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Observational Study
. 2021 Jun 30;34(7-8):507-516.
doi: 10.20344/amp.15441. Epub 2021 Jun 30.

[Rooming-in, Breastfeeding and Neonatal Follow-up of Infants Born to Mothers with COVID-19]

[Article in Portuguese]
Isabel Brito  1 , Rita Sousa  1 , Bruno Sanches  2 , João Franco  2 , Susana Marcelino  2 , Anselmo Costa  2
Affiliations
Free article
Observational Study

[Rooming-in, Breastfeeding and Neonatal Follow-up of Infants Born to Mothers with COVID-19]

[Article in Portuguese]
Isabel Brito et al. Acta Med Port. .
Free article

Abstract
in English, Portuguese

Introduction: Due to growing evidence suggesting COVID-19 may have a benign course in the newborn, a number of guidelines supporting rooming-in and breastfeeding were developed. The main aim of the study was to assess the safety of this approach, through the risk of developing severe neonatal infection.

Material and methods: Prospective observational study from April 2020 to February 2021 on the approach and neonatal follow-up of infants born to mothers with COVID-19 at the time of delivery in a hospital with advanced neonatal care, where rooming in and breastfeeding were promoted whenever possible. We collected data during hospital admission and over the phone during the neonatal period.

Results: We included 77 infants born to mothers with COVID-19 (3.8% of newborns born during the time of study), median gestational age 39 weeks + 5 days and median birth weight 3270 g; 9% were born premature (versus 12% born premature among newborns born during the time of study). Rooming-in took place in all of them although 4% were briefly admitted to the Neonatal Intensive Care Unit; 88% were discharged home up to day three, 97% were breastfed at the time of discharge and 90% were still breastfed by the end of the neonatal period. We completed neonatal follow-up of 63 newborns, eight of them developed COVID-associated symptoms, three with need of medical evaluation; 40% had no medical assessment after being discharged. Out of 77, 5% of infants were infected with SARS-CoV-2 (total of four, one mild, three asymptomatic), with no significant differences during hospital stay or follow-up.

Discussion: Neonatal infection was uncommon and mild, and there was no increase in prematurity. Rooming-in and breastfeeding were safe and should be promoted whenever clinically possible. Follow-up care after hospital discharge needs improvement.

Conclusion: Infants born to mothers with COVID-19 were safely roomed in with their mothers and exclusively breastfed.

Introdução: Dada a evidência crescente de maior benignidade da COVID-19 no recém-nascido, surgiram recomendações de promoção do alojamento conjunto e da amamentação. O principal objetivo do estudo foi avaliar a segurança dessa abordagem, através do risco de infeção neonatal grave.Material e Métodos: Estudo observacional prospetivo de abril 2020 a fevereiro 2021 da abordagem hospitalar e seguimento após a alta dos recém-nascidos de mãe com COVID-19 num hospital com apoio perinatal diferenciado, onde foram advogados o alojamento conjunto e amamentação, sempre que possível. Recolhemos os dados no internamento e em seguimento telefónico durante o período neonatal.Resultados: Incluímos 77 recém-nascidos de mãe com COVID-19 (3,8% do total de recém-nascidos), com medianas de idade gestacional 39 semanas e 5 dias e 2370 g de peso à nascença; destes, 9% nasceram pré-termos (versus 12% pré-termos no total de recém-nascidos). Todos estiveram em alojamento conjunto e 4% foram admitidos transitoriamente na Unidade de Cuidados Intensivos Neonatais; um total de 88% recém-nascidos tiveram alta até ao terceiro dia de vida, 97% tiveram alta sob aleitamento materno e 90% mantinham-no no fim do período neonatal. Dos 63 recém-nascidos com seguimento telefónico completo, oito tiveram sintomas compatíveis com COVID-19, três dos quais com observação médica. Em 40% dos casos não houve consulta médica de vigilância após a alta. Houve 5% recém-nascidos com COVID-19 (num total de quatro, registámos um quadro ligeiro e três assintomáticos), sem particularidades no internamento ou seguimento.Discussão: A infeção neonatal foi incomum, não houve quadros graves nem maior incidência de prematuridade. O alojamento conjunto e a amamentação foram práticas seguras, devendo ser promovidas desde que clinicamente possível. Destacamos que a vigilância de saúde após a alta necessita de ser melhorada.Conclusão: Os recém-nascidos de mãe com COVID-19 podem ser mantidos em alojamento conjunto e sob aleitamento materno exclusivo.

Keywords: Breast Feeding; COVID-19; Infant, Newborn; Portugal; Rooming-in Care; SARS-CoV-2.

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