SARS-CoV-2 in Pregnancy-A Retrospective Analysis of Selected Maternal and Fetal Laboratory Parameters.

Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate the effect of SARS CoV-2 infection on the mode of delivery, neonatal condition and selected maternal and fetal laboratory parameters. This was a single-center retrospective case-control study. This dataset was generated using electronic medical records collected by medical personnel. Two groups of patients, hospitalized between April, 2020 and February, 2021, were included in the study: study group (304)-pregnant women with SARS-CoV-2 and control group (N = 329)-healthy pregnant women or parturients. Mothers with a severe course of COVID-19 had higher activated partial thromboplastin-APTT (p = 0.02), C-Reactive Protein-CRP (p = 0.00) and procalcitonin (p = 0.032) levels as compared to pregnant women with mild or moderate course of the disease. Neonates born to SARS-CoV-2-infected mothers presented with worse condition at 1 and 5 minutes of life (p = 0.000 and 0.00, respectively) and lower Arterial Blood Gas-ABG pH scores (p = 0.016). Elective cesarean section is the most common mode of delivery for SARS-CoV2-infected mothers. Emergency cesarean sections are performed at earlier gestational age as compared to vaginal delivery and elective cesarean section. Lower Apgar scores were observed in neonates born to SARS-CoV-2-infected mothers who required oxygen therapy and whose procalcitonin levels were elevated. There is a relationship between more severe course of COVID-19 and APTT, as well as CRP and procalcitonin levels.

Neonatal breast-suckling skills in the context of lactation and peripartum hormonal changes and additional factors-a pilot study.

BACKGROUND: Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the glucocorticoids). The early postpartum period is crucial for both mother and newborn and has an impact on the lactation and breastfeeding process. METHODS: The study included 78 patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor stage. The levels of cortisol and prolactin in serum were assessed in these women during admission in labor, during the third labor stage, and on the second day postpartum. The levels of cortisol and prolactin in the umbilical cord serum were assessed immediately after cord clamping. The "Protocol for the assessment of breast-suckling skills" was used to assess the neonatal breast-suckling skills on the second day postpartum. Some additional parameters were evaluated in mothers via a telephone interview at three and six months postpartum. The study was conducted from January to August 2020, however the study was suspended during April-July 2020 due to the SARS-CoV-2 pandemic, which led to restrictions in the hospital limiting access to the hospital wards unless necessary. RESULTS: Early breastfeeding with skin-to-skin contact was associated with low levels of hormones, cortisol levels were lower in serum (p = 0.0108) and umbilical vein (p = 0.0273) in mothers who breastfed immediately after childbirth. At three months postpartum, 88% of the mothers who did not offer a pacifier to the child during the first few days of life breastfed the child naturally (p = 0.037), and at six months, 96% of those who did not offer a pacifier continued to breastfeed (p = 0.0008). Multiple, statistically significant correlations were observed between the variables assessed according to the "Protocol for the assessment of breast-suckling skills" and breastfeeding after three months. CONCLUSIONS: Breastfeeding immediately after childbirth, appropriate assessment of the breast-suckling skills of newborns, avoiding pacifiers and infant formula feeding, and offering support to new mothers in the early days after childbirth seem to be important factors for sustaining breastfeeding after three and six months of childbirth.

Women's Healthcare Services since the COVID-19 Pandemic Outbreak in Poland.

The COVID-19 pandemic had a direct impact on the extent of guaranteed healthcare services. Many gynecologists', obstetricians', and midwives' offices were closed, laboratories suspended their activities, the collection of necessary tests was delayed, and women had to wait much longer for test results than they had to previously. General women's healthcare prophylactic programs were suspended or delayed. In 2020, screening financed by public funds covered less than one-seventh of the female population in Poland. As medical teams, professionals, clinicians, and scientists, we have been facing a challenge to help, protect, and care for one of the most vulnerable population groups, pregnant women. A significant part of that challenge has been in preventing the spread of severe COVID-19, along with other preventable diseases, among women who are pregnant, who are in labor, or who have recently given birth.

Management of birth, postpartum care and breastfeeding - Polish recommendations and guidelines during SARS-CoV-2 pandemic.

SARS-CoV-2 pandemic is an unusual phenomenon in the modern obstetric and midwifery history. Hospital staff from the isolation wards were trained in the safety and proper use of the hazardous materials suit and the proper managing of the biohazard materials. We were not expecting the situation, so we started to create more restrictions than facilities for mothers giving birth. In the context of infection risk for the fetus, scientists still search for vertical transmission evidence, but available data are ambiguous, and more research is needed. Concerning the infant safety and to minimalize the infection risk for medical teams, the first Polish guidelines published by the national consultants in obstetrics, midwifery, neonatology, and perinatology regarding the safest formula of birth were as the following: in the case of confirmed SARS-CoV-2 infection, the cesarean section for epidemic indications should be considered, except in an advanced or rapid labor. In the lately updated consensus (14th May), it was written that because the risk of vertical and intranatal SARS-CoV-2 transmission seemed to be low, the SARS-CoV-2 infection was not the main indication to perform cesarean section for any longer. Regardless of the birth formula, the newborns are separated from their mothers immediately after the labor in Polish obstetrician hospitals. The Polish Lactation Study Centre, consociating International Breastfeeding Certified Lactation Consultant, recommends feeding the newborn with its own mother's milk, even if she is infected with SARS-CoV-2 and isolated from her infant.