Abstract
ABSTRACTObjective: To describe the structure and the processes of care for pregnant women/newborn infants, including the Essential Newborn Care (ENC), in maternity hospitals in Sergipe State, Brazil.Methods: A cross-sectional study carried out between June 2015 and April 2016 in all maternity hospitals of Sergipe with more than 500 deliveries/year (n=11). A questionnaire on the existing structure and work processes was administered to the managers. Subsequently, a representative number of postpartum women from these hospitals were interviewed (n=768). Their medical records, as well as newborn infants’ records, were also analyzed.Results: Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 beds of Intermediate Care Unit (IMCU) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for high-risk parturient care. Regarding the ENC components, only 41% (n=315) of the women had early skin-to-skin contact with their babies, 33.1% (n=254) breastfed in the first hour of life, and 18% (n=138) had a companion always during birth.Conclusions: The distribution of NICU beds between capital city and other cities of the State is adequate, considering Brazilian guidelines. However, there was a low adherence to the protocols for hypertensive and hemorrhagic emergencies, and a low coverage of humanization policies, pregnancy risk classification and ENC practices, especially breastfeeding in the first hour of life, and companion always during birth.
Highlights
The organization of perinatal care, based on a risk approach, implies that every pregnant women and newborn infant receives adequate care at the level of complexity they need.[1]
Many structures and processes are better classified than the national average, these advantages have not reflected in a better infant and neonatal mortality coefficient.[14]
A prospective cohort demonstrated that the increase in neonatal mortality in Brazilian Northeast capitals is associated with extreme low birth weight, males and Apgar with 5 minutes
Summary
The organization of perinatal care, based on a risk approach, implies that every pregnant women and newborn infant receives adequate care at the level of complexity they need.[1] the existence of a structure is essential in order to provide specialized medical support, diagnostic and therapeutic procedures necessary in each case, as well as the follow-up protocols based on the best available scientific evidence.[2]. Some progress has occurred and contributed to the reduction of neonatal and maternal mortality, this has not happened uniformly at national level.[7] Public policies try to reverse this scenario and organize the perinatal health in the country, highlighting actions of the Brazilian Ministry of Health still in the 1990s, as the Program to Support the Implementation of the State Hospital Referral Systems for High-Risk Pregnancy Care and the Prenatal and Birth Humanization Program (PBHP).[8]
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