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
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The risk of vertical transmission is unclear; transmission from family members/providers
to neonates is possible.
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Optimal personal-protective-equipment (airborne vs. droplet/contact precautions) for
providers is crucial to prevent transmission.
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Parents should be engaged in shared decision-making with options for rooming in, skin-to-skin
contact, and breastfeeding.
Keywords
neonatal resuscitation - COVID-19 - novel coronavirus - SARS-CoV-2