Table 1.
Perinatal COVID-19 Hospital Care Practices in Massachusetts.
| Survey #1 3/31-4/5 N = 28 | Survey #2 5/1-5/5 N = 24 | Survey #3a 5/24-6/8 N = 18 | |
|---|---|---|---|
| N (%) | |||
| Highest level of neonatal care of hospitals | |||
| Level 3 or 4 | 9 (32%) | 9 (37.5%) | 8 (44%) |
| Level 2 | 11 (39%) | 9 (37.5%) | 8 (44%) |
| Level 1 | 8 (29%) | 6 (25%) | 2 (11%) |
| Obstetric and Delivery Practices | |||
| Testing of Women Anticipated to Deliver | |||
| Universal testing | 0% | 20 (87%) | 17 (94%) |
| Testing based on signs and symptoms | 26 (93%) | 2 (9%) | 1 (6%) |
| Testing not routinely available for pregnant women | n/ab | 0 (0%) | 0 (0%) |
| Other | 2 (7%) | 1 (4%) | 0 (0%) |
| PPE for COVID-19 positive women delivering vaginally (check all that apply) | |||
| N95 | n/ab | 23 (100%) | 18 (100%) |
| Eye protection | n/ab | 23 (100%) | 18 (100%) |
| Cap | n/ab | 17 (74%) | 13 (72%) |
| Gown | n/ab | 22 (96%) | 18 (100%) |
| Gloves | n/ab | 23 (100%) | 18 (100%) |
| Support persons for pregnant women on Labor and Delivery | n/ab | ||
| No support persons | n/ab | 0 (0%) | 0 (0%) |
| Only 1 support person | n/ab | 23 (100%) | 18 (100%) |
| 2 or more support persons | n/ab | 0 (0%) | 0 (0%) |
| Newborn Care Practices | |||
| Location of newborn care with COVID-19 Positive Mother | |||
| Separate room from mother | 9 (39%) | 5 (23%) | 3 (18%) |
| Same room as mother with precautions to maintain separation | 6 (5%) | 5 (23%) | 2 (12%) |
| Decisions based on shared decision making on a case-by-case basis | 13 (43%) | 11 (50%) | 13 (70%) |
| Other | 0 (0%) | 1 (5%) | 0 (0%) |
| Skin-to-skin care in first hour after birth with COVID-19 Positive Mother | |||
| Prohibited or discouraged | 25 (93%) | 22 (96%) | 11 (61%) |
| Encouraged with precautions | 2 (7%) | 1 (4%) | 0 (0%) |
| Decisions based on shared decision making on a case-by-case basis | n/ab | n/ab | 7 (39%) |
| Delayed or timed cord clamping with COVID-19 Positive Motherc | |||
| Yes | 12 (44%) | 13 (59%) | 12 (65%) |
| No | 11 (41%) | 9 (41%) | 6 (35%) |
| Other | 4 (15%) | n/ab | n/ab |
| Early baths (<4 h) with COVID-19 Positive Motherd | |||
| Yes | 18 (67%) | 19 (83%) | 13 (72%) |
| No | 8 (30%) | 4 (17%) | 5 (28%) |
| Approach to direct breastfeeding with COVID-19 Positive Mother | |||
| Prohibited | 7 (28%) | 3 (13%) | 0 (0%) |
| Discouraged, but permitted if family strongly desires | n/a2 | 14 (58%) | 4 (22%) |
| Encouraged with precautions | 15 (60%) | 7 (29%) | 1 (6%) |
| Decisions based on shared decision making on a case-by-case basis | n/a2 | n/ab | 13 (72%) |
| Approach to testing for an infant delivered by cesarean section with anticipated discharge on day 3 or 4 with a COVID-19 Positive Mother | |||
| We generally do not test infants | 3 (12%)e | 3 (13%) | 0 (0%) |
| Testing is not available for infants | 0 (0%) | 0 (0%) | |
| We do 1 test | 8 (32%) | 7 (29%) | 9 (50%) |
| We do 2 or more tests | 12 (48%) | 8 (33%) | 9 (50%) |
| Other | 2 (8%) | 6 (25%) | 0 (0%) |
| Discharge Processes for non-COVID-19 Positive Mother-Infant Dyads | |||
| Timing of Discharge | |||
| Timing has not really changed | n/ab | 3 (13%) | 2 (11%) |
| Some dyads are discharged early | n/ab | 7 (30%) | 7 (39%) |
| Many dyads are discharged early | n/ab | 13 (57%) | 9 (50%) |
| All dyads discharge early unless a medical contraindication | n/ab | 0 (0%) | 0 (0%) |
aSurvey 3 was conducted as part of a national survey of COVID-19 newborn care practices; only results of Massachusetts birth hospitals are presented.
bThis answer choice was not available for this survey.
cIn survey #2 we ascertained that 92% of hospitals perform delayed or timed cord clamping among non-COVID-19 dyads.
dIn survey #3 we ascertained that 0% of hospitals perform early baths among non-COVID-19 dyads.
eIn survey #1 we did not differentiate these responses.