Andrea Ronchi1, Carlo Pietrasanta1,2, Maurizio Zavattoni3, Martina Saruggia4, Federico Schena1, Maria Teresa Sinelli5, Massimo Agosti6,7, Chryssoula Tzialla8, Felicia Filomena Varsalone9, Lea Testa1, Claudia Ballerini1, Stefania Ferrari4, Giovanna Mangili4, Maria Luisa Ventura5, Simona Perniciaro6, Elena Spada1, Giovanna Lunghi10, Antonio Piralla3, Fausto Baldanti3,11, Fabio Mosca1,2, Lorenza Pugni1. 1. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatology and NICU, Milan, Italy. 2. University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy. 3. Fondazione IRCCS Policlinico San Matteo, Microbiology and Virology Department, Molecular Virology Unit, Pavia, Italy. 4. ASST Papa Giovanni XXIII, Neonatology and NICU, Bergamo, Italy. 5. Fondazione MBBM, S. Gerardo Hospital, Neonatology and NICU, Monza, Italy. 6. Del Ponte Hospital, Neonatology and NICU, Varese, Italy. 7. University of Insubria, Department of Pediatrics, Varese, Italy. 8. Fondazione IRCCS Policlinico San Matteo, Neonatology and NICU, Pavia, Italy. 9. Bolognini Hospital, Neonatology and NICU, Seriate, Italy. 10. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Microbiology and Virology Unit, Milan, Italy. 11. University of Pavia. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Pavia, Italy.
Abstract
Importance: The management of mother-infant dyads during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic constitutes a major issue for neonatologists. In mothers with SARS-CoV-2 infection, current recommendations suggest either to separate the dyad or encourage protected rooming-in under appropriate precautions. No data are available regarding the risk of mother-to-infant transmission of SARS-CoV-2 during rooming-in. Objective: To evaluate the risk of postnatal transmission of SARS-CoV-2 from infected mothers to their neonates following rooming-in and breastfeeding. Design, Setting, and Participants: A prospective, multicenter study enrolling mother-infant dyads from March 19 to May 2, 2020, followed up for 20 days of life (range, 18-22 days), was performed. The study was conducted at 6 coronavirus disease 2019 maternity centers in Lombardy, Northern Italy. Participants included 62 neonates born to 61 mothers with SARS-CoV-2 infection who were eligible for rooming-in practice based on the clinical condition of the mother and infants whose results of nasopharyngeal swabs were negative at birth. Exposures: Mothers with SARS-CoV-2 infection were encouraged to practice rooming-in and breastfeeding under a standardized protocol to minimize the risk of viral transmission. Main Outcomes and Measures: Clinical characteristics and real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 on neonatal nasopharyngeal swabs at 0, 7, and 20 days of life. Results: Of the 62 neonates enrolled (25 boys), born to 61 mothers (median age, 32 years; interquartile range, 28-36 years), only 1 infant (1.6%; 95% CI, 0%-8.7%) was diagnosed as having SARS-CoV-2 infection at postbirth checks. In that case, rooming-in was interrupted on day 5 of life because of severe worsening of the mother's clinical condition. The neonate became positive for the virus on day 7 of life and developed transient mild dyspnea. Ninety-five percent of the neonates enrolled were breastfed. Conclusions and Relevance: The findings of this cohort study provide evidence-based information on the management of mother-infant dyads in case of SARS-CoV-2 maternal infection suggesting that rooming-in and breastfeeding can be practiced in women who are able to care for their infants.
Importance: The management of mother-infant dyads during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic constitutes a major issue for neonatologists. In mothers with SARS-CoV-2 infection, current recommendations suggest either to separate the dyad or encourage protected rooming-in under appropriate precautions. No data are available regarding the risk of mother-to-infant transmission of SARS-CoV-2 during rooming-in. Objective: To evaluate the risk of postnatal transmission of SARS-CoV-2 from infected mothers to their neonates following rooming-in and breastfeeding. Design, Setting, and Participants: A prospective, multicenter study enrolling mother-infant dyads from March 19 to May 2, 2020, followed up for 20 days of life (range, 18-22 days), was performed. The study was conducted at 6 coronavirus disease 2019 maternity centers in Lombardy, Northern Italy. Participants included 62 neonates born to 61 mothers with SARS-CoV-2 infection who were eligible for rooming-in practice based on the clinical condition of the mother and infants whose results of nasopharyngeal swabs were negative at birth. Exposures: Mothers with SARS-CoV-2 infection were encouraged to practice rooming-in and breastfeeding under a standardized protocol to minimize the risk of viral transmission. Main Outcomes and Measures: Clinical characteristics and real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 on neonatal nasopharyngeal swabs at 0, 7, and 20 days of life. Results: Of the 62 neonates enrolled (25 boys), born to 61 mothers (median age, 32 years; interquartile range, 28-36 years), only 1 infant (1.6%; 95% CI, 0%-8.7%) was diagnosed as having SARS-CoV-2 infection at postbirth checks. In that case, rooming-in was interrupted on day 5 of life because of severe worsening of the mother's clinical condition. The neonate became positive for the virus on day 7 of life and developed transient mild dyspnea. Ninety-five percent of the neonates enrolled were breastfed. Conclusions and Relevance: The findings of this cohort study provide evidence-based information on the management of mother-infant dyads in case of SARS-CoV-2 maternal infection suggesting that rooming-in and breastfeeding can be practiced in women who are able to care for their infants.
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Authors: Ryan M Pace; Janet E Williams; Kirsi M Järvinen; Courtney L Meehan; Melanie A Martin; Sylvia H Ley; Celestina Barbosa-Leiker; Aline Andres; Laxmi Yeruva; Mandy B Belfort; Beatrice Caffé; Alexandra D Navarrete; Kimberly A Lackey; Christina D W Pace; Alexandra C Gogel; Bethaney D Fehrenkamp; Miranda Klein; Bridget E Young; Casey Rosen-Carole; Nichole Diaz; Stephanie L Gaw; Valerie Flaherman; Mark A McGuire; Michelle K McGuire; Antti E Seppo Journal: Front Immunol Date: 2021-12-23 Impact factor: 7.561