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Review of guidelines and recommendations from 17 countries highlights the challenges that clinicians face caring for neonates born to mothers with COVID‐19
Author(s) -
Yeo Kee Thai,
Oei Ju Lee,
De Luca Daniele,
Schmölzer Georg M.,
Guaran Robert,
Palasanthiran Pamela,
Kumar Kishore,
Buonocore Giuseppe,
Cheong Jeanie,
Owen Louise S.,
Kusuda Satoshi,
James Jennifer,
Lim Gina,
Sharma Ankur,
Uthaya Sabita,
Gale Christopher,
Whittaker Elizabeth,
Battersby Cheryl,
Modi Neena,
Norman Mikael,
Naver Lars,
Giani Eric,
Diambomba Yenge,
Shah Prakeshkumar S.,
Gagliardi Luigi,
Harrison Michael,
Pillay Shakti,
Alburaey Abdullah,
Yuan Yuan,
Zhang Huayan
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15495
Subject(s) - medicine , rigour , breastfeeding , pandemic , covid-19 , family medicine , medline , best practice , pediatrics , disease , infectious disease (medical specialty) , political science , geometry , mathematics , pathology , law
Aim This review examined how applicable national and regional clinical practice guidelines and recommendations for managing neonates born to mothers with COVID‐19 mothers were to the evolving pandemic. Methods A systematic search and review identified 20 guidelines and recommendations that had been published by May 25, 2020. We analysed documents from 17 countries: Australia, Brazil, Canada, China, France, India, Italy, Japan, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Sweden, Switzerland, the UK and the United States. Results The documents were based on expert consensus with limited evidence and were of variable, low methodological rigour. Most did not provide recommendations for delivery methods or managing symptomatic infants. None provided recommendations for post‐discharge assimilation of potentially infected infants into the community. The majority encouraged keeping mothers and infants together, subject to infection control measures, but one‐third recommended separation. Although breastfeeding or using breastmilk was widely encouraged, two countries specifically prohibited this. Conclusion The guidelines and recommendations for managing infants affected by COVID‐19 were of low, variable quality and may be unsustainable. It is important that transmission risks are not increased when new information is incorporated into clinical recommendations. Practice guidelines should emphasise the extent of uncertainty and clearly define gaps in the evidence.