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Campbell-Yeo M, Bacchini F, Alcock L, Mitra S, MacNeil M, Mireault A, Beltempo M, Bishop T, Campbell DM, Chilcott A, Comeau JL, Dol J, Grant A, Gubbay J, Hughes B, Hundert A, Inglis D, Lakoff A, Lalani Y, Luu TM, Morton J, Narvey M, O’Brien K, Robeson P, Science M, Shah P, Whitehead L. Practice recommendations regarding parental presence in NICUs during pandemics caused by respiratory pathogens like COVID-19. Front Pediatr 2024; 12:1390209. [PMID: 38983460 PMCID: PMC11232356 DOI: 10.3389/fped.2024.1390209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/17/2024] [Indexed: 07/11/2024] Open
Abstract
Aim To co-create parental presence practice recommendations across Canadian NICUs during pandemics caused by respiratory pathogens such as COVID-19. Methods Recommendations were developed through evidence, context, Delphi and Values and Preferences methods. For Delphi 1 and 2, participants rated 50 items and 20 items respectively on a scale from 1 (very low importance) to 5 (very high). To determine consensus, evidence and context of benefits and harms were presented and discussed within the Values and Preference framework for the top-ranked items. An agreement of 80% or more was deemed consensus. Results After two Delphi rounds (n = 59 participants), 13 recommendations with the highest rated importance were identified. Consensus recommendations included 6 strong recommendations (parents as essential caregivers, providing skin-to-skin contact, direct or mothers' own expressed milk feeding, attending medical rounds, mental health and psychosocial services access, and inclusion of parent partners in pandemic response planning) and 7 conditional recommendations (providing hands-on care tasks, providing touch, two parents present at the same time, food and drink access, use of communication devices, and in-person access to medical rounds and mental health and psychosocial services). Conclusion These recommendations can guide institutions in developing strategies for parental presence during pandemics caused by respiratory pathogens like COVID-19.
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Affiliation(s)
- Marsha Campbell-Yeo
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | | | - Lynsey Alcock
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Souvik Mitra
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Morgan MacNeil
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Amy Mireault
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Marc Beltempo
- Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Tanya Bishop
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | | | | | - Jeannette L. Comeau
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Justine Dol
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Amy Grant
- Maritime SPOR SUPPORT Unit, Nova Scotia Health, Halifax, NS, Canada
| | - Jonathon Gubbay
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Brianna Hughes
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada
- Department of Nursing, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Amos Hundert
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Darlene Inglis
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | | | - Yasmin Lalani
- Canadian Premature Babies Foundation, Toronto, ON, Canada
- Humber River Health, Toronto, ON, Canada
| | - Thuy Mai Luu
- Département de Pédiatrie, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Jenna Morton
- Canadian Premature Babies Foundation, Toronto, ON, Canada
- Pickle Planet, Moncton, NB, Canada
| | - Michael Narvey
- Department of Pediatrics, Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Karel O’Brien
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Michelle Science
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Paediatrics, SickKids Hospital, Toronto, ON, Canada
| | - Prakesh Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Leah Whitehead
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
- Canadian Premature Babies Foundation, Toronto, ON, Canada
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Vila-Candel R, Martin-Arribas A, Castro-Sánchez E, Escuriet R, Martin-Moreno JM. Perinatal Outcomes at Birth in Women Infected and Non-Infected with SARS-CoV-2: A Retrospective Study. Healthcare (Basel) 2023; 11:2833. [PMID: 37957979 PMCID: PMC10648606 DOI: 10.3390/healthcare11212833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was declared as a pandemic and public health emergency on 11 March 2020 by the World Health Organization. Different clinical trials on the efficacy of mRNA vaccination have excluded pregnant women, leading to a lack of empirical evidence on the efficacy of the vaccine in this population. The aim of the study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at birth and adverse perinatal outcomes in infected and non-infected women from a university hospital in Spain. METHODS The data were obtained from electronic health records from 1 March 2020 to 28 February 2022. A bivariate descriptive analysis was performed, comparing women with and without confirmed SARS-CoV-2 infection during pregnancy using the chi-square test. A multivariate logistic regression was complementarily conducted to determine whether SARS-CoV-2 infection increases the risk of adverse obstetric and perinatal outcomes. RESULTS A total of 2676 women were divided into two groups: non-infected with SARS-CoV-2 (n = 2624) and infected with SARS-CoV-2 (n = 52). Infected women were primarily multiparous (p < 0.03) and had received an incomplete vaccination regimen (p < 0.001). A greater incidence of premature rupture of membranes (p < 0.04) was observed among the non-infected women. Pertaining to perinatal outcomes, there was a notable rise in NICU admissions (p < 0.014), coupled with an extended duration of stay (p < 0.04), for neonates born to infected mothers in comparison to their non-infected counterparts. CONCLUSION Although SARS-CoV-2 infection may pose significant risks to pregnant women and their infants, adverse obstetrical/puerperal outcomes do not significantly differ between women infected and non-infected to SARS-CoV-2 in our study. NICU admissions were higher for neonates born to infected mothers. Additionally, coronavirus disease 2019 vaccination during pregnancy is not associated with severe adverse perinatal outcomes.
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Affiliation(s)
- Rafael Vila-Candel
- Sciences Faculty, Universidad Internacional de Valencia-VIU, 46002 Valencia, Spain
- Department of Obstetrics and Gynecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
| | - Anna Martin-Arribas
- Ghenders Research Group, School of Health Sciences Blanquerna, Universitat Ramon Lull, 08025 Barcelona, Spain
| | - Enrique Castro-Sánchez
- College of Business, Arts, and Social Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Health Protection Research Unit, Healthcare-Associated Infections and Antimicrobial Resistance, Imperial College London, London SW7 2BX, UK
- Research Group on Global Health and Human Development, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Ramón Escuriet
- Ghenders Research Group, School of Health Sciences Blanquerna, Universitat Ramon Lull, 08025 Barcelona, Spain
- Catalan Health Service, Government of Barcelona, 08014 Barcelona, Spain
| | - Jose M Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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Adam AM, Popa RF, Vaduva C, Georgescu CV, Adam G, Melinte-Popescu AS, Popa C, Socolov D, Nechita A, Vasilache IA, Mihalceanu E, Harabor A, Melinte-Popescu M, Harabor V, Neagu A, Socolov R. Pregnancy Outcomes, Immunophenotyping and Immunohistochemical Findings in a Cohort of Pregnant Patients with COVID-19-A Prospective Study. Diagnostics (Basel) 2023; 13:diagnostics13071345. [PMID: 37046564 PMCID: PMC10092994 DOI: 10.3390/diagnostics13071345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
(1) Background: SARS-CoV-2 infection during pregnancy could determine important maternal and fetal complications. We aimed to prospectively assess placental immunohistochemical changes, immunophenotyping alterations, and pregnancy outcomes in a cohort of patients with COVID-19; (2) Methods: 52 pregnant patients admitted to a tertiary maternity center between October 2020 and November 2021 were segregated into two equal groups, depending on the presence of SARS-CoV-2 infection. Blood samples, fragments of umbilical cord, amniotic membranes, and placental along with clinical data were collected. Descriptive statistics and a conditional logistic regression model were used for data analysis; (3) Results: Adverse pregnancy outcomes such as preterm labor and neonatal intensive care unit admission did not significantly differ between groups. The immunophenotyping analysis indicated that patients with moderate-severe forms of COVID-19 had a significantly reduced population of T lymphocytes, CD4+ T cells, CD8+ T cells (only numeric), CD4+/CD8+ index, B lymphocytes, and natural killer (NK) cells. Our immunohistochemistry analysis of tissue samples failed to demonstrate positivity for CD19, CD3, CD4, CD8, and CD56 markers; (4) Conclusions: Immunophenotyping analysis could be useful for risk stratification of pregnant patients, while further studies are needed to determine the extent of immunological decidual response in patients with various forms of COVID-19.
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Affiliation(s)
- Ana-Maria Adam
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800216 Galati, Romania
| | - Radu-Florin Popa
- Department of Vascular Surgery, University of Medicine and Pharmacy "Grigore T. Popa", 700111 Iasi, Romania
| | - Cristian Vaduva
- Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Costinela Valerica Georgescu
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Dunarea de Jos University, 800216 Galati, Romania
| | - Gigi Adam
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Dunarea de Jos University, 800216 Galati, Romania
| | - Alina-Sinziana Melinte-Popescu
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, 'Ștefan cel Mare' University, 720229 Suceava, Romania
| | - Cristina Popa
- Discipline of Oral Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Aurel Nechita
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800216 Galati, Romania
| | - Ingrid-Andrada Vasilache
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Mihalceanu
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - AnaMaria Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800216 Galati, Romania
| | - Marian Melinte-Popescu
- Department of Internal Medicine, Faculty of Medicine and Biological Sciences, 'Ștefan cel Mare' University, 720229 Suceava, Romania
| | - Valeriu Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800216 Galati, Romania
| | - Anca Neagu
- 'Saint John' Clinical Emergency Hospital for Children, 800487 Galati, Romania
| | - Razvan Socolov
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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González-Morcillo M, Tiburcio-Palos E, Cordovilla-Guardia S, Santano-Mogena E, Franco-Antonio C. Childbirth Satisfaction during the COVID-19 Pandemic in a Hospital in Southwestern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9636. [PMID: 35954992 PMCID: PMC9367768 DOI: 10.3390/ijerph19159636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
Satisfaction, in relation to care received, is a good indicator of quality of care. The objective of this study was to analyze the degree of satisfaction with childbirth and postpartum care as reported by women from one hospital in southwestern Spain during the COVID-19 pandemic. Factors that influenced care were also examined. A cross-sectional study was carried out between the months of October 2020 and February 2021. Satisfaction was measured through the COMFORTS scale, validated in Spanish. A final sample of 116 women was included in the study. The mean age was 32.08 (±4.68) years. A total of 111 (95.69%) women were satisfied or very satisfied with the care received. The median satisfaction score was higher among multiparous women (187 (199-173)) than among primiparous women (174 (193-155.50)) (p = 0.003). Differences in satisfaction were found as a function of the use of epidural analgesia, being higher among women who had planned its use but ultimately did not use it (188 (172.50-199.75)) or who planned its use and did (186 (169.50-198)) than among those who had not planned to use epidural analgesia but ultimately received it (173.50 (187.50-146.25)) or those who did not use it, as planned, before childbirth (172 (157-185)) (p = 0.020). Overall satisfaction rate between SARS-CoV-2-negative women assisted was high. Parity and use of epidural analgesia were two factors influencing satisfaction scores in our sample.
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Affiliation(s)
| | | | - Sergio Cordovilla-Guardia
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
| | - Esperanza Santano-Mogena
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
| | - Cristina Franco-Antonio
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
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