Neonatal Intensive Care Department, 12 de Octubre University Hospital, Madrid, Spain.
Breastfeeding Clinical Unit Dr Peset University Hospital, Valencia, Spain.
Int Breastfeed J. 2021 Aug 28;16(1):66. doi: 10.1186/s13006-021-00407-y.
Although the positive effects of good clinical quality standards in perinatal care and breastfeeding support for women, newborns and families have been already demonstrated, many of these practices were disrupted during the COVID-19 pandemic. The objective of this study was to analyse the impact of the COVID-19 pandemic on perinatal care and breastfeeding support practices offered by the Spanish maternity hospitals committed to the UNICEF Baby-friendly Hospital Initiative (BFHI), to women with and without COVID-19.
Implementation of perinatal practices was assessed by a cross-sectional survey conducted in May 2020 using an online questionnaire. Comparison with pre-pandemic situation and level of commitment to BFHI practices was performed.
Response rate was 50% (58/116). Mothers with COVID-19 suffered greater restrictions in the practices compared to women without COVID-19, with lower rates of companion of choice during labour (84% vs 100%; p = 0.003), skin-to-skin contact (32% vs 52%; p = 0.04), rooming-in (74% vs 98%; p < 0.001), companion of choice during hospital stay (68% vs 90%; p = 0.006), and breastfeeding support (78% vs 94%; p = 0.02). Practices were significantly less prevalent in COVID-19 mothers compared to pre-pandemic situation. A lower accompaniment rate was observed in non-COVID-19 group during delivery (24% vs 47.9%; p < 0.01). Hospitals with higher commitment to BFHI practices reported higher rates of skin-to-skin contact (45.2% vs 10.5%; p = 0.01) and rooming-in (83.9% vs 57.9%; p < 0.05) in COVID mothers. Fewer restrictions were observed in hospitals located in the regions where the pandemic hit harder. In these regions there was a significantly higher level of BFHI commitment of the hospitals, but no significant differences were observed in the average size of the hospital. All the practices suffered even more restrictions during the first weeks of the pandemic.
All mothers suffered restrictions in perinatal care during the COVID-19 pandemic. Women with COVID-19 infection suffered more restrictions in perinatal practices than women without infection. The degree of commitment to WHO-UNICEF perinatal quality standards, integrated into the BFHI, was associated with maintenance of good clinical practices.
尽管良好的临床质量标准和母乳喂养支持对围产期护理的积极影响已经得到证实，但在 COVID-19 大流行期间，许多实践受到了干扰。本研究旨在分析 COVID-19 对参与联合国儿童基金会婴儿友好医院倡议（BFHI）的西班牙妇产医院提供的围产期护理和母乳喂养支持实践的影响，以及对 COVID-19 阳性和阴性的妇女的影响。
2020 年 5 月，采用在线问卷进行了一项横断面调查，评估了围产期实践的实施情况，并与大流行前的情况和对 BFHI 实践的承诺程度进行了比较。
应答率为 50%（58/116）。与没有 COVID-19 的妇女相比，患有 COVID-19 的母亲在实践中受到更大的限制，选择伴侣陪伴分娩的比例较低（84%对 100%；p=0.003），皮肤接触（32%对 52%；p=0.04），母婴同室（74%对 98%；p<0.001），住院期间选择伴侣陪伴（68%对 90%；p=0.006），母乳喂养支持（78%对 94%；p=0.02）。COVID-19 母亲的实践明显少于大流行前。在非 COVID-19 组中，分娩时的陪伴率较低（24%对 47.9%；p<0.01）。对 BFHI 实践承诺较高的医院报告皮肤接触（45.2%对 10.5%；p=0.01）和母婴同室（83.9%对 57.9%；p<0.05）的比例较高。在疫情较重的地区，医院的限制较少。在这些地区，医院对 BFHI 的承诺程度明显较高，但医院的平均规模没有明显差异。所有实践在大流行的头几周都受到了更大的限制。
所有母亲在 COVID-19 大流行期间都受到围产期护理的限制。COVID-19 感染的妇女比没有感染的妇女在围产期实践中受到更多的限制。对纳入 BFHI 的世卫组织-儿基会围产期质量标准的承诺程度与良好临床实践的维持有关。
