Pregnant and breastfeeding women’s attitudes and fears regarding the COVID-19 vaccination

Purpose The COVID-19 vaccination is probably the most important source to fight the COVID-19 pandemic. However, recommendations and possibilities for vaccination for pregnant and breastfeeding women are inconsistent and dynamically changing. Methods An anonymous, online, cross-sectional survey was conducted among pregnant and breastfeeding women in Germany between 30th March and 19th April 2021 addressing COVID-19 vaccination attitudes including the underlying reasons for their decision. Additionally, anxiety regarding a SARS-CoV-2 infection and a symptomatic course of the infection were evaluated. Results In total, 2339 women (n = 1043 pregnant and n = 1296 breastfeeding) completed the survey. During pregnancy the majority (57.4%) are not in favour of receiving the vaccine, 28.8% are unsure and only 13.8% would get vaccinated at the time of the survey. In contrast, 47.2% would be in favour to receive the vaccine, if more scientific evidence on the safety of the vaccination during pregnancy would be available. Breastfeeding women show higher vaccination willingness (39.5% are in favour, 28.1% are unsure and 32.5% not in favour). The willingness to be vaccinated is significantly related to the women’s anxiety levels of getting infected and to develop disease symptoms. Main reasons for vaccination hesitancy are the women’s perception of limited vaccination-specific information, limited scientific evidence on vaccination safety and the fear to harm the fetus or infant. Conclusions The results provide important implications for obstetrical care during the pandemic as well as for official recommendations und information strategies regarding the COVID-19 vaccination.

Factors influencing mothers’ decisions regarding obstetrical care in Western Kenya: a mixed-methods study

Background Siaya County in Western Kenya has one of the highest maternal mortality rates in Kenya. We sought to elucidate factors that influence mothers’ decisions regarding where to seek obstetrical care, to inform interventions that seek to promote effective use of obstetric services and reduce maternal mortalities. To guide our research, we used the “Three Delays Model”, focusing on the first delay—seeking care. While interventions to reduce maternal mortalities have focused on addressing delays in accessing and receiving care, context-specific data on drivers of the first delay are scarce. Methods We used a mixed-method study to assess how maternal decision-making of birth location is influenced by personal, contextual, and cultural factors. We conducted structured interviews with women aged 14 years or older living in Siaya, Bondo, and Yala, rural districts in Western Kenya. We then conducted focus group interviews with a subset of women to elucidate this question: How do drivers of the first delay (i.e., seeking care) affect the decision to seek home versus hospital delivery, potentially negatively influencing maternal mortality. Results Three hundred and seven women responded to the surveys, and 67 women (22%) from this group participated in focus group interviews. Although we focused on type 1 delays, we discovered that several factors that impact type 2 and type 3 delays directly contribute to type 1 delays. Our findings highlighted that factors influencing women’s decisions to seek care are not simply medical or cultural but rather contextual, involving many elements of life, particularly in rural communities. Conclusions It is imperative to address multiple-level factors that influence women’s decisions to seek care and have in-hospital deliveries. To curtail maternal mortality in rural Western Kenya and comparable settings, targeted interventions must take into consideration these important influencers.

Vertical Transmission of COVID-19: A Case Report and Review of Literature

Coronavirus disease 2019 (COVID-19) pandemic will continue affecting pregnant women with possibility of vertical transmissions. However, knowledge and evidences regarding vertical transmission of COVID-19 are just emerging. This information is very crucial in the obstetrical care of COVID-19 infected women as well as in the care of newborn born to COVID-19 positive mothers. We report a case of vertical transmission in a neonate born to asymptomatic COVID-19 infected mother. Newborn was immediately shifted to isolation nursery and formula feed was started. The nasopharyngeal swab of newborn taken at 42 hours of life tested positive for SARS-CoV-2 by RT-PCR. Therefore the vertical transmission in COVID-19 is possible. Despite this, the neonatal outcome is good. Keywords: Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn