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

Fassett, Michael J.; Lurvey, Lawrence D.; Yasumura, Lyn; Nguyen, Marielle; Colli, Joseph J.; Volodarskiy, Marianna; Gullett, Jonathan C.; Braun, David; Fong, Alex; Trivedi, Neha; Bruxvoort, Katia; Chiu, Vicki; Getahun, Darios

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.