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我国新生儿早期基本保健技术实施进展的范围综述

Progress on implementation of early essential newborn care technologies in China: a scoping review

  • 摘要:
    目的 系统分析新生儿早期基本保健技术在我国的开展现状,为临床实践及研究提供参考。
    方法 根据范围综述的研究方法,系统检索2013年1月1日至2022年12月31日中国知网、万方数据知识服务平台、中文科技期刊数据库、中国生物医学文献数据库、PubMed、Ovid-Embase、CINAHL等国内外数据库中关于我国新生儿早期基本保健技术实施进展的相关文献,对纳入的文献进行筛选、汇总和分析。
    结果 共纳入文献50篇,其中随机对照研究22篇、类实验研究23篇、质性研究2篇、病例对照研究1篇、队列研究1篇、混合性研究1篇。相关研究开展地区涉及我国19个省、直辖市和自治区,东、中、西部地区分别占33.3%、12.3%和54.4%。开展研究的机构数量涉及78所医院。37篇文献(74.0%)的研究对象为阴道分娩的足月新生儿及其母亲,而涉及剖宫产、早产儿及其母亲的文献仅13篇(26.0%)。新生儿相关结局包括喂养情况、新生儿相关并发症、生命体征、生长发育、行为状态、脐部情况、住院率、生化指标、死亡率、智力发育10项指标。随访时间介于新生儿出生后42 d至6月龄。母亲相关结局包括产后情绪体验、泌乳情况、产后出血、产后恢复指标、生化指标、分娩情况6项指标。
    结论 近年来,我国新生儿早期基本保健技术的实施评价成为研究热点,纳入文献在研究对象、核心措施、母婴健康结局随访等方面尚存在一定局限,有必要进一步推进新生儿早期基本保健技术在我国不同地区的规范开展,并持续评价其对母婴健康状况的近远期影响。

     

    Abstract:
    Objective To analyze the current status of early essential newborn care technologies in China systematically, so as to provide evidence for future research and practice.
    Methods Based on the method of scoping review, literature on the implementation progress of early essential newborn care technologies in China were retrieved from China National Konwledge Infrastructure, Wanfang Data Knowledge Service Platform, China Science and Technology Journal Database, China Biology Medicine disc, PubMed, Ovid-Embase, CINAHL and other databases from January 1st 2013 to December 31st 2022. They were filtrated, summarized and analyzed.
    Results A total of 50 papers were recruited, comprising 22 randomized controlled trials, 23 quasi-experimental studies, 2 qualitative studies, 1 case-control study, 1 cohort study, and 1 mixed-methods study. Nineteen provinces, cities and autonomous regions were involved in these studies. The eastern, central, and western regions accounted for 33.3%, 12.3% and 54.4% respectively, and 78 hospitals were involved in these studies. Study subjects of 37 (74.0%) articles were full-term vaginal delivery newborns and their mothers. Only 13 (26.0%) articles related to cesarean section, premature infants and their mothers. Newborn outcomes included feeding situation, newborn related complications, vital signs, growth and development, behavioral status, umbilical condition, hospitalization rate, biochemical indicators, mortality rate and intellectual development, with a follow-up period ranging from 42 days to 6 months after birth. The outcome of mothers included postpartum emotional experience, breast milk secretion, postpartum hemorrhage, indicators of postpartum recovery, biochemical indicators and delivery information.
    Conclusion The implementation and evaluation of early essential newborn care technologies in China has become research highlights in recent years. There are still certain limitations in these articles in terms of research subjects, core measures and follow-up of maternal and infant health outcomes. It is necessary to further promote the standardized implementation of early essential newborn care technologies in different regions of China and continuously evaluate its short and long term impact on the health status of mothers and infants.

     

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