Types and design

This is a cross-sectional study, with retrospective collection of data recorded in the medical records of newborns subjected to glycemic control in the first 48 hours of life.

Cross-sectional studies are useful for describing variables and their patterns. In this type of study, measurements are made in a single moment, with no follow-up period.

Sample design

The study was conducted in the Hospital aimed at teaching, research and assistance, and is a field of practical teaching for undergraduate students. and graduate studies in medicine, nursing, nutrition, psychology, pharmacy, obstetrics, and speech therapy.

The criteria adopted for admission to the unit are as follows:

• You do not need oxygen therapy, intravenous therapy, and continuous monitoring of heart rate, blood pressure, and oximetry;
• Have an APGAR index in the fifth minute of life greater than or equal to five;
• Weight equal to or greater than 2000 grams
• Absence of malformations and serious syndromes.

The following maternal conditions prevent you from staying in the study. 

• Eclampsia or pre-eclampsia;
• Psychological changes;
• Donation of RN;
• Infectious diseases that need isolation;
• Exhaustion due to prolonged labor (LT).

During this period, 1,586 newborns were admitted to the unit, of which 384 were subjected to blood glucose control in the first 48 hours of life.

Data collection techniques and procedures

The data collection instrument is made up of two parts, the first, referring to maternal data and the second, aimed at recording data on the newborn.

The first part included the registration of maternal data:

• Identification data of the maternal medical history, containing the registration or attendance number; 
• Maternal characterization data. 
• Sociodemographic: color, age, education, marital status, paid activity;
• Obstetrician: number of pregnancies and parity;
• Health conditions during pregnancy: prenatal care, place of birth, prenatal care, number of consultations, smoking, alcoholism and use of illicit drugs, diagnosis of gestational diabetes, use of oral hypoglycemic agents, diagnosis of hypertension, anti-hypertensive during pregnancy, other complications during pregnancy;

Regarding delivery assistance: continuous intravenous administration and intermittent glucose during labor / delivery; fasting during labor; anesthesia at delivery and type of anesthesia, type of delivery and length of stay in labor;

Lactation: positioned to breastfeed in the delivery room, presence of colostrum upon admission to the air conditioning unit, type of nipple, nipple lesions in the first 24 hours after delivery;

• Newborn data 

Identification: medical record number, date of birth, sex and color; 

Anthropometric: birth weight, gestational age by weight versus gestational age classification method;

Referring to hypoglycemia: manifestation of signs related to hypoglycemia in the first 48 hours of life, capillary blood glucose values, frequency of collection of capillary blood glucose performed in the first 48 hours of life, duration of achievement of capillary blood glucose, intervention to increase the value capillary blood glucose.

Infant feeding: time of suction and suction to the mother’s breast in the delivery room, suction to the mother’s breast in the first two hours of life, suction to the mother’s breast between 2 and 6 hours after admission to the air conditioning unit and pattern suction on the maternal breast;

Interventions: offer milk formula, transfer the newborn to the neonatal unit to start treatment with an intravenous infusion of glucose solution.

Data processing and analysis 

The survey on the number of newborns admissions in the selected period was carried out by the newborns income book, where information on the date, type of delivery, time of birth, number of maternal records and information on the procedures to be performed with the newborn, such as: prescription of capillary glycemic control, gastric lavage, neonates with contraindication to breastfeeding until confirmation of the result of the maternal HIV test, among other observations. 

Another document consulted to identify newborns subjected to capillary glycemic control was the event report in which nurses register newborns with capillary glycemic control in the day, afternoon and night shifts, including those at those who were not prescribed glycemic control but who presented signs related to transient neonatal hypoglycemia and control was started.

For the numbers of the maternal clinical history, an electronic query was made in the terminal of the unit to the patient’s system, software installed in the institution, through which the numbers of the medical history of the newborns were accessed.

Ethical aspects

For the present study, the explicit informed permission of the mothers / fathers of the newborn children will be obtained.