Management of SARS-CoV-2-positive mothers and their offspring at the beginning of the COVID-19 pandemic
Keywords:COVID-19, newborn, pandemic, patient safety, SARS-CoV-2
Introduction: The uncertainty in SARS-CoV-2 modes of transmission, particularly regarding vertical and peripartum transmission, led national and international organizations to recommend (although not unanimously) the separation of newborns and mothers.
Material and Methods: To characterize the management of offspring of confirmed/suspected SARS-CoV-2-positive mothers in the postpartum, an online questionnaire was sent to Portuguese Pediatric and Neonatology heads of department of the Portuguese National Health Service during April and May, 2020.
Results: Twenty-five out of forty-four questionnaires were retrieved and included in the study. Results showed that healthcare workers (HCWs) wore FFP2 masks and face shield/goggles in 88% of hospitals while assisting in the delivery of offspring of confirmed/suspected SARS-CoV-2-positive mothers. In 8% of hospitals, mothers were allowed to have a labor partner. Newborns were separated from their mothers in 56% of hospitals and were not breastfed in 68%. Five newborns (4%) tested positive for SARS-CoV-2 infection in a universe of 114 mothers with positive SARS-CoV-2 test. Newborn SARS-CoV-2 testing was performed with adequate swabs in 64% of hospitals, but the method employed varied among hospitals. Discharge criteria were also variable, with 45% of hospitals requiring a negative test result of the caregiver.
Conclusion: The use of personal protective equipment by HCPs during delivery of offspring of confirmed/suspected SARS-CoV-2-positive mothers complied with international recommendations. Although vertical transmission is a rare event, this study uncovered a 4% rate of SARS-CoV-2-positive newborns from positive mothers during the considered period. The development of national recommendations has the potential to avoid disparity of procedures among hospitals.
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