2.50
Hdl Handle:
http://hdl.handle.net/10755/157290
Type:
Presentation
Title:
BUILDING CAPACTIY AMONG GUATEMALAN MIDWIVES TO ASSESS NEWBORN GESTATIONAL AGE
Abstract:
BUILDING CAPACTIY AMONG GUATEMALAN MIDWIVES TO ASSESS NEWBORN GESTATIONAL AGE
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Thompson, Lisa M., RN, C-FNP, MSN, PhD
P.I. Institution Name:UCSF
Title:Assistant Professor
Contact Address:2 Koret Way, N405J, Box 0606, San Francisco, CA, 94143-0606, USA
Co-Authors:Amy Levi
BACKGROUND/PURPOSE/AIMS: In rural Guatemala, over 86% of indigenous women deliver at home, assisted by minimally trained traditional birth assistants (TBAs). Low birthweight (LBW, defined as birthweight less than 2,500 grams) was officially reported to be 12% in Guatemala (PAHO 2007), with approximately 22% of newborns not weighed at birth (UNICEF 2004). Birth weight measurement and gestational age assessment are critical elements in identifying LBW and in differentiating between LBW-preterm and LBW-IUGR. Here we report on the standardized training of Guatemalan TBAs to assess newborn gestational age and anthropometry and the predictors of low birth weight.
METHODS: In this cross-sectional comparison study conducted in August 2009, nine traditional midwives and one auxiliary nurse were selected from among 56 TBAs and auxiliary nurses who attended workshops conducted by two faculty and three midwifery students from UCSF. The ten women completed a 2-day training at the regional hospital in Capurro (4 physical and 2 neuromuscular maturity criteria) and New Ballard (6 physical and 6 neuromuscular maturity criteria) newborn gestational age assessment techniques as well as anthropometry measurements (head circumference, birth length and weight). Weight was measured using a SECA 334 digital infant scale to the nearest 10 grams. Length was measured using a SECA 210 measuring mat to the nearest 0.5 cm. A convenience sample of 43 infants was assessed at the hospital during the standardization sessions. After the training, 22 infants were assessed at home visits. Newborns were evaluated within 72 hours of birth.
RESULTS: Of the 65 babies that were evaluated, the LBW rate was 20.9% for infants born in the hospital and 54.5% for infants evaluated in their homes. The New Ballard score estimated that 53% of the infants were preterm, although the lowest gestational age was 34 weeks (+/- 2 weeks). In a multivariate regression model, four predictors (language spoken by mother, parity, male child, and New Ballard score in weeks) accounted for 27% of the variance in birthweight. Women who spoke Mam had babies that weighed 264 grams less than women who spoke Spanish (p<0.01). Weekly increments in New Ballard gestational age score accounted for an increase in infant weight of 74 grams (p <0.01). Each previous reported delivery contributed 37 grams (p=0.06) to child birthweight. Male children weighed 127 grams more than females although this difference was not statistically significant.
IMPLICATIONS: In Guatemala, LBW prevalence is underreported; our LBW rate of 32% is almost three times the national rate. Infants born to indigenous women at home are even more vulnerable, with over half of the infants weighing less than 2500 grams. With intensive training and close supervision, Guatemalan TBAs were able to assess gestational age using the New Ballard technique, which provides more precision when estimating newborn gestational age than the simplified Capurro method. Future research will extend training and standardization to help TBAs identify and refer infants at risk.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBUILDING CAPACTIY AMONG GUATEMALAN MIDWIVES TO ASSESS NEWBORN GESTATIONAL AGEen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157290-
dc.description.abstract<table><tr><td colspan="2" class="item-title">BUILDING CAPACTIY AMONG GUATEMALAN MIDWIVES TO ASSESS NEWBORN GESTATIONAL AGE</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Thompson, Lisa M., RN, C-FNP, MSN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">UCSF</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2 Koret Way, N405J, Box 0606, San Francisco, CA, 94143-0606, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lisa.thompson@nursing.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Amy Levi</td></tr><tr><td colspan="2" class="item-abstract">BACKGROUND/PURPOSE/AIMS: In rural Guatemala, over 86% of indigenous women deliver at home, assisted by minimally trained traditional birth assistants (TBAs). Low birthweight (LBW, defined as birthweight less than 2,500 grams) was officially reported to be 12% in Guatemala (PAHO 2007), with approximately 22% of newborns not weighed at birth (UNICEF 2004). Birth weight measurement and gestational age assessment are critical elements in identifying LBW and in differentiating between LBW-preterm and LBW-IUGR. Here we report on the standardized training of Guatemalan TBAs to assess newborn gestational age and anthropometry and the predictors of low birth weight.<br/>METHODS: In this cross-sectional comparison study conducted in August 2009, nine traditional midwives and one auxiliary nurse were selected from among 56 TBAs and auxiliary nurses who attended workshops conducted by two faculty and three midwifery students from UCSF. The ten women completed a 2-day training at the regional hospital in Capurro (4 physical and 2 neuromuscular maturity criteria) and New Ballard (6 physical and 6 neuromuscular maturity criteria) newborn gestational age assessment techniques as well as anthropometry measurements (head circumference, birth length and weight). Weight was measured using a SECA 334 digital infant scale to the nearest 10 grams. Length was measured using a SECA 210 measuring mat to the nearest 0.5 cm. A convenience sample of 43 infants was assessed at the hospital during the standardization sessions. After the training, 22 infants were assessed at home visits. Newborns were evaluated within 72 hours of birth.<br/>RESULTS: Of the 65 babies that were evaluated, the LBW rate was 20.9% for infants born in the hospital and 54.5% for infants evaluated in their homes. The New Ballard score estimated that 53% of the infants were preterm, although the lowest gestational age was 34 weeks (+/- 2 weeks). In a multivariate regression model, four predictors (language spoken by mother, parity, male child, and New Ballard score in weeks) accounted for 27% of the variance in birthweight. Women who spoke Mam had babies that weighed 264 grams less than women who spoke Spanish (p&lt;0.01). Weekly increments in New Ballard gestational age score accounted for an increase in infant weight of 74 grams (p &lt;0.01). Each previous reported delivery contributed 37 grams (p=0.06) to child birthweight. Male children weighed 127 grams more than females although this difference was not statistically significant.<br/> IMPLICATIONS: In Guatemala, LBW prevalence is underreported; our LBW rate of 32% is almost three times the national rate. Infants born to indigenous women at home are even more vulnerable, with over half of the infants weighing less than 2500 grams. With intensive training and close supervision, Guatemalan TBAs were able to assess gestational age using the New Ballard technique, which provides more precision when estimating newborn gestational age than the simplified Capurro method. Future research will extend training and standardization to help TBAs identify and refer infants at risk.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:44:19Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:44:19Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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