Neonatal care during the COVID-19 pandemic - a global survey of parents' experiences regarding infant and family-centred developmental care

Johanna Kostenzer; Julia Hoffmann; Charlotte von Rosenstiel-Pulver; Aisling Walsh; Luc J I Zimmermann; Silke Mader; COVID-19 Zero Separation Collaborative Group

doi:10.1016/j.eclinm.2021.101056

Neonatal care during the COVID-19 pandemic - a global survey of parents' experiences regarding infant and family-centred developmental care

EClinicalMedicine. 2021 Aug 6:39:101056. doi: 10.1016/j.eclinm.2021.101056. eCollection 2021 Sep.

Authors

Johanna Kostenzer¹, Julia Hoffmann¹, Charlotte von Rosenstiel-Pulver¹, Aisling Walsh¹, Luc J I Zimmermann^{1

2}, Silke Mader¹; COVID-19 Zero Separation Collaborative Group

Affiliations

¹ European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany.
² Department of Paediatrics, Research School Oncology and Development, Maastricht UMC+, Maastricht, the Netherlands.

Abstract

Background: The COVID-19 pandemic restrictions affect provision and quality of neonatal care. This global study explores parents' experiences regarding the impact of the restrictions on key characteristics of infant and family-centred developmental care (IFCDC) during the first year of the pandemic.

Methods: For this cross-sectional study, a pre-tested online survey with 52 questions and translated into 23 languages was used to collect data between August and November 2020. Parents of sick or preterm infants born during the pandemic and receiving special/intensive care were eligible for participation. Data analysis included descriptive statistics and statistical testing based on different levels of restrictive measures.

Findings: In total, 2103 participants from 56 countries provided interpretable data. Fifty-two percent of respondents were not allowed to have another person present during birth. Percentages increased with the extent of restrictions in the respondents' country of residence (p = 0·002). Twenty-one percent of total respondents indicated that no-one was allowed to be present with the infant receiving special/intensive care. The frequency (p < 0·001) and duration (p = 0·001) of permitted presence largely depended on the extent of restrictions. The more restrictive the policy measures were, the more the respondents worried about the pandemic situation during pregnancy and after birth.

Interpretation: COVID-19 related restrictions severely challenged evidence-based cornerstones of IFCDC, such as separating parents/ legal guardians and their newborns. Our findings must therefore be considered by public health experts and policy makers alike to reduce unnecessary suffering, calling for a zero separation policy.

Funding: EFCNI received an earmarked donation by Novartis Pharma AG in support of this study.

Keywords: Covid-19; Infant and Family-Centred Developmental Care; Kangaroo Mother Care; Low Birth Weight; Neonatal Intensive Care Unit; Newborn Infant; Pandemic; Parents; Preterm Birth; SARS-CoV-2; Survey.