-riskof PPH.Design: retrospectivecohortstudy.Setting: two obstetricunitsplusafreestandingbirthcentreinNewSouthWales(NSW)Australia.Participants: afterexcludingwomen(n¼3671)whodidnothaveopportunityforskintoskinandbreastfeeding, Ianalysedbirthrecords(n¼7548) forthecalendaryears2009and2010.Recordswereaccessedvia theelectronicdatabaseObstetriX.Intervention: skin toskincontactandbreastfeedingwithin30minutesofbirth.Measures: outcome measurewasPPHi.e.bloodlossof500mlormoreestimatedatbirth.Datawasanalysedusingdescriptivestatisticsandlogisticregression(unadjustedandadjusted).Findings: afteradjustmentforcovariates,womenwhodidnothaveskintoskinandbreastfeedingwerealmost twiceaslikelytohaveaPPHcomparedtowomenwhohadbothskintoskincontactandbreastfeeding (aOR0.55,95%CI0.41–0.72, po0.001).Thisapparentlyprotectiveeffectofskintoskinandbreast feedingonPPHheldtrueinsub-analysesforbothwomenat ‘lower’ (OR 0.22,95%CI0.17–0.30,po0.001)and ‘higher’ risk (OR0.3795%CI0.24–0.57), po0.001.Keyconclusionsandimplicationforpractice: this studysuggeststhatskintoskincontactandbreastfeeding immediatelyafterbirthmaybeeffectiveinreducingPPHratesforwomenatanylevelof riskofPPH.ThegreatesteffectwasforwomenatlowerriskofPPH.Theexplanationisthatpronurturancepromotesendogenousoxytocinrelease.Childbearingwomenshouldbeeducatedandsupported tohavepronurturanceduringthirdandfourthstagesoflabour.
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