Aktualisierte Empfehlungen zu SARS-CoV-2/COVID-19 und
                    Schwangerschaft, Geburt und Wochenbett

Zöllkau, Janine; Hagenbeck, Carsten; Hecher, Kurt; Pecks, Ulrich; Schlembach, Dietmar; Simon, Arne; Schlößer, Rolf; Schleußner, E

doi:10.1055/a-1199-6404

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…Therefore, the benefits of human milk outweigh the potential risk of SARS-CoV-2 to the newborn. With regard to national recommendations for prenatal care, delivery and the puerperium, separation of mother and neonate in the event of maternal SARS-CoV-2 infection is not required, and breastfeeding should be encouraged and supported under hygienic measures and informed consent (ZÖllkau, Hagenbeck, et al, 2021). In addition to the demonstrated effects of maternal and neonatal accommodation arrangements, changes in hospital regulations (e.g., rooming-in and visiting arrangements) must always take into account potential tremendous secondary negative effects of these measures.…”

Section: Discussionmentioning

confidence: 99%

“…hygienic precautions (Raschetti et al, 2020;Villar et al, 2021). As a result, national and international professional societies advocated direct mother-neonate contact and breastfeeding, including direct breastfeeding even during maternal SARS-CoV-2 infection (Devane et al, 2020;Williams et al, 2020;ZÖllkau, Hagenbeck, et al, 2021). Our research questions were: (i) What was the breastfeeding rate in a cohort of women infected by SARS-CoV-2 during pregnancy in Germany and Austria?…”

Section: Key Messagesmentioning

confidence: 99%

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Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS)

Zöllkau,

Heimann,

Hagenbeck

et al. 2023

J Hum Lact

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Background: The SARS-CoV-2 pandemic and its influence on peripartum processes worldwide led to issues in breastfeeding support. Research Aim: The aim of this study was to describe breastfeeding behavior and peripartum in-hospital management during the pandemic in Germany and Austria. Methods: This study was a descriptive study using a combination of secondary longitudinal data and a cross-sectional online survey. Registry data from the prospective multicenter COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS) cohort study (longitudinal, medical records of 1,815 parent-neonate pairs with confirmed SARS-CoV-2 infection during pregnancy) and a cross-sectional online survey of CRONOS hospitals’ physicians ( N = 67) were used for a descriptive comparison of feeding outcomes and postpartum management. Results: In 93.7% (n = 1700) of the cases in which information on the neonate's diet was provided, feeding was with the mother’s own milk. Among neonates not receiving their mother’s own milk, 24.3% ( n = 26) reported SARS-CoV-2 infection as the reason. Peripartum maternal SARS-CoV-2 infection, severe maternal COVID-19 including the need for intensive care unit (ICU) treatment or invasive ventilation, preterm birth, mandatory delivery due to COVID-19, and neonatal ICU admission were associated with lower rates of breastfeeding. Rooming-in positively influenced breastfeeding without affecting neonatal SARS-CoV-2 frequency (4.2% vs. 5.6%). CRONOS hospitals reported that feeding an infant their mother’s own milk continued to be supported during the pandemic. In cases of severe COVID-19, four of five hospitals encouraged breastfeeding. Conclusion: Maintaining rooming-in and breastfeeding support services in the CRONOS hospitals during the pandemic resulted in high breastfeeding rates.

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Section: Discussionmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS)

Zöllkau,

Heimann,

Hagenbeck

et al. 2023

J Hum Lact

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“…Current national and international guidelines recommend breastfeeding and rooming-in with appropriate hygiene measures in spite of maternal infection [11,28]. As the pandemic progressed clinicians appeared to adapt more to the peripartum procedures in case of maternal SARS-CoV-2 infection [29].…”

Section: Rooming-in Admission Of the Newborn To Nicumentioning

confidence: 99%

“…With the ongoing COVID-19 pandemic and increasing knowledge, breastfeeding in case of SARS-CoV-2 infection was considered to be a low risk for mother-to-infant transmission when hygiene requirements were met [10][11][12][13]. Rooming-in of mother and infant is applicable when a bundle of hygiene recommendations is followed [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data from the CRONOS Registry

Longardt,

Zöllkau,

Mand

et al. 2024

Z Geburtshilfe Neonatol

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SARS-CoV-2 infection and COVID-19 disease are thought to have an impact on breastfeeding rate – besides other known peripartal issues. Data of the national CRONOS registry regarding breastfeeding behavior in 6,746 women was analyzed regarding the time window between maternal SARS-CoV-2 infection and time of delivery. In addition, other influencing factors like the predominant viral variant, maternal disease severity, and gestational age at delivery were taken into account. Our data suggest that within the variables analyzed, in the case of acute maternal infection (<14 days before birth), breastfeeding behavior improved with increasing gestational age at birth (p<0.0001), with less severe maternal illness (p<0.0001) and as the pandemic progressed with less virulent viral variants (p=0.01). When adjusting for COVID-19-associated and non-associated factors, rooming-in remains the most important factor positively influencing breastfeeding behavior. With regards to the benefits for mother and infants from breastfeeding, a separation of mother and child even in case of infectious settings should be avoided.

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“…It is unlikely that placental insufficiency rapidly evolved caused by SARS-CoV-2 infection in our study cases. Still, consecutive measurements of fetal growth as well as fetal Doppler sonography every four weeks are recommended for pregnant women with SARS-CoV-2 infection to rule out placental insufficiency in the course of pregnancy [21,22].…”

Section: Vascular Abnormalitiesmentioning

confidence: 99%

Covid-19 during Pregnancy – Histopathological Lesions of the Placenta

Kummer,

Ameli,

Jebens

et al. 2023

Z Geburtshilfe Neonatol

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Introduction Pregnant women and their offspring represented a vulnerable patient collective during the Covid-19 pandemic. Beyond the direct effect of SARS-CoV-2 via vertical transmission, an indirect impact on the fetus can occur through placental lesions deteriorating placental villous function. We performed a histopathological analysis of placentas of parturients with SARS-CoV-2 compared to healthy controls. Methods and materials Between February 2022 and July 2022 we conducted a prospective case–control study analyzing placental specimens of parturients with SARS-CoV-2 infection compared to specimens of placentas of healthy controls. Patient history, Covid-19-specific symptoms, and obstetric outcomes were recorded. Statistical analysis was performed. Results During the observation period 71 patients were included with a gestational age 37 1/7–41 5/7 weeks. Thirty-six patients presented with SARS-CoV-2 infection. The control group consisted of 35 patients and showed no placental abnormalities. Among SARS-CoV-2-positive parturients, 66.7% of placentas of the case group showed histopathological abnormalities classified as vascular or inflammatory abnormalities. 22.2% of placentas showed acute ischemic infarction areas. 8.3% of placentas showed subchorionic layered thrombi. There was one case of severe acute subchorionitis. SARS-CoV-2 increased the risk of placental lesions significantly (OR 3.000, CI 1.890–4.762, p=0.0001). Placental lesions had no significant impact on perinatal acidosis (OR 0.455, CI 0.044–4.667, p=0.498) or number of cesarean sections (OR 2.314, CI 0.717–7.473, p=0.156). Conclusion SARS-CoV-2 infection during labor and delivery increased the risk of adverse outcomes. Histopathological analysis indicated that the placenta as a maternal-fetal interface was affected by SARS-CoV-2, leading to systemic vasculopathy and inflammation.

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Aktualisierte Empfehlungen zu SARS-CoV-2/COVID-19 und Schwangerschaft, Geburt und Wochenbett

Cited by 11 publications

References 36 publications

Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS)

Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS)

Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data from the CRONOS Registry

Covid-19 during Pregnancy – Histopathological Lesions of the Placenta

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