This study investigates maternal and neonatal variables related to the early use of nasal CPAP in the delivery room in a public maternity.
This cross-sectional study included 161 newborns admitted to the delivery room at the Assis Chateaubriand Maternity of the Federal University of Ceará, Brazil, from August 2022 to August 2023. Data was collected from the participant's medical records using a specific data collection instrument from the QualiNeo Strategy. The maternal variables include maternal age, education level, type of delivery, antepartum rupture time of the ovular membrane (RAMO), and gestational diseases. The neonatal variables include birth weight, gestational age, length, head circumference, and neonatal respiratory distress. The study included data from newborns admitted to the delivery room who underwent nasal CPAP after birth, regardless of gestational age and birth weight. Newborns with clinical conditions that contraindicated the use of nasal CPAP after birth, those initially submitted to invasive mechanical ventilation, and those with improperly recorded study variables were excluded. Descriptive analysis was performed (%); Mean ± Standard Deviation (Median); Fisher's exact test; Chi-square test of independence for association variables (α=0.05) using the R Studio program. The study followed ethical recommendations and was approved by the Research Ethics Committee of the Maternity (Opinion number 6,779,662).
The study found that neonatal factors such as low birth weight (p 0.001), low gestational age (p 0.001), shorter length (p 0.001), smaller head circumference (p 0.001), and the presence of neonatal respiratory distress syndrome (RDS) (p 0.001) were associated with the need for nasal CPAP in the delivery room. The maternal variables, including maternal age, education level, type of delivery, antepartum rupture time of the ovular membranes (RAMO), and gestational diseases, did not demonstrate statistical significance.
Conclusion: The study revealed that factors such as low birth weight, lower gestational age, smaller head circumference, and neonatal respiratory distress syndrome at birth are related to the need for nasal CPAP in the delivery room, while maternal variables did not show a statistically significant association.
The present study showed that neonatal factors should be identified and monitored during the assessment of newborns. Understanding these factors helps in promoting and reinforcing best practices, implementing direct interventions, and improving neonatal care in delivery rooms.
Continuous Positive Airway Pressure (CPAP)
Delivery Rooms.
