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Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study
- Source :
- The Lancet Child & Adolescent Health, The Lancet. Child & Adolescent Health, Journal of Paediatrics and Child Health
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Summary Background The risk of vertical and perinatal transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, which causes COVID-19), the most appropriate management, and the neonate's risk of developing COVID-19 during the perinatal period are unknown. Therefore, we aimed to elucidate best practices regarding infection control in mother–newborn dyads, and identify potential risk factors associated with transmission. Methods In this observational cohort study, we identified all neonates born between March 22 and May 17, 2020, at three New York Presbyterian Hospitals in New York City (NY, USA) to mothers positive for SARS-CoV-2 at delivery. Mothers could practice skin-to-skin care and breastfeed in the delivery room, but had to wear a surgical mask when near their neonate and practice proper hand hygiene before skin-to-skin contact, breastfeeding, and routine care. Unless medically required, neonates were kept in a closed Giraffe isolette in the same room as their mothers, and were held by mothers for feeding after appropriate hand hygiene, breast cleansing, and placement of a surgical mask. Neonates were tested for SARS-CoV-2 by use of real-time PCR on nasopharyngeal swabs taken at 24 h, 5–7 days, and 14 days of life, and were clinically evaluated by telemedicine at 1 month of age. We recorded demographics, neonatal, and maternal clinical presentation, as well as infection control practices in the hospital and at home. Findings Of 1481 deliveries, 116 (8%) mothers tested positive for SARS-CoV-2; 120 neonates were identified. All neonates were tested at 24 h of life and none were positive for SARS-CoV-2. 82 (68%) neonates completed follow-up at day 5–7 of life. Of the 82 neonates, 68 (83%) roomed in with the mothers. All mothers were allowed to breastfeed; at 5–7 days of life, 64 (78%) were still breastfeeding. 79 (96%) of 82 neonates had a repeat PCR at 5–7 days of life, which was negative in all; 72 (88%) neonates were also tested at 14 days of life and none were positive. None of the neonates had symptoms of COVID-19. Interpretation Our data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies. Funding None.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
media_common.quotation_subject
Heads Up
Pneumonia, Viral
Breastfeeding
Mothers
Article
Cohort Studies
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Pregnancy
Hygiene
030225 pediatrics
medicine
Developmental and Educational Psychology
Humans
Infection control
030212 general & internal medicine
Pediatrics, Perinatology, and Child Health
Pregnancy Complications, Infectious
Pandemics
media_common
SARS-CoV-2
business.industry
Transmission (medicine)
Infant, Newborn
COVID-19
medicine.disease
Infectious Disease Transmission, Vertical
United States
Surgical mask
Pediatrics, Perinatology and Child Health
Female
Observational study
Coronavirus Infections
business
Follow-Up Studies
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 23524642
- Database :
- OpenAIRE
- Journal :
- The Lancet Child & Adolescent Health
- Accession number :
- edsair.doi.dedup.....747358742b28d54b42d5acf5ef7410ca
- Full Text :
- https://doi.org/10.1016/s2352-4642(20)30235-2