Obstetric outcomes in breastfeeding women in the first hour of delivery before and during the COVID-19 pandemic.

Introduction: Breastfeeding provides several benefits to the health of women and newborns and constituting a protective factor against infant morbidity and mortality in the short and long term.

Objectives/research Questions: The study aims to compare obstetric outcomes in women who did and did not breastfeed after birth.

Method: Cross-sectional epidemiological study, nested in a cohort, carried out with secondary data from the survey "Birth and breastfeeding in children of mothers infected with SARS-CoV-2", carried out in 2020, in Brazil. The results obtained were compared with those of the study "Birth in Belo Horizonte: survey on childbirth and birth", carried out in 2011-2012.

Results: 1082 women were included in the sample of the survey carried out in the pandemic period and 382 in the pre-pandemic period. A total of 1,082 women were included in the sample of the research carried out during the pandemic period and 382 during the pre-pandemic period. A higher proportion of women who breastfed within the first hour after delivery and: did not have an indication for cesarean section in the pre-pandemic period and women without obstetric complications in the pre-pandemic period were observed when compared to the pandemic period. Regarding the comparison between infected/suspected and non-infected women, we observed: higher proportions of women who had a vaginal delivery and breastfed after delivery in non-infected women and higher proportions of non-infected women, with no indication for cesarean section at the time of admission and who breastfed within the first hour after delivery - when compared to infected/suspected women. Finally, regarding the multivariate analysis of the pre-pandemic period, we observed that women who had fewer than 7 prenatal consultations reduced, on average, 0.36 times the chance of breastfeeding after delivery (p = 0.007). Regarding the pandemic period, we observed that women who underwent cesarean section reduced, on average, 0.61 times the chance of breastfeeding after delivery (p = 0.027), women who had a newborn weighing less than 2500 g reduced, on average, 0.29 times the chance of breastfeeding after delivery (p = 0.031) and women who had a newborn with complications after delivery reduced, on average, 0.05 times the chance of breastfeeding after delivery (p < 0.001).

Conclusions: These findings highlight the importance of prenatal monitoring and childbirth assistance, especially in times of crisis, to promote breastfeeding. Furthermore, these findings may provide important contributions to improving health and care related to labor, delivery, birth and the postpartum period.