Although the positive effects of good clinical quality standards in perinatal care and breastfeeding support for women, newborns and families have been already demonstrated, many of these practices were disrupted during the COVID-19 pandemic. The objective of this study was to analyse the impact of the COVID-19 pandemic on perinatal care and breastfeeding support practices offered by the Spanish maternity hospitals committed to the UNICEF Baby-friendly Hospital Initiative (BFHI), to women with and without COVID-19. Implementation of perinatal practices was assessed by a cross-sectional survey conducted in May 2020 using an online questionnaire. Comparison with pre-pandemic situation and level of commitment to BFHI practices was performed. Response rate was 50% (58/116). Mothers with COVID-19 suffered greater restrictions in the practices compared to women without COVID-19, with lower rates of companion of choice during labour (84% vs 100%; p = 0.003), skin-to-skin contact (32% vs 52%; p = 0.04), rooming-in (74% vs 98%; p < 0.001), companion of choice during hospital stay (68% vs 90%; p = 0.006), and breastfeeding support (78% vs 94%; p = 0.02). Practices were significantly less prevalent in COVID-19 mothers compared to pre-pandemic situation. A lower accompaniment rate was observed in non-COVID-19 group during delivery (24% vs 47.9%; p < 0.01). Hospitals with higher commitment to BFHI practices reported higher rates of skin-to-skin contact (45.2% vs 10.5%; p = 0.01) and rooming-in (83.9% vs 57.9%; p < 0.05) in COVID mothers. Fewer restrictions were observed in hospitals located in the regions where the pandemic hit harder. In these regions there was a significantly higher level of BFHI commitment of the hospitals, but no significant differences were observed in the average size of the hospital. All the practices suffered even more restrictions during the first weeks of the pandemic. All mothers suffered restrictions in perinatal care during the COVID-19 pandemic. Women with COVID-19 infection suffered more restrictions in perinatal practices than women without infection. The degree of commitment to WHO-UNICEF perinatal quality standards, integrated into the BFHI, was associated with maintenance of good clinical practices.

中文翻译：

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第一波 COVID-19 大流行期间围产期护理和母乳喂养保护的良好做法：西班牙 BFHI 产科医院的全国情况分析

尽管良好的临床质量标准在围产期护理和对妇女、新生儿和家庭的母乳喂养支持方面的积极影响已经得到证明，但其中许多做法在 COVID-19 大流行期间遭到破坏。本研究的目的是分析 COVID-19 大流行对致力于联合国儿童基金会爱婴医院倡议 (BFHI) 的西班牙产科医院向患有和未患有 COVID-19 的妇女提供的围产期护理和母乳喂养支持实践的影响. 围产期实践的实施是通过 2020 年 5 月使用在线问卷进行的横断面调查来评估的。与大流行前的情况和对 BFHI 实践的承诺水平进行了比较。响应率为 50% (58/116)。与没有 COVID-19 的妇女相比，患有 COVID-19 的母亲在实践中受到更大的限制，分娩期间选择伴侣的比率较低（84% 对 100%；p = 0.003）、皮肤接触（32% 对52%；p = 0.04）、同房（74% 对 98%；p < 0.001）、住院期间的首选伴侣（68% 对 90%；p = 0.006）和母乳喂养支持（78% 对 94%） ; p = 0.02)。与大流行前的情况相比，这种做法在 COVID-19 母亲中的流行率明显较低。在分娩期间观察到非 COVID-19 组的伴随率较低（24% 对 47.9%；p < 0.01）。对 BFHI 实践有更高承诺的医院报告说，COVID 母亲的皮肤接触率更高（45.2% 对 10.5%；p = 0.01）和同住（83.9% 对 57.9%；p < 0.05）。在大流行病重灾区的医院中，观察到的限制较少。在这些地区，医院的 BFHI 承诺水平明显较高，但医院的平均规模没有显着差异。在大流行的最初几周，所有的做法都受到了更多的限制。在 COVID-19 大流行期间，所有母亲都在围产期护理方面受到限制。感染 COVID-19 的女性比未感染的女性在围产期实践中受到更多限制。对纳入 BFHI 的 WHO-UNICEF 围产期质量标准的承诺程度与维持良好的临床实践有关。但在医院的平均规模上没有观察到显着差异。在大流行的最初几周，所有的做法都受到了更多的限制。在 COVID-19 大流行期间，所有母亲都在围产期护理方面受到限制。感染 COVID-19 的女性比未感染的女性在围产期实践中受到更多限制。对纳入 BFHI 的 WHO-UNICEF 围产期质量标准的承诺程度与维持良好的临床实践有关。但在医院的平均规模上没有观察到显着差异。在大流行的最初几周，所有的做法都受到了更多的限制。在 COVID-19 大流行期间，所有母亲都在围产期护理方面受到限制。感染 COVID-19 的女性比未感染的女性在围产期实践中受到更多限制。对纳入 BFHI 的 WHO-UNICEF 围产期质量标准的承诺程度与维持良好的临床实践有关。