Childbirth Care among SARS-CoV-2 Positive Women in Italy

• Main Authors: Serena Donati, Edoardo Corsi, Michele Antonio Salvatore, Alice Maraschini, Silvia Bonassisa, Paola Casucci, Ilaria Cataneo, Irene Cetin, Paola D’Aloja, Gabriella Dardanoni, Elena De Ambrosi, Enrico Ferrazzi, Stefania Fieni, Massimo Piergiuseppe Franchi, Gianluigi Gargantini, Enrico Iurlaro, Livio Leo, Marco Liberati, Stefania Livio, Mariavittoria Locci, Luca Marozio, Claudio Martini, Gianpaolo Maso, Federico Mecacci, Alessandra Meloni, Anna Domenica Mignuoli, Luisa Patanè, Edda Pellegrini, Francesca Perotti, Enrica Perrone, Federico Prefumo, Luca Ramenghi, Raffaella Rusciani, Valeria Savasi, Sergio Crescenzo Antonio Schettini, Daniela Simeone, Serena Simeone, Arsenio Spinillo, Martin Steinkasserer, Saverio Tateo, Giliana Ternelli, Roberta Tironi, Vito Trojano, Patrizia Vergani, Sara Zullino, on behalf of the ItOSS COVID-19 Working Group
• Format: Article
• Language: English
• Published: MDPI AG 2021-04-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: birth; breastfeeding; COVID-19; perinatal care; pregnancy; SARS-CoV-2
• Online Access: https://www.mdpi.com/1660-4601/18/8/4244
• ISSN: 1661-7827; 1660-4601

The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother’s milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to “better safe than sorry” care choices. An improvement of the peripartum care indicators was observed over time.