在意大利新冠肺炎大流行期间,母乳喂养和妇女的选择:当前的地区数据和出生时的良好做法。

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologia & Prevenzione Pub Date : 2023-07-01 DOI:10.19191/EP23.4-5.A587.066
Francesca Zambri, Anna Maria Nannavecchia, Sonia Brescianini, Franca Rusconi, Edoardo Corsi Decenti, Monia Puglia, Martina Pacifici, Pietro Buono, Sara Cantoira, Luigi Gagliardi, Paola Ghiotti, Olivia Leoni, Caterina Masè, Monica Mazzucato, Luisa Mondo, Edda Pellegrini, Riccardo Pertile, Alessandro Scoppa, Laura Visonà Dalla Pozza, Angela Giusti
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引用次数: 0

摘要

目的:描述住院期间母乳喂养的每月趋势,以及分娩和分娩期间女性选择伴侣的情况,以及主要地区响应者在意大利几个地区第一次新冠肺炎大流行之前、期间(2020年2月至5月)和之后对支持人员存在的同质性/异质性的看法。设计:两阶段研究。背景和参与者:分析了2019年1月1日至2021年3月31日期间意大利六个地区的意大利出生证明数据。对主要区域受访者进行了半结构化访谈。主要结果指标:从整体和每个地区计算母乳喂养的频率分布和女性选择伴侣的存在。结果:从2019年1月到2021年3月,新冠肺炎大流行期间,婴儿喂养方式的变化小于分娩和分娩期间女性选择伴侣存在的变化。在所有地区,纯母乳喂养的最高值记录在2020年9月(72.1%;95%CI 71.3-72.8),而最低值记录在2021年3月(62.5%;95%CI 61.5-63.4)。在疫情期间,分娩和分娩期间女性选择的伴侣的存在减少,没有恢复到疫情前的水平。出生时父亲在场的最高值记录在2019年3月(59.0%;95%CI 58.2-59.8),而最低值记录在2020年4月(50.0%;95%CI 49.1-50.8)。主要的新兴主题是:国家、地区和地方适应症的存在;促进者(例如,爱婴医院倡议的实施,工作人员的强烈动机)和支持人员在场管理的关键点(例如,对临床流行病学背景的分析不足,适应症不均匀)。结论:紧急情况改变了卫生服务的提供,而卫生服务并不总是保证最佳做法的应用。最好是评估出生证明数据的适当性,以收集更准确的信息并提供临床建议。
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Breastfeeding and presence of the companion of woman's choice during COVID-19 pandemic in Italy: regional population-based routine data and best practices at birth

Objectives: to describe the monthly trend of breastfeeding during hospitalization and the presence of companion of woman's choice during labour and birth, and the key regional responders' perspective of homogeneity/heterogeneity of the presence of the support person, before, during (February-May 2020), and after the first COVID-19 pandemic wave in a few Italian Regions.

Design: two-phase study.

Setting and participants: data from the italian birth certificate of six Italian Regions between 01.01.2019 and 31.03.2021 were analysed. Semi-structured interviews were conducted with the key regional respondents.

Main outcome measures: the frequency distributions of breastfeeding and the presence of companion of woman's choice were calculated as a whole and for each Region.

Results: the infant feeding practices experienced smaller changes during COVID-19 pandemic than the presence of the companion of woman's choice during labour and birth, from January 2019 to March 2021. The highest value of exclusive breastfeeding was recorded in September 2020 (72.1%; 95%CI 71.3-72.8) in all Regions, while the lowest was recorded in March 2021 (62.5%; 95%CI 61.5-63.4). The presence of companion of woman's choice during labour and birth decreased during the pandemic and did not return to pre-pandemic levels. The highest value of presence of father during birth was recorded in March 2019 (59.0%; 95%CI 58.2-59.8), while the lowest in April 2020 (50.0%; 95%CI 49.1-50.8). The main emerging themes were: the existence of national, regional and local indications; the facilitators (e.g., Baby-Friendly Hospital Initiative implementation, strong motivation of the staff) and the critical points (e.g., inadequate analysis of the clinical-epidemiological context, inhomogeneous indications) of management of the support person presence.

Conclusions: the emergency has changed the provision of health services that not always guaranteed the application of best practices. It would be desirable to work for assessing the appropriateness of the birth certificate data to collect more accurate information and to provide clinical recommendations.

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来源期刊
Epidemiologia & Prevenzione
Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.60
自引率
14.30%
发文量
0
审稿时长
>12 weeks
期刊介绍: Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.
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