386 Knowledge, attitudes and expectations of perinatal care during the COVID-19 pandemic

Background There is limited evidence regarding the transmission SARS-CoV-2 from mother to infant, as well as the optimal management of infected women and infant during pregnancy, labor and early postnatal period. The knowledge, concerns and expectations of women with regards to perinatal and neonatal care during this current COVID-19 pandemic is currently unclear. Objectives This study aimed to investigate the knowledge and expectations of pregnant women on perinatal and neonatal care during the coronavirus disease 2019 (COVID-19) pandemic in Singapore. Methods A cross-sectional survey was administered via a secure online platform to pregnant women attending the antenatal clinics between August 2020 and September 2020. Participants aged >21 years who were pregnant and had no history of confirmed COVID-19 were included in the study. The survey consisted of 10 questions formulated to evaluate the knowledge and expectations of these women on the perinatal and neonatal care during this current pandemic. Results A total of 313 pregnant women completed the survey during the study period. The mean age of the participants was 30 years (SD 4; range 22–43 years). The median gestational age of women at survey participation was 25 weeks (range 4–40 weeks). The participants were predominantly multiparous (54%) and almost all (98%) had completed secondary level education. Majority of participants were aware of the spread of COVID-19 by respiratory secretions and contact (90%), and the importance of hand hygiene and face masking (94%). Up to 72% agreed or strongly agreed that in-utero transmission of SARS-CoV-2 to the unborn foetus was possible. Most were unsure of the optimal mode of delivery (77%) and only 22% believed that breastfeeding was safe in a pregnant women with active COVID-19. There was no significant association between the sociodemographic factors evaluated and maternal agreement with the possibility of in-utero SARS-CoV-2 transmission and the risk associated with vaginal delivery in women with COVID-19. Although 46% of participants were concerned about the increased risk of contracting COVID-19 during routine clinic appointments at the hospital, only 37% of the cohort were agreeable with teleconferencing of clinic appointments. More than half (56%) of the participants reported that their postnatal confinement plans were affected by the current pandemic. Conclusions Our survey revealed that majority of participants were aware of modes of transmission and the prevention strategies of SARS-CoV-2, there were however significant gaps identified in their knowledge related to the risk of in-utero transmission and safety of breast feeding along with significant variability to the agreement with alterations to the perinatal care. For best practice we recommend provision of evidence based information early to expectant mothers by the healthcare professionals to reduce misinformation and anxiety amongst pregnant women related to the current pandemic.