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      Parental perceptions of the impact of neonatal unit visitation policies during COVID-19 pandemic

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          Abstract

          Objectives

          To ascertain parental perceptions of the impact of restricted visiting policies to neonatal intensive care units during the current COVID-19 pandemic.

          Design

          Cross-sectional survey of parents impacted by visitation policies.

          Setting

          Six tertiary level neonatal units, four from the UK and two from the USA, participated in the study.

          Participants

          Parents and families of infants hospitalised in the participating centres between 1 May 2020 and 21 August 2020.

          Methods

          Online-based and/or paper-based survey, querying the visitation policies and their impact on parents’ ability to visit, care for and bond with their infants.

          Results

          A total of 231 responses were received. Visitation limited to a single visitor with no restrictions on duration was the most frequently reported policy; 140/217 (63%). Visitation policies were perceived as being restrictive by 62% (138/219) of the respondents with 37% (80/216) reporting being able to visit less often than desired, 41% (78/191) reporting being unable to bond enough and 27% (51/191) reporting not being able to participate in their baby’s daily care. Mild to severe impact on breast feeding was reported by 36% (75/209) of respondents. Stricter policies had a higher impact on families and were significantly associated with a lack of bonding time, inability to participate in care and an adverse impact on breast feeding.

          Conclusions

          Visitation policies during the COVID-19 pandemic varied between centres and over time with stricter restrictions implemented earlier on in the pandemic. Parents reported significant impacts on their ability to visit, care for and bond with their infants with perceived severity of impact worse with stricter restrictions.

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          Most cited references22

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

            Abstract Objectives To describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants. Design Prospective national population based cohort study using the UK Obstetric Surveillance System (UKOSS). Setting All 194 obstetric units in the UK. Participants 427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020. Main outcome measures Incidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission. Results The estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth. Conclusions Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation. Study registration ISRCTN 40092247.
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              Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU.

              To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU.
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                Author and article information

                Journal
                BMJ Paediatr Open
                BMJ Paediatr Open
                bmjpo
                bmjpo
                BMJ Paediatrics Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2399-9772
                2020
                11 November 2020
                : 4
                : 1
                : e000899
                Affiliations
                [1 ]departmentDepartment of Pediatrics , Creighton University School of Medicine , Omaha, Nebraska, USA
                [2 ]Saint Joseph’s Hospital and Medical Center , Phoenix, Arizona, USA
                [3 ]Neonatology Association Limited, Obstetrix Medical Group of Phoenix, Mednax , Phoenix, United States
                [4 ]departmentDivision of Neonatology, Department of Pediatrics , Baylor Scott and White McLane Children’s Medical Center , Temple, Texas, USA
                [5 ]departmentDivision of Neonatology, Department of Paediatrics , University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK
                [6 ]departmentNeonatal Intensive Care Unit, Jenny Lind Children's Hospital , Norfolk and Norwich University Hospitals NHS Foundation Trust , Norwich, Norfolk, UK
                [7 ]departmentNeonatal Intensive Care Unit , Ashford and St Peter’s Hospitals NHS Foundation Trust , Chertsey, Surrey, UK
                [8 ]Baylor Scott and White Research Institute , Temple, Texas, USA
                [9 ]departmentNeonatal Intensive Care Unit , University Hospital of Wales, Cardiff and Vale University Health Board , Cardiff, UK
                [10 ]MEDNAX Inc , Sunrise, Florida, USA
                [11 ]Norwich Medical School, University of East Anglia , Norwich, United Kingdom
                Author notes
                [Correspondence to ] Dr Hemananda Muniraman; hemu_muniraman@ 123456mednax.com
                Author information
                http://orcid.org/0000-0003-0254-2607
                http://orcid.org/0000-0002-4353-0656
                http://orcid.org/0000-0001-6203-7632
                Article
                bmjpo-2020-000899
                10.1136/bmjpo-2020-000899
                7661349
                34192184
                6d85e771-9879-4843-9498-f420f444aba5
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 02 October 2020
                : 23 October 2020
                : 23 October 2020
                Categories
                Neonatology
                1506
                2474
                Original research
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                neonatology,health services research
                neonatology, health services research

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