Author:
Corsi Decenti Edoardo,Salvatore Michele Antonio,Mandolini Donatella,Sampaolo Letizia,D’Aloja Paola,Alberi Irene,Arena Saverio,Brunelli Roberto,Cagnacci Angelo,Camandona Franco,Casucci Paola,Caudullo Sebastiano,Cetin Irene,Ceccaroni Marcello,Ciavattini Andrea,Cromi Antonella,Rì Pietro Dal,Di Cerbo Lidia,Di Sebastiano Francesca,Farsetti Daniele,Franchi Massimo Piergiuseppe,Iurlaro Enrico,Leo Livio,Liberati Marco,Sacchi Lucia Li,Livio Stefania,Locci Mariavittoria,Lovotti Massimo,Marozio Luca,Martini Claudio,Maso Gianpaolo,Mecacci Federico,Meloni Alessandra,Mignuoli Anna Domenica,Mondo Luisa,Morano Danila,Patanè Luisa,Paradiso Rocco,Pellegrino Antonio,Perotti Francesca,Perrone Enrica,Piccino Roberta,Prefumo Federico,Ramenghi Luca,Rocca Morena,Sala Alessia,Sangaletti Marina,Savasi Valeria,Schettini Sergio Crescenzo Antonio,Simeone Daniela,Simeone Serena,Steinkasserer Martin,Taddei Fabrizio,Tesorone Marina,Trojano Vito,Tronci Caterina,Veneziano Micaela,Vergani Patrizia,Vimercati Antonella,Donati Serena,
Abstract
Abstract
Background
Despite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy.
Methods
A prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother–child separation at birth; rooming-in; breastfeeding. Logistic regression models including women’ socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases.
Results
During the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery (n = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section (n = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births.
Conclusions
Despite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference42 articles.
1. World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization. ; 2018. https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;sequence=1. Accessed 23 June 2023.
2. Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012;5(5):CD003519.
3. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766.
4. Brimdyr K, Stevens J, Svensson K, Blair A, Turner-Maffei C, Grady J, et al. Skin-to-skin contact after birth: developing a research and practice guideline. Acta Paediatr. 2023. https://doi.org/10.1111/apa.16842.
5. Adesanya AM, Barrett S, Moffat M, Aquino MRJ, Nicholson W, Turner G, et al. Impact of the COVID-19 pandemic on expectant and new parents’ experience of pregnancy, childbirth, breast feeding, parental responsiveness and sensitivity, and bonding and attunement in high-income countries: a systematic review of the evidence. BMJ Open. 2022;12(12):e066963.