Abstract
Background
The COVID-19 pandemic threatens global newborn health. We describe the current state of national and local protocols for managing neonates born to SARS-CoV-2-positive mothers.
Methods
Care providers from neonatal intensive care units on six continents exchanged and compared protocols on the management of neonates born to SARS-CoV-2-positive mothers. Data collection was between March 14 and 21, 2020. We focused on central protocol components, including triaging, hygiene precautions, management at delivery, feeding protocols, and visiting policies.
Results
Data from 20 countries were available. Disease burden varied between countries at the time of analysis. In most countries, asymptomatic infants were allowed to stay with the mother and breastfeed with hygiene precautions. We detected discrepancies between national guidance in particular regarding triaging, use of personal protection equipment, viral testing, and visitor policies. Local protocols deviated from national guidance.
Conclusions
At the start of the pandemic, lack of evidence-based guidance on the management of neonates born to SARS-CoV-2-positive mothers has led to ad hoc creation of national and local guidance. Compliance between collaborators to share and discuss protocols was excellent and may lead to more consensus on management, but future guidance should be built on high-level evidence, rather than expert consensus.
Impact
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At the rapid onset of the COVID19 pandemic, all countries presented protocols in place for managing infants at risk of COVID19, with a certain degree of variations among regions.
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A detailed review of ad hoc guidelines is presented, similarities and differences are highlighted.
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We provide a broad overview of currently applied recommendations highlighting the need for international context-relevant coordination.
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Acknowledgements
In memory of our friends Enrico R. and Nicoletta M., and to all the victims of SARS-CoV-19, whose death represents an immeasurable loss for our world community; to their families; to our friends Marco Mantero, Luisa Napolitano, Francesca Orsenigo, and all our colleagues who fight on the frontline against the COVID-19 pandemic; to everybody who is joining our fight with their own means, at work or at home: they inspired us to join efforts for this collaborative neonatology project.
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A.L., C.K., J.P., J.A.F.Z., and C.C.R. developed the initial research question. All authors contributed in identifying knowledge resources and completing information on local and national guidance. A.L., together with C.K., J.P., J.A.F.Z., E.J.M., and C.C.R., produced the first draft of the manuscript. A.S.D. and F.M. contributed to concluding the analysis and manuscript. All collaborators were included on the completion of the manuscript.
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Lavizzari, A., Klingenberg, C., Profit, J. et al. International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic. Pediatr Res 89, 940–951 (2021). https://doi.org/10.1038/s41390-020-0976-5
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DOI: https://doi.org/10.1038/s41390-020-0976-5
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