Review of guidelines and recommendations from 17 countries highlights the challenges that clinicians face caring for neonates born to mothers with COVID-19.
- Yeo KT KK Women's & Children's Hospital, Singapore, Singapore.
- Oei JL School of Women's and Children's Health, University of New South Wales, Australia.
- De Luca D Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospitals, APHP, Paris, France.
- Schmölzer GM University of Alberta, Edmonton, AB, Canada.
- Guaran R NSW Perinatal Services Network, Sydney, NSW, Australia.
- Palasanthiran P Sydney Children's Hospital Network, Randwick, NSW, Australia.
- Kumar K Cloudnine Hospitals, Bangalore, India.
- Buonocore G Azienda Ospedaliera Universitaria Senese, Siena, Italy.
- Cheong J Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Owen LS Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Kusuda S Kyorin University, Tokyo, Japan.
- James J Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Lim G Ulsan University Hospital, Ulsan, South Korea.
- Sharma A Royal Hospital for Women, Randwick, NSW, Australia.
- Uthaya S Imperial College London and Chelsea and Westminster NHS Foundation Trust, London, UK.
- Gale C Imperial College London and Chelsea and Westminster NHS Foundation Trust, London, UK.
- Whittaker E Imperial College Healthcare NHS Trust, London, UK.
- Battersby C Imperial College London and Chelsea and Westminster NHS Foundation Trust, London, UK.
- Modi N Imperial College London and Chelsea and Westminster NHS Foundation Trust, London, UK.
- Norman M Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
- Naver L Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
- Giannoni E Department Mother-Woman-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Diambomba Y Mount Sinai Hospital, Toronto, ON, Canada.
- Shah PS Mount Sinai Hospital, Toronto, ON, Canada.
- Gagliardi L Ospedale Versilia, Lido di Camaiore, AUSL Toscana Nord Ovest, Pisa, Italy.
- Harrison M University of Cape Town, Cape Town, South Africa.
- Pillay S University of Cape Town, Cape Town, South Africa.
- Alburaey A Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
- Yuan Y Guangzhou Women and Children's Medical Center, Guangzhou, China.
- Zhang H Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- 2020-07-28
Published in:
- Acta paediatrica (Oslo, Norway : 1992). - 2020
English
AIM
This review examined how applicable national and regional clinical practice guidelines and recommendations for managing neonates born to mothers with COVID-19 mothers were to the evolving pandemic.
METHODS
A systematic search and review identified 20 guidelines and recommendations that had been published by May 25, 2020. We analysed documents from 17 countries: Australia, Brazil, Canada, China, France, India, Italy, Japan, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Sweden, Switzerland, the UK and the United States.
RESULTS
The documents were based on expert consensus with limited evidence and were of variable, low methodological rigour. Most did not provide recommendations for delivery methods or managing symptomatic infants. None provided recommendations for post-discharge assimilation of potentially infected infants into the community. The majority encouraged keeping mothers and infants together, subject to infection control measures, but one-third recommended separation. Although breastfeeding or using breastmilk was widely encouraged, two countries specifically prohibited this.
CONCLUSION
The guidelines and recommendations for managing infants affected by COVID-19 were of low, variable quality and may be unsustainable. It is important that transmission risks are not increased when new information is incorporated into clinical recommendations. Practice guidelines should emphasise the extent of uncertainty and clearly define gaps in the evidence.
This review examined how applicable national and regional clinical practice guidelines and recommendations for managing neonates born to mothers with COVID-19 mothers were to the evolving pandemic.
METHODS
A systematic search and review identified 20 guidelines and recommendations that had been published by May 25, 2020. We analysed documents from 17 countries: Australia, Brazil, Canada, China, France, India, Italy, Japan, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Sweden, Switzerland, the UK and the United States.
RESULTS
The documents were based on expert consensus with limited evidence and were of variable, low methodological rigour. Most did not provide recommendations for delivery methods or managing symptomatic infants. None provided recommendations for post-discharge assimilation of potentially infected infants into the community. The majority encouraged keeping mothers and infants together, subject to infection control measures, but one-third recommended separation. Although breastfeeding or using breastmilk was widely encouraged, two countries specifically prohibited this.
CONCLUSION
The guidelines and recommendations for managing infants affected by COVID-19 were of low, variable quality and may be unsustainable. It is important that transmission risks are not increased when new information is incorporated into clinical recommendations. Practice guidelines should emphasise the extent of uncertainty and clearly define gaps in the evidence.
- Language
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- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1111/apa.15495
- PMID 32716579
- Persistent URL
- https://folia.unifr.ch/global/documents/297614
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