Impact of the COVID‐19 pandemic on neonatal services and outcomes in a tertiary hospital in Tshwane, South Africa
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Abstract
Background. The COVID‐19 pandemic’s collateral damage has severely impacted global child health services. This study investigates its effects on neonatal services and outcomes at a tertiary hospital in Tshwane, South Africa.
Objective. The main aim was to assess if decreased breastfeeding, coupled with increased infant formula use owing to COVID‐19‐related visitation disruptions, was associated with higher incidences of healthcare‐associated infections (HAI) and necrotising enterocolitis (NEC) in the hospital’s neonatal unit.
Methods. As part of the Tshwane Maternal‐Child COVID‐19 study, we collected relevant data from three periods: pre‐COVID‐19, COVID‐year‐1 (COVID‐Y1) and COVID‐year‐2 (COVID‐Y2).
Results. Exclusive breastfeeding at discharge decreased from 72.9% pre‐COVID‐19 to 47.0% during COVID‐19. Preterm formula purchases rose by 37.5% in COVID‐Y1 and 25.0% in COVID‐Y2, and term formula purchases increased by 77.8% in COVID‐Y1. HAI incidence increased in both COVID‐Y1 and COVID‐Y2 compared with pre‐COVID‐19 (11.6% v. 8.1% and 12.0% v. 8.1%). NEC incidence significantly increased in COVID‐Y2 for infants ≥1 500 g (1.8% v. 0.7%).
Conclusion. This study underscores the indirect consequences of COVID‐19 parental visitation restrictions, leading to infringements of breastfeeding rights and coinciding with increased HAI and NEC incidences in the hospital’s neonatal unit.
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