Maternal and Infant Outcomes Associated with Maternity Practices Related to COVID-19: The COVID Mothers Study
Por:
Bartick MC, Valdés V, Giusti A, Chapin EM, Bhana NB, Hernández-Aguilar MT, Duarte ED, Jenkins L, Gaughan J and Feldman-Winter L
Publicada:
1 mar 2021
Ahead of Print:
1 feb 2021
Resumen:
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.
Filiaciones:
Bartick MC:
Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
Valdés V:
Department of Family Medicine, School of Medicine, Catholic University, Santiago, Chile
Lactation Committee, Chilean Pediatric Society, Santiago, Chile
Giusti A:
National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità (National Institute of Health), Rome, Italy
Chapin EM:
Baby Friendly Initiatives, Italian National Committee for UNICEF, Rome, Italy
Bhana NB:
Cooper Medical School, Rowan University, Camden, New Jersey, USA
:
Unidad de Lactancia, Dr. Peset University Hospital, Valencia, Spain
Baby-Friendly Initiative (IHAN), Spain
Duarte ED:
Department of Maternal and Child Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil
Jenkins L:
BabyCafe USA, Melrose, Massachusetts, USA
Gaughan J:
Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
Feldman-Winter L:
Department of Pediatrics, Children's Regional Hospital, Cooper University Healthcare-Cooper Medical School of Rowan University, Camden, New Jersey, USA
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