“From the seNeu register on the incidence of the coronavirus in pregnant women and their babies, it can be deduced, until November 2022, that practically all the babies of covid mothers do not have the infection; so much so that skin-to-skin contact and breastfeeding are two indispensable strategies for their health”, Dr. proudly points out. Manuel Sánchez Luna, president of the Spanish Society of Neonatology
Coronavirus, mother and baby: there is no possible trio
“Hospitalizations of babies have been due to heterogeneous causes, never related to the SARS-CoV-2 pandemic: the possible transmission of the virus from mother to baby has occurred in only 1.3% of cases, a insignificant figure, the impact was always mild”, he underlines.
“We can assure, based on the data from the SeNeo register, that COVID-19 has not been a neonatal pandemic“Affirms the head of the Neonatology Service at the Gregorio Marañón University General Hospital in Madrid.
“Therefore, from this result it follows that the health measures taken in our country have been very effective in preserving the health and routine care of both babies and mothers,” he adds.
Coronavirus and pregnancy, a practically non-existent relationship
The register of covid cases of the Spanish Society of Neonatology is created to know the impact of SARS-Cov-2 infection on babies; a set of “own data” collected both from infected mothers and their babies – perinatal situation – and from those other babies who were infected in the postnatal period.
The main objective of this registry was and is to compile all clinical statistics on pregnancies and births during the pandemic in order to draw up a series of recommendations based on scientific evidence.
“This comprehensive database, fed by hundreds of professionals, coordinated by the infectious diseases group of seNeo, under the leadership of the Dr. Belén Fernández Colomerneonatologist at the Hospital Central d’Astúries, has enormously improved our strategies in the face of an unknown and unpredictable disease at the beginning of 2020″.
“We didn’t know what we were up againstas the clinical information and research articles coming from our Chinese, European and American colleagues were alarming”.
Dr. Manuel Sanchez Luna
To date, 138 hospitals have participated in the SeNeo register, practically the entire Spanish public and private hospital network, including in this large analytical study 6748 mothers and 6872 babies.
The majority of expectant mothers (77%) were infected during the third trimester, and the caesarean section rate was 22% of cases, lower than the national average outside the epidemic (25% in 2019).
“At the beginning of the pandemic we observed a high rate of prematurity due to the fact that the disease was extremely serious in women, basically becoming infected in the third trimester of pregnancy. The mothers were suffering from respiratory failure and we were forced to remove the babies very early,” he says.
The most serious infections in pregnant women were recorded, above all, in obese women and diagnosed with preeclampsia.
“These babies did not have infectious problems due to transmission from the mother via the placenta, but organic difficulties generated by prematurity”, he points out.
Severity clearly decreased with the start of vaccination in pregnant women.
“Vaccines meant a before and an after, since they modified the severity profile; it is now very rare for vaccinated pregnant women to be admitted to the ICU”, he testifies.
At the same time, knowing the virus much better, it was possible to significantly decrease the number of premature births: “The global rate of prematurityfortunately, it has been going down throughout the pandemic”, he insists.
Magnificent results of the SeNeo strategy in the face of the COVID-19 pandemic
Since cases began to be assessed during the first wave of the pandemic, the profile of pregnant women was placed in a fork between 31 and 33 years; and 73% –date of February 2022– was previously healthy, despite showing a high prevalence of obesity.
In this period, the pregnant women – 80% of the cases analyzed – did not suffer from gestational pathologies; being the preeclampsia the most frequent complication in this group of women.
“The mothers who were admitted to the ICU due to covid developed the disease in the third trimester, probably due to greater respiratory compromise. More cases of obesity and preeclampsia were described in this group of patients”, he reiterates.
“We have to take into account that serious forms of covid are more common among pregnant women than in non-pregnant women,” explains Dr. Manuel Sanchez Luna.
The Spanish Society of Neonatology (SeNeo) recommended, shortly after the start of the pandemic, and after verifying the scant affectation of the virus in the babies, that the birth be carried out under the same conditions as in the absence of SARS-CoV infection -2.
“It was expressly advised not to separate the mother from her child and to maintain, as far as possible, joint hospitalization and skin-to-skin contact between the two after childbirth, as well as breastfeeding,” emphasizes the galler Madrid
At the same time, SeNeo established appropriate hygiene measures to prevent infection from expectant mothers to babies after delivery and also to healthcare personnel.
Following these indications, data in January 2022 from SeNeo estimated that skin-to-skin contact had been achieved in 80% of cases, co-housing in the hospital room in 97% of cases of asymptomatic infants, and breastfeeding was maintained in 88% of cases.
“It has been very interesting to observe how the rate of infection in the babies who were not separated from their mothers turned out to be lower than that of the group of babies who had to be separated from their mothers; and in addition, in which breastfeeding was maintained the rate was lower than those who received given milk of other mothers”, concludes Dr. Manuel Sanchez Luna.
In November 2022, the numbers have consolidated and offer peace of mind to newborn babies, their mothers and fathers, families, healthcare professionals already in the rest of the population.