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1.
Semin Perinatol ; 45(5): 151431, 2021 08.
Article in English | MEDLINE | ID: covidwho-1454526

ABSTRACT

We discuss the use of tele-mental health in settings serving expectant parents in fetal care centers and parents with children receiving treatment in neonatal intensive care units within a pediatric institution. Our emphasis is on the dramatic rise of tele-mental health service delivery for this population in the wake of the onset of the COVID-19 pandemic in the U.S., including relevant practice regulations, challenges and advantages associated with the transition to tele-mental health in these perinatal settings.


Subject(s)
Delivery of Health Care , Intensive Care Units, Neonatal/trends , Mental Health/trends , Perinatal Care , Psychosocial Intervention , Telemedicine , COVID-19/epidemiology , COVID-19/prevention & control , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Female , Humans , Infection Control , Male , Parents/education , Parents/psychology , Perinatal Care/methods , Perinatal Care/organization & administration , Pregnancy , Prenatal Education/trends , Psychosocial Intervention/methods , Psychosocial Intervention/trends , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , United States/epidemiology
2.
BMC Pregnancy Childbirth ; 21(1): 587, 2021 Aug 26.
Article in English | MEDLINE | ID: covidwho-1371956

ABSTRACT

BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused ongoing challenges in health services worldwide. Despite the growing body of literature on COVID-19, reports on perinatal care in COVID-19 cases are limited. CASE PRESENTATION: We describe a case of severe acute respiratory distress syndrome (ARDS) in a 36-year-old G5/P2 pregnant woman with morbid obesity, confirmed severe acute respiratory syndrome coronavirus 2 infection, and fulminant respiratory failure. At 28+ 1 gestational weeks, the patient delivered an uninfected newborn. Using ImmunoCAP ISAC® technology, we found no immunoglobulin (Ig) M antibodies, suggesting that no mother-to-child viral transmission occurred during pregnancy or delivery. The maternal respiratory state improved rapidly after delivery; both maternal and neonatal outcomes were encouraging given the early gestational age and fulminant course of respiratory failure in our patient. CONCLUSIONS: The management of ARDS in pregnant women with COVID-19 is complex and requires an individualized, multidisciplinary approach, while considering maternal and fetal outcomes.


Subject(s)
COVID-19 , Cesarean Section/methods , Pneumonia, Viral , Pregnancy Complications, Infectious , Premature Birth , Respiratory Distress Syndrome , SARS-CoV-2/isolation & purification , Adult , COVID-19/complications , COVID-19/diagnosis , Female , Fetal Monitoring/methods , Gestational Age , Humans , Obesity, Morbid/diagnosis , Obesity, Morbid/physiopathology , Patient Care Team/organization & administration , Perinatal Care/methods , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/etiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/virology , Pregnancy Outcome , Premature Birth/etiology , Premature Birth/therapy , Respiration, Artificial/methods , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/physiopathology , Respiratory Distress Syndrome/therapy , Treatment Outcome
3.
JAAPA ; 34(8): 1-4, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1328939

ABSTRACT

ABSTRACT: This literature review assesses recent research highlighting the clinical characteristics of COVID-19 in pregnant patients and children. With better understanding, clinicians can offer risk assessment for those planning pregnancies amid the pandemic while using the best practice guidelines to reassure and assist pregnant patients throughout all spectrums of perinatal care, delivery, and postpartum care.


Subject(s)
COVID-19/psychology , Maternal Health/statistics & numerical data , Pregnancy Complications, Infectious/psychology , Pregnant Women/psychology , Prenatal Education/methods , Adaptation, Psychological , Female , Humans , Maternal Health Services , Perinatal Care/methods , Pregnancy , Pregnancy Complications, Infectious/prevention & control
4.
J Med Internet Res ; 23(6): e27132, 2021 06 04.
Article in English | MEDLINE | ID: covidwho-1242264

ABSTRACT

BACKGROUND: Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the United Kingdom, with outbreaks of disease, like the COVID-19 pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies. OBJECTIVE: The aim of this study was to conduct a mixed methods evaluation of the current state of perinatal mental health care provision in the United Kingdom, as well as users' (women and partners) and midwives' interest in using a digital mental health assessment throughout the perinatal period. METHODS: Women, partners, and midwives were recruited to participate in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Behavior model and summarized using descriptive statistics. RESULTS: A total of 829 women, 103 partners, and 90 midwives participated in the study. The provision of adequate perinatal mental health care support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The majority of respondents (n=781, 76.42%) expressed that they would feel comfortable or very comfortable using or recommending a digital mental health assessment. The majority of women and partners showed a preference for in-person consultations (n=417, 44.74%), followed by a blended care approach (ie, both in-person and online consultations) (n=362, 38.84%), with fewer participants preferring online-only consultations (n=120, 12.88%). Identified benefits and barriers mainly related to physical opportunity (eg, accessibility), psychological capability (eg, cognitive skills), and automatic motivation (eg, emotions). CONCLUSIONS: This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision making in the assessment of perinatal mental health concerns in the United Kingdom.


Subject(s)
Maternal Health Services , Mental Disorders/diagnosis , Perinatal Care/methods , Pregnancy Complications/diagnosis , Proof of Concept Study , Adult , Clinical Decision-Making , Female , Humans , Mental Health , Midwifery , Parturition , Pregnancy , Surveys and Questionnaires , United Kingdom
5.
J Perinat Neonatal Nurs ; 35(2): 105-109, 2021.
Article in English | MEDLINE | ID: covidwho-1201358

ABSTRACT

The Covid-19 pandemic has further illuminated the already existing need for methods of building resilience in perinatal caregivers. Using a scoping review approach, literature was examined to identify evidence-based models of resilience building in a cohort of perinatal clinicians. Research published between January 2015 and 2020 was evaluated using PubMed, CINAHL, EMBASE, and PsycINFO databases. Of the initial 3399 records reviewed, 2 qualitative studies met the inclusion criteria. Given the deleterious effects of Covid-19 on perinatal care providers, and in light of the paucity of available studies, personnel, time, and funding should be allocated for research to address these issues.


Subject(s)
Burnout, Professional , COVID-19 , Nurses, Neonatal/psychology , Occupational Stress , Perinatal Care/methods , Resilience, Psychological , Adaptation, Psychological , Burnout, Professional/prevention & control , Burnout, Professional/psychology , COVID-19/epidemiology , COVID-19/psychology , Crew Resource Management, Healthcare/methods , Female , Humans , Infant, Newborn , Midwifery , Mindfulness/methods , Obstetric Nursing/methods , Occupational Stress/prevention & control , Occupational Stress/rehabilitation , Pregnancy , SARS-CoV-2
6.
Clin Obstet Gynecol ; 64(2): 333-344, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1197047

ABSTRACT

Telehealth has expanded its reach significantly since its inception due to the advances in technology over the last few decades. Social determinants of health (SDOH) negatively impact the health of pregnant and postpartum women and need to be considered when deploying telehealth strategies. In this article, we describe telehealth modalities and their application to improve the SDOH that impact pregnancy and postpartum outcomes. Physicians and patients alike report satisfaction with telehealth as it improves access to education, disease monitoring, specialty care, prenatal and postpartum care. Ten years ago, we developed a program, Moms2B, to eliminate disparities in pregnancy outcomes for underserved women. Using a case study, we describe how Moms2B, devoted to improve the SDOH for pregnant women, transitioned from an in-person to a virtual format. Telehealth benefited women before the recent coronavirus disease 2019 pandemic and increasingly after emergency authorizations has allowed telehealth to flourish.


Subject(s)
Health Services Accessibility/organization & administration , Health Status Disparities , Healthcare Disparities , Perinatal Care/methods , Prenatal Care/methods , Social Determinants of Health , Telemedicine/methods , Female , Humans , Mobile Applications , Ohio , Outcome Assessment, Health Care , Perinatal Care/organization & administration , Poverty , Pregnancy , Pregnancy Outcome , Prenatal Care/organization & administration , Telemedicine/organization & administration
8.
BMC Pregnancy Childbirth ; 21(1): 171, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1112430

ABSTRACT

BACKGROUND: Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States. METHODS: A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions. RESULTS: During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare. After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status. Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes. Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants. CONCLUSIONS: To better support perinatal women's mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.


Subject(s)
Adaptation, Psychological , COVID-19 , Health Resources/organization & administration , Health Services Accessibility , Parenting/psychology , Perinatal Care , Prenatal Education/methods , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Female , Health Care Rationing/statistics & numerical data , Health Services Accessibility/standards , Health Services Accessibility/trends , Humans , Infant, Newborn , Mental Health/standards , Needs Assessment , Perinatal Care/methods , Perinatal Care/organization & administration , Perinatal Care/trends , Pregnancy , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/prevention & control , Telemedicine/methods , Telemedicine/organization & administration , United States
9.
Child Psychiatry Hum Dev ; 52(2): 200-204, 2021 04.
Article in English | MEDLINE | ID: covidwho-1095713

ABSTRACT

The COVID-19 pandemic exposed mothers to stress and social isolation during the pre- and post-natal periods. The deleterious effects of stress on both pregnant women and their infants are well documented, with research suggesting that effects are exacerbated by reduced social support. In this brief report, we summarize evidence linking stress and social isolation to negative outcomes for mothers and infants and present a conceptual model featuring inflammation as a driving mechanism. There is strong evidence that the coronavirus pandemic will affect mothers and infants through immune pathways that, in previous research, have been shown to link stress and social isolation during the pre- and post-natal periods with deficits in maternal mental health and infant well-being and development across developmental stages. We close with recommendations for novel research, policy changes, and integrated clinical care that can address these biological threats to infants and mothers while leveraging the anti-inflammatory effects of social support.


Subject(s)
COVID-19 , Child Development , Mothers/psychology , Perinatal Care , Social Isolation/psychology , Stress, Psychological , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Family Health/trends , Female , Forecasting , Humans , Infant, Newborn , Mental Health/trends , Perinatal Care/methods , Perinatal Care/standards , Pregnancy , Psychosocial Support Systems , SARS-CoV-2 , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology
10.
Obstet Gynecol ; 137(3): 487-492, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1066431

ABSTRACT

The use of telemedicine in U.S. perinatal care has drastically increased during the coronavirus disease 2019 (COVID-19) pandemic, and will likely continue given the national focus on high-value, patient-centered care. If implemented in an equitable manner, telemedicine has the potential to reduce disparities in care access and related outcomes that stem from systemic racism, implicit biases and other forms of discrimination within our health care system. In this commentary, we address implementation factors that should be considered to ensure that disparities are not widened as telemedicine becomes more integrated into care delivery.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/standards , Healthcare Disparities , Perinatal Care/methods , Telemedicine/economics , COVID-19/epidemiology , Female , Health Policy , Humans , Patient Acceptance of Health Care , Pregnancy , United States
11.
Epidemiol Prev ; 44(5-6 Suppl 2): 369-373, 2020.
Article in English | MEDLINE | ID: covidwho-1068159

ABSTRACT

During a pandemic, pregnancy and the postnatal period are complicated by multiple factors. On the one hand, worries about one's own health and the health of loved ones, in particular of the newborn child, can increase the risk of some mental disorders, such as depression and anxiety in the pregnant woman. On the other hand, as happened for the COVID-19 epidemic in Italy, given the need for physical distancing, the maintenance of the social and family network, so important for new parents in the perinatal period, is lacking. In addition, health services are forced to reorganize their offerings to ensure maximum safety for their operators and patients. This work proposes a model of screening and treatment aimed at identifying women at risk and providing them with effective and safe treatment.


Subject(s)
Anxiety/diagnosis , COVID-19/epidemiology , Depression/diagnosis , Mass Screening/organization & administration , Pandemics , Perinatal Care/organization & administration , Pregnancy Complications/diagnosis , Pregnant Women/psychology , Puerperal Disorders/diagnosis , SARS-CoV-2 , Adult , Anxiety/epidemiology , COVID-19/psychology , Depression/etiology , Depression/therapy , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Depression, Postpartum/therapy , Diagnostic Self Evaluation , Empowerment , Evidence-Based Medicine , Female , Follow-Up Studies , Humans , Italy/epidemiology , Perinatal Care/methods , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/psychology , Pregnancy Complications/therapy , Program Evaluation , Puerperal Disorders/epidemiology , Puerperal Disorders/psychology , Puerperal Disorders/therapy , Risk Factors , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology , Telemedicine
12.
Acta Obstet Gynecol Scand ; 100(7): 1219-1229, 2021 07.
Article in English | MEDLINE | ID: covidwho-1039800

ABSTRACT

INTRODUCTION: Evidence on perinatal mental health during the coronavirus disease 2019 (COVID-19) pandemic and its potential determinants is limited. Therefore, this multinational study aimed to assess the mental health status of pregnant and breastfeeding women during the pandemic, and to explore potential associations between depressive symptoms, anxiety, and stress and women's sociodemographic, health, and reproductive characteristics. MATERIAL AND METHODS: A cross-sectional, web-based study was performed in Ireland, Norway, Switzerland, the Netherlands, and the UK between 16 June and 14 July 2020. Pregnant and breastfeeding women up to 3 months postpartum who were older than 18 years of age were eligible. The online, anonymous survey was promoted through social media and hospital websites. The Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder seven-item scale (GAD-7), and the Perceived Stress Scale (PSS) were used to assess mental health status. Regression model analysis was used to identify factors associated with poor mental health status. RESULTS: In total, 9041 women participated (including 3907 pregnant and 5134 breastfeeding women). The prevalence of major depressive symptoms (EDS ≥ 13) was 15% in the pregnancy cohort and and 13% the breastfeeding cohort. Moderate to severe generalized anxiety symptoms (GAD ≥ 10) were found among 11% and 10% of the pregnant and breastfeeding women. The mean (±SD) PSS scores for pregnant and breastfeeding women were 14.1 ± 6.6 and 13.7 ± 6.6, respectively. Risk factors associated with poor mental health included having a chronic mental illness, a chronic somatic illness in the postpartum period, smoking, having an unplanned pregnancy, professional status, and living in the UK or Ireland. CONCLUSIONS: This multinational study found high levels of depressive symptoms and generalized anxiety among pregnant and breastfeeding women during the COVID-19 outbreak. The study findings underline the importance of monitoring perinatal mental health during pandemics and other societal crises to safeguard maternal and infant mental health.


Subject(s)
Anxiety , Breast Feeding , COVID-19 , Depression , Mental Health/statistics & numerical data , Perinatal Care , Stress, Psychological , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Breast Feeding/methods , Breast Feeding/psychology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Female , Humans , Ireland/epidemiology , Perinatal Care/methods , Perinatal Care/statistics & numerical data , Peripartum Period/psychology , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy Outcome/psychology , Psychiatric Status Rating Scales , Risk Factors , SARS-CoV-2 , Socioeconomic Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , United Kingdom/epidemiology
13.
An Pediatr (Engl Ed) ; 94(3): 173-178, 2021 Mar.
Article in Spanish | MEDLINE | ID: covidwho-1030114

ABSTRACT

INTRODUCTION: The impact of maternal SARS-CoV-2 infection and its risk of vertical transmission is still not well known. Recommendations from scientific societies seek to provide safety for newborns without compromising the benefits of early contact. The aim of the study is to describe characteristics and evolution of newborns born to mothers with SARS-CoV-2 infection, as well as the implemented measures following recommendations from the Sociedad Española de Neonatología. METHODS: Observational, prospective and single-center cohort study. A specific circuit was designed for mothers with SARS-CoV-2 infection and their newborns. Epidemiological and clinical data were collected. PCR were performed in newborns at delivery and at 14 days of age. RESULTS: 73 mothers and 75 newborns were included in the study. 95.9% of maternal infections were diagnosed during the third trimester of pregnancy, 43.8% were asymptomatic. Median gestational age was 38 weeks (IQR: 37-40), 25.9% of newborns required admission to Neonatology. Skin-to-skin mother care was performed in 68% of newborns, 80% received exclusive maternal or donated breast milk during hospital stay. No positive PCR results were observed in newborns at delivery, one case of positive PCR was observed in an asymptomatic neonate at 14 days of age. CONCLUSIONS: Risk of SARS-CoV-2 transmission is low when complying to the recommendations issued by Sociedad Española de Neonatología, allowing rooming-in and promoting breastfeeding.


Subject(s)
COVID-19 , Infectious Disease Transmission, Vertical/statistics & numerical data , Pregnancy Complications, Infectious , Adult , Breast Feeding , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19/transmission , COVID-19 Testing , Female , Humans , Infant Care/methods , Infant, Newborn , Male , Perinatal Care/methods , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Prospective Studies , Spain/epidemiology
14.
Disaster Med Public Health Prep ; 14(4): e19-e21, 2020 08.
Article in English | MEDLINE | ID: covidwho-989594

ABSTRACT

An outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. In this major outbreak, women are a special group, especially pregnant patients. Many problems faced by clinicians are still unclear and need to be solved. As the largest obstetrics and gynecology hospital in North China, here we summarize the diagnosis and treatment process and key points of obstetrics and gynecology patients in our hospital during the period of the COVID-19 pandemic, hoping to provide available information to inform care of obstetrics and gynecology patients.


Subject(s)
COVID-19/prevention & control , Disease Outbreaks/prevention & control , Obstetrics/methods , Perinatal Care/methods , COVID-19/epidemiology , COVID-19/therapy , China/epidemiology , Disease Outbreaks/statistics & numerical data , Humans , Obstetrics/trends , Pandemics , Perinatal Care/trends
15.
Eur J Pediatr ; 180(4): 1009-1031, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-921751

ABSTRACT

The clinical spectrum of the perinatal COVID-19 and prospective data on neonatal outcomes remains largely unexplored. Most of the existing literature is in the form of case series or single-centre experience. In this review, we aim to summarize available literature on the clinical spectrum of COVID-19 in neonates and mothers and suggest a practical approach towards management of clinical scenarios. This review explores the clinical characteristics and outcomes of COVID-19 in neonates born to mothers who were detected with the virus during the pregnancy. We conducted a comprehensive search of PubMed, Google Scholar and Cochrane Database of Systematic Review between November 2019 and June 2020 and screened articles related to perinatal COVID-19. This review included 786 mothers, among which 64% (504) were delivered by caesarian section. There were 3 still births and 107 (14%) were delivered preterm. Out of 793 neonates born, 629 neonates (79%) were tested after birth. The commonest symptom in neonates was respiratory distress. Respiratory support was needed in 60 neonates (7.6%), with 14 babies needing mechanical ventilation (1.8%), 25 needing non-invasive ventilation and 21 needing nasal oxygen. Only 35 of the 629 tested neonates (5.5%) were positive for COVID-19. Of the 35 positive neonates, 14 (40%) were symptomatic. The COVID-19 seems to have favourable neonatal outcomes. Majority of neonates are asymptomatic. Respiratory distress is the most common manifestation. What is known: •COVID-19 affects all ages. •Neonatal disease is usually mild. What is new: •Vertical transmission is a possible route of infection in neonates. •Breast milk and skin-to-skin contact are safe in COVID-19-infected mothers if performed with appropriate use of precautions such as hand and breast hygiene and masking.


Subject(s)
COVID-19/therapy , Perinatal Care/methods , Pregnancy Complications, Infectious/therapy , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Testing , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/diagnosis
16.
J Perinat Med ; 49(3): 263-268, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-902091

ABSTRACT

OBJECTIVES: Data regarding the pathogenesis and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, however, there's limited data in regard to maternal and neonatal outcomes. Therefore, we conducted a retrospective analysis of all pregnant women who tested positive for SARS-CoV-2 within Nuvance Health system. METHODS: Data were abstracted from the medical records of each patient and descriptive analysis was performed. Variables included demographics, COVID testing results, symptoms, management, labor course, neonatal information, and complications. RESULTS: Total of 40 patients were identified. Average age was 29.6 years old, 35% were Hispanic, and approximately one in three patients had comorbidities. Of the patients who had repeated testing, the average number of days between first positive test and negative test was 36.8 days (± 19.9 days). Three out of four women reported symptoms. Of the 40 pregnant women who were positive for SARS-CoV-2, 25 of them delivered. About 84% of the women delivered after 37 weeks. Twelve percent of the women delivered under 33 and 6/7 weeks. Most patients had vaginal deliveries (68%) and the remaining had cesarean deliveries. Neonatal outcomes included: mean 1 and 5 min Apgar scores of 8 and 8.8, respectively and the mean birth weight was 3212 g. Twenty neonates were tested for SARS-CoV-2 and were all found to be negative. CONCLUSIONS: Overall, with routine prenatal care and preventive measures, pregnant patients and neonates in our study had good outcomes. At this time, there appears to be no evidence of vertical transmission.


Subject(s)
COVID-19 Testing , COVID-19 , Infectious Disease Transmission, Vertical , Perinatal Care/methods , Pregnancy Complications, Infectious , Adolescent , Adult , Apgar Score , Birth Weight , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19/transmission , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , New York/epidemiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Pregnancy Outcome , Retrospective Studies , Treatment Outcome , Young Adult
19.
Indian Pediatr ; 57(12): 1166-1171, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-887892

ABSTRACT

The limited evidence on neonatal coronavirus disease (COVID-19) suggests that vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rare, and most neonates seem to acquire the infection postnatally through respiratory droplets and contact. Testing of neonates with perinatal or postnatal exposure to COVID-19 infection plays a vital role in the early diagnosis, management and institution of infection prevention measures thereby cutting off the chain of epidemic transmission. A recently concluded online neonatal COVID-19 conference conducted by the National Neonatology Forum (NNF) of India and a nationwide online survey pointed to substantial variation in neonatal testing strategies. We, herein, summarize the relevant literature about the incidence and outcomes of neonatal COVID-19 and call for a universal and uniform testing strategy for exposed neonates. We anticipate that the testing strategy put forth in this article will facilitate better management and safe infection prevention measures among all units offering neonatal care in the country.


Subject(s)
COVID-19 Testing/methods , COVID-19 , Disease Transmission, Infectious/prevention & control , Perinatal Care/methods , Pregnancy Complications, Infectious , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , COVID-19/transmission , Early Diagnosis , Female , Humans , Incidence , India/epidemiology , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Male , Neonatology/methods , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Time-to-Treatment
20.
Ginekol Pol ; 91(9): 564-568, 2020.
Article in English | MEDLINE | ID: covidwho-842389

ABSTRACT

The World Health Organization announced on 12 March 2020 a global pandemic of the new SARS-CoV-2 coronavirus causing COVID-19 disease associated with pneumonia and acute respiratory failure. SARS-CoV-2 has caused so far over 6.66 million recorded cases, of which 393,000 ended in death (as of June 1, 2020). Despite the demographic statistics of incidence, there is no current recording of cases in the group of pregnant or perinatal women. Changes occurring in the female body system during pregnancy also affect and alter the immune system, and as studies based on other viral respiratory infections have shown, the population of pregnant women is at risk of having a severe course of the disease. The aim of the study is to summarize current reports on the course of COVID-19 disease in a group of pregnant women and the possible impact of SARS-CoV-2 on the foetus and vertical transmission, taking into account changes occurring in the woman's immune system during pregnancy. Available advice and recommendations for antenatal and perinatal care of pregnant women during the pandemic period are also included.


Subject(s)
Coronavirus Infections , Delivery, Obstetric , Infection Control , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Perinatal Care , Pneumonia, Viral , Pregnancy Complications, Infectious , Betacoronavirus , Breast Feeding , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Delivery, Obstetric/methods , Delivery, Obstetric/trends , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Pandemics/prevention & control , Perinatal Care/methods , Perinatal Care/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Risk Factors , SARS-CoV-2
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