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% |