[新型冠状病毒肺炎母亲所生婴儿的母婴同室、母乳喂养及新生儿随访]

[Rooming-in, Breastfeeding and Neonatal Follow-up of Infants Born to Mothers with COVID-19].

作者信息

Brito Isabel, Sousa Rita, Sanches Bruno, Franco João, Marcelino Susana, Costa Anselmo

机构信息

Serviço de Pediatria. Hospital Garcia de Orta. Almada. Portugal.

Serviço de Pediatria. Hospital Garcia de Orta. Almada. Unidade de Cuidados Intensivos Neonatais. Hospital Garcia de Orta. Almada. Portugal.

出版信息

Acta Med Port. 2021 Jun 30;34(7-8):507-516. doi: 10.20344/amp.15441.

DOI:10.20344/amp.15441

PMID:34851815

Abstract

INTRODUCTION

Due to growing evidence suggesting COVID-19 may have a benign course in the newborn, a number of guidelines supporting rooming-in and breastfeeding were developed. The main aim of the study was to assess the safety of this approach, through the risk of developing severe neonatal infection.

MATERIAL AND METHODS

Prospective observational study from April 2020 to February 2021 on the approach and neonatal follow-up of infants born to mothers with COVID-19 at the time of delivery in a hospital with advanced neonatal care, where rooming in and breastfeeding were promoted whenever possible. We collected data during hospital admission and over the phone during the neonatal period.

RESULTS

We included 77 infants born to mothers with COVID-19 (3.8% of newborns born during the time of study), median gestational age 39 weeks + 5 days and median birth weight 3270 g; 9% were born premature (versus 12% born premature among newborns born during the time of study). Rooming-in took place in all of them although 4% were briefly admitted to the Neonatal Intensive Care Unit; 88% were discharged home up to day three, 97% were breastfed at the time of discharge and 90% were still breastfed by the end of the neonatal period. We completed neonatal follow-up of 63 newborns, eight of them developed COVID-associated symptoms, three with need of medical evaluation; 40% had no medical assessment after being discharged. Out of 77, 5% of infants were infected with SARS-CoV-2 (total of four, one mild, three asymptomatic), with no significant differences during hospital stay or follow-up.

DISCUSSION

Neonatal infection was uncommon and mild, and there was no increase in prematurity. Rooming-in and breastfeeding were safe and should be promoted whenever clinically possible. Follow-up care after hospital discharge needs improvement.

CONCLUSION

Infants born to mothers with COVID-19 were safely roomed in with their mothers and exclusively breastfed.

摘要

引言

由于越来越多的证据表明新冠病毒感染在新生儿中可能呈良性病程，因此制定了一些支持母婴同室和母乳喂养的指南。本研究的主要目的是通过评估发生严重新生儿感染的风险，来评估这种方法的安全性。

材料与方法

2020年4月至2021年2月，在一家具备先进新生儿护理条件的医院，对分娩时母亲感染新冠病毒的婴儿的护理方式及新生儿随访情况进行前瞻性观察研究，尽可能推行母婴同室和母乳喂养。我们在婴儿住院期间及新生儿期通过电话收集数据。

结果

我们纳入了77名母亲感染新冠病毒的婴儿（占研究期间出生新生儿的3.8%），中位胎龄39周加5天，中位出生体重3270克；9%为早产儿（研究期间出生的新生儿中早产儿占12%）。所有婴儿均实现了母婴同室，尽管4%的婴儿曾短暂入住新生儿重症监护病房；88%的婴儿在出生后第三天出院回家，97%的婴儿在出院时进行了母乳喂养，90%的婴儿在新生儿期末仍在进行母乳喂养。我们完成了63名新生儿的随访，其中8名出现了新冠相关症状，3名需要医学评估；40%的婴儿出院后未进行医学评估。在77名婴儿中，5%感染了新冠病毒（共4例，1例症状轻微，3例无症状），住院期间或随访期间无显著差异。