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Isolation of Neonatal Extrahepatic Cholangiocytes
Published on: June 5, 2014
Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing
Sonam Mokha1, Chana Heintz2, Vikash Agrawal3
1Department of Pediatrics, University of California Davis, Sacramento, California, United States.
Insights
Social distancing during COVID-19 nearly tripled newborn readmissions for hyperbilirubinaemia. Younger mothers and increased breastfeeding highlight potential gaps in postpartum and lactation support.
Area of Science:
- Neonatal Health
- Public Health
- Epidemiology
Background:
- COVID-19 pandemic social distancing measures impacted healthcare access and social support systems.
- Resurgence of highly transmissible strains necessitates ongoing evaluation of restrictions and their effects on newborn health.
- Concerns regarding diminished postpartum support prompted an investigation into the correlation between social distancing and hyperbilirubinemia readmissions.
Purpose of the Study:
- To determine if social distancing guidelines during the COVID-19 pandemic correlated with increased rates of newborn readmission for hyperbilirubinemia.
- To assess the impact of social distancing on healthcare utilization for neonatal jaundice.
- To identify potential factors contributing to increased readmission rates during the pandemic.
Main Methods:
- A retrospective chart review was conducted for all hyperbilirubinemia readmissions between January 2018 and April 2020 in Western New York.
- Infant and maternal demographics, along with hospital course data, were collected for control and social distancing cohorts.
- Nineteen outpatient clinics were surveyed regarding the availability of lactation support services.
Main Results:
- Monthly readmissions for hyperbilirubinemia nearly tripled during the social distancing period (0.90 ± 0.91 to 2.63 ± 2.29 per 1000 births, P = 0.015).
- No significant differences were observed in disease severity, need for therapies, or length of hospital stay between cohorts.
- Mothers in the social distancing cohort were younger and exhibited higher rates of primiparity and exclusive breastfeeding compared to controls.
Conclusions:
- Social distancing measures were associated with a significant increase in newborn readmissions for hyperbilirubinemia.
- Younger maternal age, high rates of primiparity, and exclusive breastfeeding suggest potential inadequacy in social and lactation support.
- Proactive identification of at-risk mothers and expansion of remote lactation services are recommended to address challenges during pandemic waves.
Aim:
Social distancing guidelines implemented with the COVID-19 pandemic impacted health-care utilisation and disrupted critical social supports. Resurgence of highly transmissible strains has resulted in revisiting restrictions with potential impacts on newborn health. With concerns for inadequate post-partum support, we sought to determine if social distancing correlated with increased rates of readmission for hyperbilirubinaemia.
Methods:
Retrospective chart review identified all readmissions for hyperbilirubinaemia between 1/18 and 4/20 in Western New York. Infant/maternal demographics and data on hospital course were collected on control (1/1/18-31/1/20) and social distancing (1/2/20-30/4/20) cohorts. Nineteen outpatient clinics were surveyed regarding lactation support.
Results:
Monthly readmissions for hyperbilirubinaemia nearly tripled during social distancing (0.90 ± 0.91 vs. 2.63 ± 2.29 per 1000 births during early COVID, P = 0.015). Comparable severity of disease at readmission was observed with no difference in the need for therapies (phototherapy, intravenous immunoglobulin or exchange transfusion) or length of hospital stay. Mothers were younger (25.8 ± 3.3 vs. 31.3 ± 4.7 years; P = 0.005) with higher rates of primiparity and exclusive breastfeeding than national norms, however not significantly higher than controls in our small cohort (62.5 vs. 37.0% for primiparity; 87.5 vs. 81.5% for breastfeeding). Of 19 clinics surveyed, only six confirmed a telemedicine option for lactation support.
Conclusions:
Rates of readmission for hyperbilirubinaemia increased during social distancing. Younger maternal age with high rates of primiparity and exclusive breastfeeding raise concern for inadequate social and/or lactation support. Proactive identification of mothers at risk and expansion of remote lactation services may be indicated with recurrent waves of the pandemic.
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