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Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

Am J Perinatol. 2020 Sep;37(11):1110-1114. doi: 10.1055/s-0040-1714060. Epub 2020 Jul 3.

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has created a need for data regarding the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women. After implementing universal screening for COVID-19 in women admitted for delivery, we sought to describe the characteristics of COVID-19 in this large cohort of women.

Study design: An observational study of women admitted to labor and delivery units in Kaiser Permanente Southern California (KPSC) hospitals between April 6 and May 11, 2020 who were universally offered testing for SARS-CoV-2 infection (n = 3,963). Hospital inpatient and outpatient physician encounter, and laboratory records were used to ascertain universal testing levels, test results, and medical and obstetrical histories. The prevalence of SARS-CoV-2 infection was estimated from the number of women who tested positive during labor per 100 women delivered.

Results: Of women delivered during the study period, 3,923 (99.0%) underwent SARS-CoV-2 testing. A total of 17 (0.43%; 95% confidence interval: 0.23-0.63%) women tested positive, and none of them were symptomatic on admission. There was no difference in terms of characteristics between SARS-CoV-2 positive and negative tested women. One woman developed a headache attributed to COVID-19 3 days postpartum. No neonates had a positive test at 24 hours of life.

Conclusion: The findings suggest that in pregnant women admitted for delivery between April 6 and May 11, 2020 in this large integrated health care system in Southern California, prevalence of SARS-CoV-2 test positive was very low and all patients were asymptomatic on admission.

Key points: · The prevalence of SARS-CoV-2 infection in a large diverse cohort of term pregnant women was 0.43%.. · 99% of women accepted SARS-CoV-2 screening on admission to labor and delivery.. · All women with positive test results were asymptomatic at the time of testing..

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Asymptomatic Infections
  • Betacoronavirus / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • California / epidemiology
  • Clinical Laboratory Techniques* / methods
  • Clinical Laboratory Techniques* / statistics & numerical data
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Delivery, Obstetric* / methods
  • Delivery, Obstetric* / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Outcome
  • Prevalence
  • SARS-CoV-2

Grants and funding

Funding This study was supported by Kaiser Permanente Direct Community Benefit Funds.