Universal Screening for SARS-CoV-2 in Pregnant Women at Term Admitted to an East London Maternity Unit

Abeysuriya, Sanduni; Wasif, Samreen; Counihan, Callum; Shah, Neha; Iliodromiti, Stamatina; Cutino-Moguel, Maria-Teresa; Saeed, Ferha; Velauthar, Luxmimalar

OBJECTIVE: To explore the prevalence of asymptomatic SARS-CoV-2 in the maternity population. STUDY DESIGN: Newham University Hospital based in East London serving a population with the highest death rate secondary to SARS-CoV-2 in the UK, commenced universal screening of all admissions to the Maternity Unit from 22nd April to 5th May, 2020. A proforma was created to capture key patient demographics, indication for admission and presence of SARS-CoV-2 related symptoms at the point of presentation. RESULTS: A total of 180 women with a mean age of 29.9 (SD 7.4) years, at a median gestation of 39 (IQR 37 + 1to 40 + 3) weeks underwent universal screening with nasopharyngeal PCR swabs during the two-week period of the study. BAME identity or parity was not associated with the likelihood of a positive result. Seven women (3.9%, 1.6 to 7.8) were tested positive for SARS-CoV-2, of whom 6 (3.3%, 1.2 to 7.1) were asymptomatic; 85.7% (42.1 to 99.6) of the SARS-CoV-2 positive women were asymptomatic. The sensitivity of symptom-driven testing was 14.3% (0.36 to 57.87) and specificity was 91.86% (86.72 to 95.48) with a positive predictive value of 6.67% (1.08 to 31.95) and a negative predictive value of 96.34% (95.10 to 97.28). CONCLUSION: The prevalence of SARS-CoV-2 in the maternity population served by Newham University Hospital was 3.9%, four weeks after lockdown. Of the women who were found to be SARS-CoV-2 positive, a high proportion (87.9%) were asymptomatic. These findings support the need for universal testing to enable targeted isolation and robust infectious control measures to mitigate outbreaks of SARS-CoV-2 in maternity units.