NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Paediatric and Adolescent Medicine, University Hospital of North Norway, Tromso, Norway.
Pediatr Res. 2021 Mar;89(4):940-951. doi: 10.1038/s41390-020-0976-5. Epub 2020 Jun 15.
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.
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.
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.
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.
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. A detailed review of ad hoc guidelines is presented, similarities and differences are highlighted. We provide a broad overview of currently applied recommendations highlighting the need for international context-relevant coordination.
COVID-19 大流行威胁着全球新生儿健康。我们描述了目前针对 SARS-CoV-2 阳性母亲所生新生儿的国家和地方管理协议的现状。
来自六大洲新生儿重症监护病房的护理人员交流并比较了针对 SARS-CoV-2 阳性母亲所生新生儿的管理协议。数据收集于 2020 年 3 月 14 日至 21 日进行。我们重点关注了中央协议部分，包括分诊、卫生预防措施、分娩时的管理、喂养方案和探视政策。
来自 20 个国家的数据可用。在分析时，各国的疾病负担不同。在大多数国家，无症状婴儿可以与母亲在一起，并在卫生预防措施下进行母乳喂养。我们发现国家指南之间存在差异，特别是在分诊、个人防护设备使用、病毒检测和访客政策方面。地方协议与国家指南也存在差异。
在大流行开始时，缺乏针对 SARS-CoV-2 阳性母亲所生新生儿管理的循证指导，导致国家和地方指南的临时制定。合作者之间分享和讨论协议的合规性非常好，可能会导致对管理的更多共识，但未来的指导应该建立在高级别证据的基础上，而不是专家共识。
在 COVID19 大流行迅速爆发之际，所有国家都制定了管理有感染 COVID19 风险的婴儿的协议，不同地区之间存在一定程度的差异。我们详细审查了临时指南，突出了异同之处。我们提供了目前应用建议的广泛概述，强调了国际背景下协调的必要性。
