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Childbirth Care among SARS-CoV-2 Positive Women in Italy.

ABSTRACT: The new coronavirus emergency spread to Italy when little was known about the infection's impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother-child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother-newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother's milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to "better safe than sorry" care choices. An improvement of the peripartum care indicators was observed over time.

SUBMITTER: Donati S

PROVIDER: S-EPMC8074190 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Childbirth Care among SARS-CoV-2 Positive Women in Italy.

Donati Serena S Corsi Edoardo E Salvatore Michele Antonio MA Maraschini Alice A Bonassisa Silvia S Casucci Paola P Cataneo Ilaria I Cetin Irene I D'Aloja Paola P Dardanoni Gabriella G De Ambrosi Elena E Ferrazzi Enrico E Fieni Stefania S Franchi Massimo Piergiuseppe MP Gargantini Gianluigi G Iurlaro Enrico E Leo Livio L Liberati Marco M Livio Stefania S Locci Mariavittoria M Marozio Luca L Martini Claudio C Maso Gianpaolo G Mecacci Federico F Meloni Alessandra A Mignuoli Anna Domenica AD Patanè Luisa L Pellegrini Edda E Perotti Francesca F Perrone Enrica E Prefumo Federico F Ramenghi Luca L Rusciani Raffaella R Savasi Valeria V Schettini Sergio Crescenzo Antonio SCA Simeone Daniela D Simeone Serena S Spinillo Arsenio A Steinkasserer Martin M Tateo Saverio S Ternelli Giliana G Tironi Roberta R Trojano Vito V Vergani Patrizia P Zullino Sara S

International journal of environmental research and public health 20210416 8

The new coronavirus emergency spread to Italy when little was known about the infection's impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother-child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 Ju ...[more]

PMID: 33923642

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Project description:BackgroundDespite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy.MethodsA prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother-child separation at birth; rooming-in; breastfeeding. Logistic regression models including women' socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases.ResultsDuring the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery (n = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section (n = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births.ConclusionsDespite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies.

Dataset Information

Childbirth Care among SARS-CoV-2 Positive Women in Italy.

Publications

Childbirth Care among SARS-CoV-2 Positive Women in Italy.

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