Perinatal care during the COVID-19 pandemic in the state of Paraná.
Emily Marques Alves, Adriana Zilly, Lhays Emilly da Silva Moraes Ribeiro and 2 others
PMID 41983880WHAT IT FOUND
In Paraná maternity care during the pandemic, skin-to-skin contact was linked to Apgar scores of 7 and above at 1 and 5 minutes, and referral to a reference hospital was linked to the 1-minute score.
For vaginal births, no good practice showed this pattern.
Key findings
01In the whole sample, first-minute Apgar was associated with referral to a reference hospital, and first- and fifth-minute Apgar were associated with skin-to-skin contact.
02Among women who had vaginal delivery, there was no association between Apgar and the good obstetric practices.
03For cesarean section, first-minute and fifth-minute Apgar were associated with connection to the reference hospital and skin-to-skin contact, and fifth-minute Apgar was associated with presence of a companion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional observational study, so it can show links between care practices and Apgar scores, not that one practice caused a better score. The paper states that 1,503 women were eligible and 327 were excluded for missing data, but it does not state the final number analysed. Data collection by different interviewers in several health regions led to incomplete or inconsistent records. The analysis looked at many obstetric practices and both 1-minute and 5-minute Apgar scores, so some reported p values, including p=0.053, need cautious reading. The study could not confirm whether cesarean sections occurred before labor. Non-pharmacological pain relief methods were not analyzed separately. Because several practices were analyzed together, the contribution of any single practice cannot be separated.
The easy way to misread this
Do not read the reported links as proof that skin-to-skin contact, referral to a reference hospital, or a companion caused Apgar scores of 7 and above. The study was cross-sectional and observational, and it analyzed several care practices together, so the contribution of any single practice cannot be separated. In vaginal deliveries, no good obstetric practice was associated with Apgar.