What Can Mothers & Infants Expect on Day 1
Test expecting women for coronavirus infection at hospital admission
Across the USA, the COVID-19 disease is radically altering medical care for pregnant women and their babies entering the world.
“In the last 6-weeks, our entire world that was known as being normal has completely turned around,” said Dr. Edith Cheng, division chief for maternal-fetal medicine at the University of Washington.
According to Kaiser news reporting on April 24, 2020, hospitals from Seattle to St. Louis are recommending separating infected mothers from their newborns for days, and asking the women to forgo the intimacy of skin-to-skin contact, and sometimes breastfeeding, to help prevent their infants from contracting the disease.
Separation runs counter to most birth plans — and opposite to the latest research on family-centered care.
But experts say it’s important to put protections in place, given the still-evolving understanding of the effects of COVID-19 during pregnancy and childbirth.
The actions are based on guidance from medical associations, until recent changes.
Officials with the Centers for Disease Control and Prevention had advised separation across the board until updating their guidance on April 4, 2020, to consider it case by case.
The revised CDC guidance has been updated to clarify the following:
- Considerations related to visitors and essential support persons to pregnant women who have known or suspected COVID-19 infection
- Prioritized testing of pregnant women with suspected COVID-19 at admission or who develop symptoms of COVID-19 during admission
- Isolation of infants with suspected COVID-19 from other healthy infants
- Determination of whether to keep a mother with known or suspected COVID-19 and her infant together or separated after birth on a case-by-case basis, using shared decision-making between the mother and the clinical team.
“Can babies be infected if the mother is infected at birth? The answer is yes, not commonly, but yes,” said Dr. Karen Puopolo, an associate professor of pediatrics at the University of Pennsylvania School of Medicine and co-author of the American Academy of Pediatrics (AAP) guidelines on COVID-19 and newborns.
The AAP published a listing for relevant FAQs at this link.
It’s not clear how many pregnant women have been infected with COVID-19 across the USA.
They accounted for just 2% of cases tallied in one early report.
A new study published in the NEJM on April 13, 2020, found 29/210 (13.8%) of all women from this New York City sample were asymptomatic and positive.
Furthermore, 29 of the 33 women who were found to be positive for SARS-CoV-2 at admission (87.9%), did not display any symptoms of COVID-19 disease at presentation.
The good news from this study was ‘there were no confirmed cases of COVID-19 detected in neonates upon initial testing on the first day of life.’
This new study’s findings indicate that expecting mothers living in a COVID-19 outbreak zone may not know they were infected with the new coronavirus.
SARS-CoV-2 pandemic news published by CoronavirusToday.