Preterm care during the COVID-19 pandemic: A comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection.
Preterm care during the COVID-19 pandemic: A comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection.
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DOI：
10.1016/j.eclinm.2021.100733
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发表时间：
2021-03
影响因子：
15.1
通讯作者：
COVID-19 Small and Sick Newborn Care Collaborative Group
中科院分区：
文献类型：
--
作者：
Minckas N;Medvedev MM;Adejuyigbe EA;Brotherton H;Chellani H;Estifanos AS;Ezeaka C;Gobezayehu AG;Irimu G;Kawaza K;Kumar V;Massawe A;Mazumder S;Mambule I;Medhanyie AA;Molyneux EM;Newton S;Salim N;Tadele H;Tann CJ;Yoshida S;Bahl R;Rao SPN;Lawn JE;COVID-19 Small and Sick Newborn Care Collaborative Group
COVID-19正在扰乱母亲和新生儿的卫生服务，特别是在低收入和中等收入国家（LMIC）。早产儿尤其脆弱。我们分析了袋鼠妈妈护理（KMC）对体重≤2000 g的新生儿存活率的益处，并与从受感染的母亲/照顾者获得SARS-CoV-2的风险进行了比较。我们在12个月内模拟了两种情况。情景1比较了KMC的生存益处与全民覆盖率（99%）和COVID-19导致的死亡风险。情景2估计了由于覆盖率降低和KMC完全中断而增加的死亡人数。预测是根据127个中低收入国家（约占全球出生人数的90%）的最新数据进行的，结果汇总到五个区域。我们的最坏情况（100%传播）可能导致1，950名新生儿死于COVID-19。相反，全民KMC覆盖可以挽救125 680名新生儿的生命。因此，KMC的益处是COVID-19死亡风险的65倍。如果采用最近的10%传播率的证据，该比率将是630倍。我们估计，KMC覆盖率下降50%可能导致12，570例死亡增加，完全中断可能导致25，140例死亡增加，这意味着127个国家的新生儿死亡率增加2.3%-4.6%。KMC的生存益处远远超过COVID-19导致的微小死亡风险。早产新生儿处于危险之中，特别是在低收入国家，中断的后果是巨大的。政策制定者和医疗保健专业人员需要保护服务，并确保更明确的信息，以保持母亲和新生儿在一起，即使母亲是SARS-CoV-2阳性。尤妮斯·肯尼迪·施莱佛国家儿童健康与人类发展研究所;比尔和梅林达·盖茨基金会;埃尔玛慈善机构;惠康信托基金会;以及卫生和社会护理部、国际发展部、医学研究理事会和惠康信托基金会的联合全球健康试验计划。
COVID-19 is disrupting health services for mothers and newborns, particularly in low- and middle-income countries (LMIC). Preterm newborns are particularly vulnerable. We undertook analyses of the benefits of kangaroo mother care (KMC) on survival among neonates weighing ≤2000 g compared with the risk of SARS-CoV-2 acquired from infected mothers/caregivers. We modelled two scenarios over 12 months. Scenario 1 compared the survival benefits of KMC with universal coverage (99%) and mortality risk due to COVID-19. Scenario 2 estimated incremental deaths from reduced coverage and complete disruption of KMC. Projections were based on the most recent data for 127 LMICs (~90% of global births), with results aggregated into five regions. Our worst-case scenario (100% transmission) could result in 1,950 neonatal deaths from COVID-19. Conversely, 125,680 neonatal lives could be saved with universal KMC coverage. Hence, the benefit of KMC is 65-fold higher than the mortality risk of COVID-19. If recent evidence of 10% transmission was applied, the ratio would be 630-fold. We estimated a 50% reduction in KMC coverage could result in 12,570 incremental deaths and full disruption could result in 25,140 incremental deaths, representing a 2·3–4·6% increase in neonatal mortality across the 127 countries. The survival benefit of KMC far outweighs the small risk of death due to COVID-19. Preterm newborns are at risk, especially in LMICs where the consequences of disruptions are substantial. Policymakers and healthcare professionals need to protect services and ensure clearer messaging to keep mothers and newborns together, even if the mother is SARS-CoV-2-positive. Eunice Kennedy Shriver National Institute of Child Health & Human Development; Bill & Melinda Gates Foundation; Elma Philanthropies; Wellcome Trust; and Joint Global Health Trials scheme of Department of Health and Social Care, Department for International Development, Medical Research Council, and Wellcome Trust.
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DOI：
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发表时间：
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影响因子：
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DOI：
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发表时间：
2021-03
期刊：
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影响因子：
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作者：
Gale C;Quigley MA;Placzek A;Knight M;Ladhani S;Draper ES;Sharkey D;Doherty C;Mactier H;Kurinczuk JJ
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