key: cord-0875258-5p89d3v2
authors: Bellini, Carlo; Gente, Maurizio; Dufour, Francesca; Andreato, Chiara; Massirio, Paolo; Ramenghi, Luca Antonio
title: Italian neonatal transport changed during the pandemic due to some hospitals being re‐designated for COVID‐19 cases
date: 2021-09-28
journal: Acta Paediatr
DOI: 10.1111/apa.16120
sha: 6fed10d48b749e89c7b9b71c1f1e0353b3eb63f5
doc_id: 875258
cord_uid: 5p89d3v2

COVID-19 has had a significant impact on Italian healthcare, including perinatal care. We describe the effects on the Italian neonatal emergency transport system (NETS) from the first lockdown in March 2020 to the end of December 2020.

Italian neonatal transport changed during the pandemic due to some hospitals being re-designated for COVID-19 cases has had a significant impact on Italian health care, including perinatal care. We describe the effects on the Italian neo- During the first Italian lockdown, from 9 March 2020, maternity wards closed if they were in hospitals that were only treating COVID-19 patients. At the same time, reference centres were set up for pregnant women who had tested positive for the virus or were highly likely to have been infected. Virus-positive pregnancies were mostly concentrated in adult hospitals that did not always have tertiary neonatology units, as paediatric hospitals needed to be COVID-19-free. If a newborn infant was born to a virus-positive mother, but they both remained healthy, they were kept together in an isolation room. Neonatal transport was activated if the infant started to display COVID-19 symptoms or needed to be moved to a neonatal intensive care unit. This hospital reorganisation led to unavoidable changes. For example, it was not always possible to provide tertiary obstetric care and neonatal care together and more than a quarter of infants born to mothers with COVID-19 needed NETS transfers. All 55 NETS said they guaranteed round-the-clock coverage 365 days a year. In 2020, NETS transported 6112 infants. Table 1 The changing face of neonatal transport was a consequence of these initial difficulties. 4,5 NETS is a niche area, particularly when we look at the devastating impact the pandemic has had on public health. We believe that Italian NETS have addressed the COVID-19 pandemic as positively and effectively as they could have done in such demanding circumstances.

The finding that more than a quarter of NETS transports were related to COVID-19 appears to have been due to the reorganisation of adult hospitals during the pandemic and not to any failing of health services or the regionalisation of Italian perinatal care.

Nationwide survey of neonatal transportation practices in Italy

Neonatal emergency transport has played a key role in the regionalisation of perinatal care in the Liguria Region of Italy

The neonatal transport index could be used as a reference tool for the Italian perinatal care regionalisation plan

COVID-19 outbreak impact on neonatal emergency transport

European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients