Epidemics, such as COVID-19, profoundly impact healthcare delivery, especially affecting vulnerable groups like preterm infants and their parents. Changes in hospital visitation policies and disruptions to standard care practices present significant challenges. New research highlights both parents' experiences during the COVID-19 pandemic and proposes a standardized set of health outcomes for maternal and neonatal care during future epidemics.

Parental experiences in NICUs during COVID-19

A recent study conducted in Turkey explored how parents of preterm infants in neonatal intensive care units (NICUs) were affected by the COVID-19 pandemic. Before COVID-19, parents frequently visited and engaged closely in the care of their preterm infants. However, during the pandemic, severe restrictions drastically reduced visitation and physical contact, including essential bonding practices such as Kangaroo Mother Care (KMC). Although visitation and care involvement improved somewhat after restrictions were relaxed, they never fully returned to pre-pandemic levels. This underscores a need for clear policies supporting unrestricted parental involvement to ensure the best outcomes for preterm infants.

Defining essential health outcomes during epidemics

While this study highlights the emotional and developmental impact of limited parental involvement, another line of research focuses on improving the overall quality and consistency of maternal and neonatal care during epidemics. An international team of experts has established a core outcome set (COS) specifically for maternal and neonatal health during epidemic situations. This set aims to ensure consistent and comparable reporting of health outcomes, facilitating quicker, evidence-based responses in future outbreaks. The proposed outcomes include maternal aspects such as pregnancy outcome, maternal death, and infection status, and neonatal outcomes like neonatal death, infection, prematurity, breastfeeding, and skin-to-skin contact. The COS was developed through global expert consensus, with the active involvement of EFCNI (now GFCNI), emphasizing outcomes critically important across all epidemic scenarios.

Recommendations and future directions

Both studies emphasize that epidemics significantly alter parental roles and care practices in NICUs, directly affecting infant development and parental mental health. By adopting the recommended core outcome set, healthcare providers can better monitor and respond to the unique challenges posed by epidemics, ensuring that essential maternal and neonatal care continues effectively despite external disruptions. The goal is to minimize the long-term impacts on infant health and parental well-being through robust, consistent, and supportive healthcare practices.

Paper available at: A core outcome set for maternal and neonatal health research and surveillance of emerging and ongoing epidemic threats (MNH-EPI-COS): a modified Delphi-based international consensus - eClinicalMedicine

Full list of authors: Pingray V.; Klein K.; Alonso J.; Belizan M.; Babinska M.; Alger J.; Barsosio H.; Blackburn K.; Bolaji O.; Carson C.; Castiglioni S.; De Luca D.; Dhaded S.; Engmann C.; Escobar Vidarte M.; Escuriet R.; Kara E.; Kim C.; Knight M.; Lamprianou S.; Lota M.; Mader S.; Madrid L.; Marcone A.; Mazzoni A.; Montenegro R.; Mukisa-Bisoborwa R.; Munoz F.; Okomo U.; Okong P.; Ortega V.; Salva F.; Schwartz D.; Sudjaritruk T.; Yates L.; Younus M.; Zafar N.; Oladapo O.; Berrueta M.; Bonet M.

DOI: https://doi.org/10.1016/j.eclinm.2024.103025

Paper available at: Comparing Parents' Experiences of Contact with Their Preterm Infants in NICUs in Türkiye Before, During, and After the COVID-19 Pandemic: A Cross-Sectional Study | Article | Türkiye Klinikleri

Full list of authors: Okay İ.; Okay P.; Keskin R.; Arasan Doğan İ.

DOI: https://doi.org/10.5336/healthsci.2024-104868