Am J Perinatol 2020; 37(08): 813-824
DOI: 10.1055/s-0040-1709688
Clinical Opinion
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Resuscitation and Postresuscitation Care of Infants Born to Mothers with Suspected or Confirmed SARS-CoV-2 Infection

Praveen Chandrasekharan
1  Division of Neonatology, Department of Pediatrics, Oishei Children's Hospital of Buffalo, University at Buffalo, Buffalo, New York
,
Maximo Vento
2  Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Daniele Trevisanuto
3  Department of Pediatrics, University-Hospital of Padova, Padova, Italy
,
Elizabeth Partridge
4  Division of Infectious Disease, Department of Pediatrics, University of California, Davis, California
,
Mark A. Underwood
5  Division of Neonatology, Department of Pediatrics, University of California, Davis, California
,
Jean Wiedeman
4  Division of Infectious Disease, Department of Pediatrics, University of California, Davis, California
,
Anup Katheria
6  Sharp Mary Birch Hospital for Women and Newborns, San Diego, California
,
Satyan Lakshminrusimha
5  Division of Neonatology, Department of Pediatrics, University of California, Davis, California
› Author Affiliations
Further Information

Publication History

30 March 2020

30 March 2020

Publication Date:
08 April 2020 (online)

Abstract

The first case of novel coronavirus disease of 2019 (COVID-19) caused by severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) was reported in November2019. The rapid progression to a global pandemic of COVID-19 has had profound medical, social, and economic consequences. Pregnant women and newborns represent a vulnerable population. However, the precise impact of this novel virus on the fetus and neonate remains uncertain. Appropriate protection of health care workers and newly born infants during and after delivery by a COVID-19 mother is essential. There is some disagreement among expert organizations on an optimal approach based on resource availability, surge volume, and potential risk of transmission. The manuscript outlines the precautions and steps to be taken before, during, and after resuscitation of a newborn born to a COVID-19 mother, including three optional variations of current standards involving shared-decision making with parents for perinatal management, resuscitation of the newborn, disposition, nutrition, and postdischarge care. The availability of resources may also drive the application of these guidelines. More evidence and research are needed to assess the risk of vertical and horizontal transmission of SARS-CoV-2 and its impact on fetal and neonatal outcomes.

Key Points

  • The risk of vertical transmission is unclear; transmission from family members/providers to neonates is possible.

  • Optimal personal-protective-equipment (airborne vs. droplet/contact precautions) for providers is crucial to prevent transmission.

  • Parents should be engaged in shared decision-making with options for rooming in, skin-to-skin contact, and breastfeeding.

Note

D.T., P.C., and S.L. are scientific experts associated with ILCOR and S.L. is a member of the steering committee of the American Academy of Pediatrics Neonatal Resuscitation Program. M.V. is the Chairman of the European Board of Neonatology (European Society for Pediatric Research) and the Chairman of the Spanish Maternal, Neonatal, and Developmental Network SAMID (Instituto de Investigación Sanitaria Carlos III, Ministry of Science and Innovation, Kingdom of Spain). However, the views expressed in this article are individual opinions of the authors and do not reflect official recommendations of these organizations.