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Variation in United States COVID-19 newborn care practices: results of an online physician survey.
Parker, Margaret G; Gupta, Arun; Healy, Helen; Peaceman, Aviel; Kerr, Stephen M; Heeren, Timothy C; Hudak, Mark L; Gupta, Munish.
  • Parker MG; Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 801 Albany St, Room 2010, Boston, MA, 02446, USA. margaret.parker@bmc.org.
  • Gupta A; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, USA.
  • Healy H; Division of Neonatology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
  • Peaceman A; Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 801 Albany St, Room 2010, Boston, MA, 02446, USA.
  • Kerr SM; Slone Epidemiology Center, Boston University School of Medicine, Boston, USA.
  • Heeren TC; Department of Biostatistics, Boston University School of Public Health, Boston, USA.
  • Hudak ML; Department of Pediatrics, University of Florida Health, University of Florida College of Medicine, Jacksonville, USA.
  • Gupta M; Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
BMC Pediatr ; 22(1): 55, 2022 01 21.
Article in English | MEDLINE | ID: covidwho-1643122
ABSTRACT

BACKGROUND:

Newborn care practices that best promote the health and well-being of mother-infant dyads after birth while minimizing transmission of COVID-19 were uncertain at the onset of the COVID-19 pandemic.

OBJECTIVE:

Examine variation in COVID-19 newborn care practices among U.S. birth hospitals and by hospital characteristics (U.S. census region, highest level of neonatal level of care, and Baby-Friendly hospital status). STUDY

DESIGN:

We surveyed physicians via American Academy of Pediatrics email listservs and social media between 5/26/2020-6/8/2020. Physicians identified the birth hospital in which they provided newborn care and their hospital's approach to obstetrical and newborn care related to COVID-19. Chi-square tests were used to examine variation in hospital practices by U.S. census region, highest level of neonatal care, and Baby-Friendly hospital status.

RESULTS:

Four hundred thirty three physicians responded from 318 hospitals across 46 states. Variation in care of SARS-CoV-2 positive mother-infant dyads was greatest for approaches to location of newborn care (31% separation, 17% rooming-in, and 51% based on shared-decision making), early skin-to-skin care (48% prohibited/discouraged, 11% encouraged, and 40% based on shared-decision making) and direct breastfeeding (37% prohibited/discouraged, 15% encouraged, and 48% based on shared-decision making). Among presumed uninfected dyads, 59% of hospitals discharged at least some mother-infant dyads early. We found variation in practices by U.S. census region.

CONCLUSION:

Approaches to newborn care and breastfeeding support for mother-infant dyads with positive SARS-CoV-2 testing differed across U.S. birth hospitals during the COVID-19 pandemic. Early discharge of presumed uninfected mother-infant dyads was common.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / COVID-19 Type of study: Diagnostic study / Observational study Limits: Child / Female / Humans / Infant / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03129-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / COVID-19 Type of study: Diagnostic study / Observational study Limits: Child / Female / Humans / Infant / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03129-0