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Management and Early Outcomes of Neonates Born to Women with SARS-CoV-2 in 16 U.S. Hospitals.
Congdon, Jayme L; Kair, Laura R; Flaherman, Valerie J; Wood, Kelly E; LoFrumento, Mary Ann; Nwaobasi-Iwuh, Eberechi; Phillipi, Carrie A.
  • Congdon JL; Department of Pediatrics, University of California San Francisco, San Francisco, California.
  • Kair LR; Department of Pediatrics, University of California, Davis, Sacramento, California.
  • Flaherman VJ; Department of Pediatrics, University of California San Francisco, San Francisco, California.
  • Wood KE; Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa.
  • LoFrumento MA; Department of Pediatrics, Columbia University, New York, New York.
  • Nwaobasi-Iwuh E; Department of Pediatrics, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey.
  • Phillipi CA; Department of Pediatrics, Oregon Health and Science University, Portland, Oregon.
Am J Perinatol ; 38(6): 622-631, 2021 05.
Article in English | MEDLINE | ID: covidwho-1135708
ABSTRACT

OBJECTIVE:

There is a paucity of evidence to guide the clinical care of late preterm and term neonates born to women with perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The objective of this case series is to describe early neonatal outcomes and inpatient management in U.S. hospitals. STUDY

DESIGN:

We solicited cases of mother-infant dyads affected by novel coronavirus disease 2019 (COVID-19) from the Better Outcomes through Research for Newborns (BORN) Network members. Using a structured case template, participating sites contributed deidentified, retrospective birth hospitalization data for neonates ≥35 weeks of gestation at birth with mothers who tested positive for SARS-CoV-2 before delivery. We describe demographic and clinical characteristics, clinical management, and neonatal outcomes.

RESULTS:

Sixteen U.S. hospitals contributed 70 cases. Birth hospitalizations were uncomplicated for 66 (94%) neonates in which 4 (6%) required admission to a neonatal intensive care unit. None required evaluation or treatment for infection, and all who were tested for SARS-CoV-2 were negative (n = 57). Half of the dyads were colocated (n = 34) and 40% directly breastfed (n = 28). Outpatient follow-up data were available for 13 neonates, all of whom remained asymptomatic.

CONCLUSION:

In this multisite case series of 70 neonates born to women with SARS-CoV-2 infection, clinical outcomes were overall good, and there were no documented neonatal SARS-CoV-2 infections. Clinical management was largely inconsistent with contemporaneous U.S. COVID-19 guidelines for nursery care, suggesting concerns about the acceptability and feasibility of those recommendations. Longitudinal studies are urgently needed to assess the benefits and harms of current practices to inform evidence-based clinical care and aid shared decision-making. KEY POINTS · Birth hospitalizations were uncomplicated for late preterm and term infants with maternal COVID-19.. · Nursery management of dyads affected by COVID-19 varied between hospitals.. · Adherence to contemporaneous U.S. clinical guidelines for nursery care was low.. · Breastfeeding rates were lower for dyads roomed separately than those who were colocated..
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Breast Feeding / Premature Birth / Term Birth / COVID-19 / Hospitalization Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: Am J Perinatol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Breast Feeding / Premature Birth / Term Birth / COVID-19 / Hospitalization Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: Am J Perinatol Year: 2021 Document Type: Article