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Published on: August 12, 2020
COVID-19: neonatal-perinatal perspectives
Alejandra Barrero-Castillero1,2, Kristyn S Beam1,2, Laura B Bernardini2
1Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Insights
The COVID-19 pandemic rarely infected newborns, with low transmission risk from mothers when precautions are used. Psychosocial impacts and racial disparities in care require attention for mothers and infants.
Area of Science:
- Neonatal care during the COVID-19 pandemic.
- Perinatal transmission of SARS-CoV-2.
- Maternal-newborn health and infectious diseases.
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, severely impacted adults, including pregnant women.
- Neonatal infections were rare, but understanding pathogenesis and transmission evolved.
- Guidelines for maternal-neonatal care changed due to incomplete knowledge.
Purpose of the Study:
- To provide a comprehensive overview of COVID-19 from a neonatal-perinatal perspective.
- To review basic science, care recommendations, and psychosocial aspects.
- To address ethical and racial/ethnic disparities in maternal-newborn care during the pandemic.
Main Methods:
- Literature review synthesizing current knowledge on COVID-19 in pregnancy and neonates.
- Analysis of evolving clinical guidelines and transmission data.
- Examination of psychosocial, ethical, and racial/ethnic considerations.
Main Results:
- Neonatal infection with SARS-CoV-2 is uncommon.
- The risk of perinatal/postnatal transmission is low with appropriate precautions.
- The pandemic highlighted significant psychosocial and racial/ethnic disparities in care.
Conclusions:
- Maternal-to-neonatal SARS-CoV-2 transmission risk is minimal with recommended precautions.
- Addressing psychosocial implications and health disparities is crucial for maternal-newborn care.
- A multidisciplinary approach is needed for comprehensive care during infectious disease pandemics.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic, resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused severe and widespread illness in adults, including pregnant women, while rarely infecting neonates. An incomplete understanding of disease pathogenesis and viral spread has resulted in evolving guidelines to reduce transmission from infected mothers to neonates. Fortunately, the risk of neonatal infection via perinatal/postnatal transmission is low when recommended precautions are followed. However, the psychosocial implications of these practices and racial/ethnic disparities highlighted by this pandemic must also be addressed when caring for mothers and their newborns. This review provides a comprehensive overview of neonatal-perinatal perspectives of COVID-19, ranging from the basic science of infection and recommendations for care of pregnant women and neonates to important psychosocial, ethical, and racial/ethnic topics emerging as a result of both the pandemic and the response of the healthcare community to the care of infected individuals.
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