新生儿娩出后早期皮肤接触的证据总结

Evidence summary of early skin-to-skin contact in newborns after delivery

目的:检索、评价和总结新生儿娩出后早期皮肤接触的最佳证据,为医护人员开展更好的母婴服务提供指导。方法:计算机检索UpToDate临床顾问、BMJ、美国指南网(NGC)、加拿大安大略注册护士协会(RNAO)、苏格兰学院指南网(SIGN)、英国国家健康学会(NICE)、JBI、Cochrane Library、PubMed、EMbase、WHO专业网站、中国生物医学文献数据库关于新生儿娩出后早期皮肤接触的所有指南、证据总结、系统评价等,检索时限为建库至2019年11月30日。2名研究人员进行评价和数据提取,并从符合质量标准的文献中提取证据。结果:共纳入4篇文献,其中2篇指南,2篇系统评价。对于新生儿娩出后皮肤早接触的证据大多聚焦于早期母婴皮肤接触对于新生儿及母亲的益处,WHO临床实践指南提出分娩后应即刻皮肤接触,至少接触90 min。本文从生后30 s内、生后30 s~3 min、生后90 min内3个方面进行证据总结。结论:临床中,助产士应针对新生儿娩出后的健康情况,根据相关证据实施新生儿早接触管理方案。

Objective To retrieve,evaluate,and summarize the best evidence of early skin-to-skin contact after delivery,so as to provide guidance for medical and nursing staff to develop good maternal and infant services.Methods Guidelines,evidence summaries and systematic reviews on the early skin-to-skin contact of newborns after delivery were searched in UpToDate Clinical Consultant,British Medical Journal(BMJ),National Guideline Clearinghouse(NGC),Registered Nurses'Association of Ontario(RNAO),Scottish Intercollegiate Guidelines Network(SIGN),National Institute for Health and Clinical Excellence(NICE),Joanna Briggs Institute(JBI),Cochrane Library,PubMed,EMbase,World Health Organization(WHO)professional websites and Chinese Biomedical Literature Database by computer.The search time limit was from the establishment of the database to November 30,2019.Two researchers conducted evaluation and data extraction,and extracted evidence from literature that met the quality standards.Results A total of 4 articles were included,including 2 guidelines and 2 systematic reviews.The evidence of early skin-to-skin contact of newborns after delivery mostly focused on the benefits of early mother-to-child skin-to-skin contact for newborns and mothers.The WHO clinical practice guidelines suggested that skin-to-skin contact should be made immediately after delivery for at least 90 minutes.This article summarized the evidence from three aspects,namely within 30 s after birth,30 s to 3 min after birth,and within 90 min after birth.Conclusions In clinical practice,midwives should focus on the health of newborns after delivery and implement newborn early contact management programs based on relevant evidence.