BACKGROUND Neonatal pressure injuries (PIs) are typically considered postnatal events, however, case evidence shows that some lesions originate in utero and are already present at birth. Their recognition is clinically relevant because they may mimic other congenital dermatological conditions and require specific neonatal wound care strategies. Misclassification can delay appropriate care and distort quality metrics. A clear framework distinguishing prenatal from postnatal lesions is needed. METHODS A JBI-guided scoping review was designed in order to identify and synthesize the available evidence on pressure injuries of intrauterine origin, focusing on etiology, clinical presentation, and wound care management. A three-step search strategy was adopted and the PRISMA 2020 flow diagram was used to document the study selection process. DISCUSSION Five studies met the inclusion criteria (4 case reports and one case series), describing 7 neonates. Most cases involved preterm infants delivered by cesarean section, frequently associated with premature rupture of membranes. The main etiological factors were reduced or absent amniotic fluid and intrauterine compression, including one case related to intrauterine medical devices. According to the EPUAP/NPIAP classification, lesions ranged from Stage 1 to deep tissue injury. All cases were managed conservatively, with healing times ranging from 1 week to several months and favorable outcomes. IMPLICATIONS FOR RESEARCH AND PRACTICE Increased clinical awareness and early recognition of intrauterine PIs are essential. Further research is required to establish standardized definitions, improve diagnostic accuracy, and develop neonatal-specific, evidence-based wound care protocols.
PURPOSE This scoping review explores intersecting relationships among the concepts of postpartum depression, maternal-infant (dyadic) attachment (or bonding), and breastfeeding self-efficacy within postpartum populations and how often these concept relationships are examined among predominantly historically marginalized populations (non-White, low-income, low education level). BACKGROUND To address the ongoing public health concern of postpartum depression, we must understand its relationship with dyadic attachment and breastfeeding self-efficacy. DISCUSSION Four studies met inclusion criteria, examining the relationships between the concepts of postpartum depression, dyadic attachment, and breastfeeding self-efficacy. Because these 4 studies had heterogeneous study designs, study measures, and study time points, the exact nature of the relationship between these 3 concepts is difficult to parse. Furthermore, only 1 study evaluated these concepts in historically marginalized populations (low-income). Future research using rigorous study design approaches is warranted. IMPLICATIONS FOR RESEARCH AND PRACTICE While studies found a relationship between increased breastfeeding self-efficacy and increased dyadic attachment, mixed results remain regarding the relationships between postpartum depression and dyadic attachment or breastfeeding self-efficacy. Nevertheless, dyad-focused interventions have shown the potential to improve breastfeeding self-efficacy and dyadic attachment while reducing postpartum depression. The scoping review findings suggest that these concepts collectively need more research attention, given their potential effects on improving maternal-child dyadic outcomes.
Background: Implementing family-centered care (FCC) presents challenges to parental-healthcare provider partnership and collaboration in newborn care in neonatal intensive care units (NICUs). Aims: To explore NICU nurses' perceptions of FCC (respect, collaboration, and support) during the COVID-19 pandemic and to compare these between nurses working in secondary and tertiary/higher care settings. Methods: A multicenter, cross-sectional exploratory online survey design study was conducted to identify Thai NICU nurses' perceptions. The online survey of the Perceptions of Family-Centered Care-Staff (PFCC-S) was distributed via a Web page and professional networks between July and September 2022. Results: Of the 187 survey respondents, most NICU nurses worked in the NICU for less than 16 years and were employed in tertiary care/higher care settings in southern Thailand. There was a significant difference in perceptions of support subscale between NICU nurses in secondary (mean: 3.32, SD +/- 0.53) and tertiary/higher care settings (mean: 3.17, SD +/- 0.46) (P < .05). Conclusion: Despite the challenges of the visitation restriction of COVID-19 in Thailand, nurses' perceptions of the value of FCC were maintained. Relevance to Clinical Practice: Further research is recommended to investigate how FCC can be implemented where there is a lack of material and infrastructure resources and staff shortage.
Background:Relationships between parents and infants are essential for mitigating stressors encountered in neonatal intensive care units (NICUs) and are supported by parent presence and engagement.Purpose:The purpose of this study was to compare NICU parent and infant outcomes pre- and postimplementation of an intervention aimed at increasing parent presence and engagement in the NICU. This family-centered care intervention consisted of communicating specific guidelines for parent presence.Methods:Data related to parent presence, skin-to-skin care, and breastfeeding; parental stress; infant outcomes including weight gain, length of stay, feeding status at discharge, and stress; and unit-level outcomes were collected from a convenience sample of 40 NICU families recruited preimplementation and compared with data for 38 NICU families recruited postimplementation of specific guidelines for parent presence. To establish comparability of groups, infants were assigned scores using the Neonatal Medical Index.Results:Parent presence, engagement in skin-to-skin care, and breastfeeding rates were not significantly different between groups. Stress-related outcomes were significantly decreased in NICU mothers, fathers, and infants, and infant feeding outcomes were improved in the postintervention group.Conclusions:Specific guidelines for parent presence may represent an invitation for parents to engage with their NICU infants and may positively impact parent and infant stress.
Purpose:This study aims to examine the effect of paternal skin-to-skin contact on breastfeeding after cesarean section.Background:Skin-to-skin contact can be used to strengthen breastfeeding in newborns.Methods:The study was conducted between April 2023 and August 2023 in the obstetrics clinic of a hospital in a province in eastern Turkey, with a total of 126 postpartum women who had cesarean sections. A socio-demographic characteristics introduction form, a questionnaire on skin-to-skin contact and breastfeeding process, and the LATCH Breastfeeding Assessment Tool were used to collect research data.Results:The time to initiate breastfeeding was determined as 67.54 +/- 10.69 minutes in the skin-to-skin contact group and 86.38 +/- 35.14 minutes in the control group. The mean LATCH score of postpartum women in the skin-to-skin contact group was 8.13 +/- 1.27, while the mean LATCH score of mothers in the control group was 6.13 +/- 1.69. Statistically significant differences were found between the groups in terms of time to initiate breastfeeding, postpartum women's first breastfeeding durations, time for the newborn to latch onto the breast, babies' first latch-on behavior, swallowing movement during sucking, behaviors after feeding, supplementary food intake, postpartum LATCH score, and LATCH score at discharge.Conclusions:The study concluded that skin-to-skin contact applied through fathers after cesarean section has a positive effect on breastfeeding behaviors.Implications for Practice and Research:As healthcare professionals, it is recommended that fathers be informed about skin-to-skin contact during the antenatal period, encouraged for skin-to-skin contact in the postpartum process, and that hospital policy health policies include policies that encourage fathers' active participation in the postpartum process.
