Management of infants born to mothers with SARS-CoV2 infection: a prospective observational study.

OBJECTIVES: To assess the clinical risk of mother-to-infant transmission of SARS-CoV2 and transmission during rooming in and breast feeding in infants born to mothers with COVID-19. DESIGN: Prospective observational study. SETTING: A large tertiary maternal and neonatal care centre based in the UAE. PARTICIPANTS: Infants born to mothers diagnosed to have COVID-19 at the time of delivery, born between 1 April and 15 June 2020. MAIN OUTCOME MEASURES: Rate of transmission of SARS-CoV2 from mother to infant (vertical or horizontal) while rooming in and breast feeding in hospital and post discharge and associated morbidity and mortality in the neonatal period. RESULTS: 73 infants were born to mothers with COVID-19 at the time of delivery. Two infants tested positive for SARS-CoV2 after birth-one had respiratory symptoms related to other causes and the other infant remained well. 57 of mother-infant dyads who were well enough, roomed in while in hospital and all were breast fed. All surviving infants were followed up by telephone at 2 weeks and 4 weeks (or from the patient record review if still on the Neonatal Intensive Care Unit. Majority of the discharged infants were still rooming in with mothers (95% at 2 weeks, 99% at 4 weeks) and still breast fed (99% at 2 weeks, 99% at 4 weeks). None of the infants developed any significant health issues or developed symptoms attributable to SARS-CoV2. CONCLUSIONS: The risk of mother-to-infant transmission of SARS-CoV2, vertically or horizontally, in the perinatal period is very low. Breast feeding and rooming in can be practised safely with adequate infection control precautions with negligible clinical risk to the infant.

Patient initiated home blood pressure recordings are accurate in hypertensive pregnant women.

OBJECTIVE: We undertook this study to determine the accuracy and reliability of patient initiated blood pressure measurement and recording. METHODS: We recruited 72 women from the antenatal hypertension clinic in a university teaching hospital. All were at high risk for preeclampsia and were asked to measure and record their blood pressure three times per day at home using a validated blood pressure device with an internal memory. RESULTS: From 979 measurements taken only 28 (2.9% were inaccurate). The inaccurate readings were restricted to three women. On further questioning two women admitted that the device had been used by other family members thus making comparison with the memory impossible. Thus the true nonconcordance rate amongst participants was 1/72 (1.4%). CONCLUSIONS: We conclude that blood pressure recordings taken and documented by high-risk women at home are accurate. This allows more frequent measurements to be taken without the inconvenience of additional visits to hospital and may therefore lead to the earlier detection of preeclampsia.