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Table 1 COVID-19 Related Hospital Care Practices Among Mothers with Healthy, Term Infants Among US Birth Hospitals

From: Variation in United States COVID-19 newborn care practices: results of an online physician survey

Overall, n (%)

N (%)

95% CI

318 (100%)

Obstetric and Delivery Practices

Testing of Women Anticipated to Deliver

  Universal testing

235 (73.9%)

68.7%, 78.6%

  Testing based on signs and symptoms

68 (21.4%)

17.0%, 26.3%

  Testing not routinely available for pregnant women

3 (0.9%)

0.2%, 2.7%

  Other1

10 (3.1%)

1.5%, 5.7%

PPE for COVID-19 positive women delivering vaginally (check all that apply)

  N95

305 (95.9%)

93.1%, 97.8%

  Regular Surgical Mask

17 (5.3%)

3.1%, 8.4%

  Eye protection

310 (97.5%)

95.1%, 98.9%

  Cap

206 (64.8%)

59.3%, 70.0%

  Gown

305 (95.9%)

93.1%, 97.8%

  Gloves

310 (97.5%)

95.1%, 98.9%

Support persons for pregnant women on Labor and Delivery

  No support persons

2 (0.6%)

0.1%, 2.3%

  Only 1 support person

311 (97.8%)

95.5%, 99.1%

  2 or more support persons

3 (0.9%)

0.2%, 2.7%

Approach to testing asymptomatic support persons of COVID positive mothers

  Not offered or required

250 (78.6%)

73.7%, 83.0%

  Offer some testing

41 (12.9%)

9.4%, 17.1%

  Required

24 (7.5%)

4.9%, 11.0%

Newborn Care Practices

Location of newborn care with COVID-19 Positive Mother

  Separate room from mother

97 (30.5%)

25.5%, 35.9%

  Same room as mother with precautions to maintain separation

55 (17.3%)

13.3%, 21.9%

  Same room as mother with no precautions

1 (0.3%)

0.0%, 1.7%

  Decisions based on shared decision making on a case-by-case basis

161 (50.6%)

45.0%, 56.3%

  Other2

3 (0.9%)

0.2%, 2.7%

Skin-to-skin care in first hour after birth with COVID-19 Positive Mother

  Prohibited

40 (12.6%)

9.1%, 16.7%

  Discouraged

114 (35.8%)

30.6%, 41.4%

  Encouraged with precautions

33 (10.4%)

7.3%, 14.3%

  Encouraged with no precautions

2 (0.6%)

0.1%, 2.3%

  Decisions based on shared decision making on a case-by-case basis

127 (39.9%)

34.5%, 45.6%

Delayed or timed cord clamping with COVID-19 Positive Mother

  Yes

207 (65.1%)

59.6%, 70.3%

  No

111 (34.9%)

29.7%, 40.4%

Delayed or timed cord clamping with non-COVID Positive Mother

  Yes

296 (93.1%)

89.7%, 95.6%

  No

22 (6.9%)

4.4%, 10.3%

Early baths (<4 hours) with COVID-19 Positive Mother

  Yes

260 (81.8%)

77.1%, 85.8%

  No

58 (18.2%)

14.2%, 22.9%

Early baths (<4 hours) with non-COVID-19 Positive Mother

  Yes

25 (7.9%)

5.2%, 11.4%

  No

293 (92.1%)

88.6%, 94.8%

Approach to direct breastfeeding with COVID-19 Positive Mother

  Prohibited

15 (4.7%)

2.7%, 7.7%

  Discouraged, but permitted if family strongly desires

101 (31.8%)

26.7%, 37.2%

  Encouraged with precautions

49 (15.4%)

11.6%, 19.9%

  Decisions based on shared decision making on a case-by-case basis

153 (48.1%)

42.5%, 53.8%

Approach to expressed breast milk with COVID-19 Positive Mother (check all that apply)

  May be given by the mother with precautions

189 (59.4%)

53.9%, 64.9%

  May be given by another caregiver

245 (77.0%)

72.0%, 81.6%

  Discouraged

3 (0.9%)

0.2%, 2.7%

Approach to testing for an infant delivered by cesarean section with anticipated discharge on day 3 or 4 with a COVID-19 Positive Mother

  We generally do not test infants

31 (9.7%)

6.7%, 13.6%

  We do 1 test

93 (29.2%)

24.3%, 34.6%

  We do 2 tests

169 (53.1%)

47.5%, 58.7%

  More than 2 tests

3 (0.9%)

0.2%, 2.7%

  Unsure

19 (6.0%)

3.6%, 9.2%

  Other3

3 (0.9%)

0.2%, 2.7%

Time of first test (n = 265; respondents that reported 1, 2, or 2+ tests)

  Before 24 hours

12 (4.5%)

2.4%, 7.8%

  Around 24 hours

199 (75.1%)

69.4%, 80.2%

  Between 24-48 hours

42 (15.8%)

11.7%, 20.8%

  Around 48 hours or after 48 hours

9 (3.4%)

1.6%, 6.3%

Time of second test (n = 172; respondents that reported 2 or 2+ tests)

  Between 24-48 hours

7 (4.1%)

1.7%, 8.2%

  Around 48 hours

141 (82.0%)

75.4%, 87.4%

  After 48 hours

23 (13.4%)

8.7%, 19.4%

Discharge Processes for Infants with COVID-19 Positive Mothers

Hearing screening

  Have not changed process

244 (76.7%)

71.7%, 81.3%

  Changed process, but occurs during hospitalization

32 (10.1%)

7.0%, 13.9%

  Deferred until after discharge

39 (12.3%)

8.9%, 16.4%

Circumcisions

  Have not changed process

209 (65.7%)

60.2%, 70.9%

  Changed process, but occurs during hospitalization

53 (16.7%)

12.7%, 21.2%

  Deferred until after discharge

49 (15.4%)

11.6%, 19.9%

Hepatitis B

  Have not changed process

310 (97.5%)

95.1%, 98.9%

  Changed process, but occurs during hospitalization

4 (1.3%)

0.3%, 3.2%

  Deferred until after discharge

0 (0.0%)

--

Bilirubin checks

  Have not changed process

297 (93.4%)

90.1%, 95.9%

  Changed process, but occurs during hospitalization

18 (5.7%)

3.4%, 8.8%

  Deferred until after discharge

0 (0.0%)

--

Newborn screen

  Have not changed process

297 (93.4%)

90.1%, 95.9%

  Changed process, but occurs during hospitalization

18 (5.7%)

3.4%, 8.8%

  Deferred until after discharge

0 (0.0%)

--

Congenital heart disease screen

  Have not changed process

301 (94.7%)

91.6%, 96.9%

  Changed process, but occurs during hospitalization

13 (4.1%)

2.2%, 6.9%

  Deferred until after discharge

0 (0.0%)

--

Red reflex

  Have not changed process

306 (96.2%)

93.5%, 98.0%

  Changed process, but occurs during hospitalization

5 (1.6%)

0.5%, 3.6%

  Deferred until after discharge

3 (0.9%)

0.2%, 2.7%

Discharge Processes for non-COVID-19 Positive Mother-Infant Dyads

Timing of Discharge

  Timing hasn’t really changed

129 (40.6%)

35.1%, 46.2%

  Some dyads are discharged early

91 (28.6%)

23.7%, 33.9%

  Many dyads are discharged early

73 (23.0%)

18.4%, 28.0%

  All dyads discharge early unless a medical contraindication

24 (7.5%)

4.9%, 11.0%

  1. PPE personal protective equipment, L&D labor and delivery
  2. 1Other maternal testing answers were test based on symptoms OR a scheduled admission for delivery (n = 4), test for a scheduled admission (n = 4), “based on obstetrical practice” (n = 1), and “universal test at 38 weeks” (n = 1)
  3. 2Other location of newborn care answers were if mother asymptomatic and desires same room and if mother symptomatic separate rooms (n = 3)
  4. 3Other newborn testing answers were “test infant if symptomatic” (n = 1), decision made on case by case basis by provider (n = 1) or infection control (n = 1)