Management of newborns exposed to mothers with confirmed or suspected COVID-19

There is limited information about newborns with confirmed or suspected COVID-19. Particularly in the hospital after delivery, clinicians have refined practices in order to prevent secondary infection. While guidance from international associations is continuously being updated, all facets of care o...

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Bibliographic Details
Published in:	Journal of perinatology Vol. 40; no. 7; pp. 987 - 996
Main Authors:	Amatya, Shaili, Corr, Tammy E., Gandhi, Chintan K., Glass, Kristen M., Kresch, Mitchell J., Mujsce, Dennis J., Oji-Mmuo, Christiana N., Mola, Sara J., Murray, Yuanyi L., Palmer, Timothy W., Singh, Meenakshi, Fricchione, Ashley, Arnold, Jill, Prentice, Danielle, Bridgeman, Colin R., Smith, Brandon M., Gavigan, Patrick J., Ericson, Jessica E., Miller, Jennifer R., Pauli, Jaimey M., Williams, Duane C., McSherry, George D., Legro, Richard S., Iriana, Sarah M., Kaiser, Jeffrey R.
Format:	Journal Article
Language:	English
Published:	New York Nature Publishing Group US 01-07-2020 Nature Publishing Group
Subjects:	692/699/255 692/699/255/2514 Algorithms Betacoronavirus - isolation & purification Breast feeding China Coronavirus Infections - diagnosis Coronavirus Infections - epidemiology Coronavirus Infections - therapy Coronaviruses COVID-19 Customs Development and progression Earthquakes Evidence-Based Practice Female Health care facilities Humans Infant Care - methods Infant Care - organization & administration Infant, Newborn Infants (Newborn) Infection Infection control Infectious Disease Transmission, Vertical Medicine Medicine & Public Health Neonates Newborn babies Pandemics Pediatric Surgery Pediatrics Phototherapy Pneumonia, Viral - diagnosis Pneumonia, Viral - epidemiology Pneumonia, Viral - therapy Postnatal Care - organization & administration Practice Guidelines as Topic Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - virology Protective equipment Review Review Article SARS-CoV-2 Secondary infection Steroid hormones Steroids Telemedicine Triage - methods Triage - organization & administration China
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Summary:	There is limited information about newborns with confirmed or suspected COVID-19. Particularly in the hospital after delivery, clinicians have refined practices in order to prevent secondary infection. While guidance from international associations is continuously being updated, all facets of care of neonates born to women with confirmed or suspected COVID-19 are center-specific, given local customs, building infrastructure constraints, and availability of protective equipment. Based on anecdotal reports from institutions in the epicenter of the COVID-19 pandemic close to our hospital, together with our limited experience, in anticipation of increasing numbers of exposed newborns, we have developed a triage algorithm at the Penn State Hospital at Milton S. Hershey Medical Center that may be useful for other centers anticipating a similar surge. We discuss several care practices that have changed in the COVID-19 era including the use of antenatal steroids, delayed cord clamping (DCC), mother–newborn separation, and breastfeeding. Moreover, this paper provides comprehensive guidance on the most suitable respiratory support for newborns during the COVID-19 pandemic. We also present detailed recommendations about the discharge process and beyond, including providing scales and home phototherapy to families, parental teaching via telehealth and in-person education at the doors of the hospital, and telehealth newborn follow-up.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	0743-8346 1476-5543 1476-5543
DOI:	10.1038/s41372-020-0695-0