Journal Article

Perinatal care in SARS-CoV-2 infected women: the lesson learnt from a national prospective cohort study during the pandemic in Italy

Sampaolo, Letizia, Salvatore, Michele Antonio, Mandolini, Donatella, Corsi Decenti, Edoardo, D’Aloja, Paola, Donati, Serena

2023

Overview

Background Despite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy. Methods A prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother–child separation at birth; rooming-in; breastfeeding. Logistic regression models including women’ socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases. Results During the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery ( n  = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section ( n  = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births. Conclusions Despite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Biostatistics / Birth / Breast feeding / Breastfeeding & lactation / Cesarean Section / Child / Childbirth & labor / Childbirth care / Clinical outcomes / COVID-19 / COVID-19 - epidemiology / Environmental Health / Epidemiology / Female / Health aspects / Humans / Immunization / Indicators / Infant, Newborn / Maternal and child access to health and healthcare / Maternal health services / Medicine / Medicine & Public Health / Neonates / Pandemics / Perinatal Care / Pregnancy / Pregnancy Complications, Infectious - epidemiology / Pregnancy Complications, Infectious - therapy / Pregnant women / Prenatal care / Prospective Studies / Public Health / Quality of care / Regression analysis / Regression models / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Skin / Skin-to-skin / Social aspects / Vaccine / Variation / Viral diseases / Women / Womens health