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Grand Rounds

COVID-19 and Vertical Transmission: Best Practices and Subsequent Outcomes

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BACKGROUND AND PURPOSE:

  • Salvatore et al. (The Lancet, 2020) aimed to elucidate best practices regarding infection control and assess the risk for COVID-19 vertical transmission

METHODS:

  • Observational cohort study
  • Setting
    • Three New York City hospitals (March 22 to May 17, 2020)
  • Participants
    • All neonates born during the study period
    • Mothers positive for SARS-CoV-2 at delivery
  • Study design
    • Mothers could practice skin-to-skin care and breastfeed in the delivery room
      • Surgical masks and practice proper hand hygiene required
    • Neonates kept in a closed Giraffe isolette in the same room as mothers unless separation was medically necessary
    • Neonates tested for SARS-CoV-2 (RT-PCR) at 24 h, 5 to 7 days, and 14 days of life
    • Neonates Medically evaluated at 1 month of age by telemedicine

RESULTS:

  • A total of 1481 deliveries
    • Positive maternal COVID-19 rate: 8%
  • Positive neonatal COVID-19 rate
    • At 24 hours: 0%
    • At 5-7 days of life: 0%
    • At 14 days of life: 0%
  • Clinical practice
    • Roomed in: 83%
    • Still breastfeeding at 5-7 days: 78%
    • Symptomatic neonates: 0%

CONCLUSION:

  • Vertical transmission of COVID-19 unlikely if mothers and healthcare workers follow proper hygiene protocols (e.g. washing hands, mask wearing)
  • Neonates can room in with mothers and breastfeeding can occur with appropriate infant protection strategies

Learn More – Primary Sources:

Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study

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Related ObG Topics:

Vertical Transmission in Pregnancies with Confirmed COVID-19
COVID-19 Case Series: Pregnancy and Infant Outcomes
COVID-19 in Newborns: What are the Clinical Features and Outcomes?

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