Maternal and Infant Outcomes Associated with Maternity Practices Related to COVID-19: The COVID Mothers Study.
Breastfeed Med
; 16(3): 189-199, 2021 03.
Article
in English
| MEDLINE | ID: covidwho-1075426
ABSTRACT
Background:
Maternity care practices such as skin-to-skin care, rooming-in, and direct breastfeeding are recommended, but it is unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding.Methods:
We performed a retrospective cohort study of 357 mothers and their infants <12 months who had confirmed or suspected COVID-19. Subjects came from an anonymous worldwide online survey between May 4 and September 30, 2020, who were recruited through social media, support groups, and health care providers. Using multivariable logistic regression, Fisher's exact test, and summary statistics, we assessed the association of skin-to-skin care, feeding, and rooming-in with SARS-CoV-2 outcomes, breastfeeding outcomes, and maternal distress.Results:
Responses came from 31 countries. Among SARS-CoV-2+ mothers whose infection was ≤3 days of birth, 7.4% of their infants tested positive. We found a nonsignificant decrease in risk of hospitalization among neonates who roomed-in, directly breastfed, or experienced uninterrupted skin-to-skin care (p > 0.2 for each). Infants who did not directly breastfeed, experience skin-to-skin care, or who did not room-in within arms' reach, were significantly less likely to be exclusively breastfed in the first 3 months, adjusting for maternal symptoms (p ≤ 0.02 for each). Nearly 60% of mothers who experienced separation reported feeling "very distressed," and 29% who tried to breastfeed were unable. Presence of maternal symptoms predicted infant transmission or symptoms (adjusted odds ratio = 4.50, 95% confidence interval = 1.52-13.26, p = 0.006).Conclusion:
Disruption of evidence-based quality standards of maternity care is associated with harm and may be unnecessary.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pregnancy Complications, Infectious
/
Pregnancy Outcome
/
Infectious Disease Transmission, Vertical
/
COVID-19 Testing
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Female
/
Humans
/
Infant
/
Infant, Newborn
/
Pregnancy
Language:
English
Journal:
Breastfeed Med
Journal subject:
Nutritional Sciences
Year:
2021
Document Type:
Article
Affiliation country:
Bfm.2020.0353
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