PURPOSE:

• Tekbali et al. (AJOG, 2020) report on hospital admission experience of pregnant vs non-pregnant patients in New York State during the COVID-19 pandemic, with a specific focus on SARS-CoV-2 positive rates

METHODS:

• Retrospective data review (between March 2 and March 29, 2020)
  • 14 hospitals in New York State
  • Universal SARS-CoV-2 testing not performed | Symptom-based testing
• Data collection
  • Week of admission | Pregnancy status | SARS-CoV-2 testing status (on admission, during hospitalization or postpartum)

RESULTS:

• Total admissions: 21,980 patients
  • Pregnant or postpartum: 3,064 patients
• SARS-CoV-2 infection status for all admissions increased over the 4 weeks of the study
  • Week 1: 1.08%
  • Week 4: 49.79%
• SARS-CoV-2 infection status for pregnant and postpartum patients increased over the 4 weeks of the study
  • Week 1: 0.14%
  • Week 4: 5.65% in week 4
  • Relative risk (RR): 14.81 (95% CI, 2.07 to 107.38)
• SARS-CoV-2 status non-pregnant patients also increased over the 4 weeks
  • Week 1: 1.21%
  • Week: 4: 56.79%
  • RR: 46.99 (95% CI, 36.72 to 60.15)

CONCLUSION:

• Both the SARS-CoV-2 positive rate on admission and rate of rise was significantly higher in the non-pregnant population
• The authors suggest that this difference is likely based on lack of universal screening of all patients entering hospital
  • Pregnant women are younger and more likely to be admitted to hospital for obstetric care vs non-pregnant population | Pregnant women may have SARS-COV-2 infection on admission but are asymptomatic and therefore not tested
  • Non-pregnant individuals are more likely to be admitted with symptoms compatible with COVID-19 and would therefore undergo testing
• The authors reference Britain’s most senior midwife who has called for maternity services to be “ringfenced” (i.e., protected from external risk) | This study concludes with the following

Human and material maternity resources should be ringfenced from redeployment which may potentially impair the capacity of labor & delivery units and to ensure that pregnant and postpartum women and their newborns continue to receive the safest possible care

Learn More – Primary Sources:

Pregnant versus non-pregnant SARS-CoV-2 and COVID-19 Hospital Admissions: The first 4 weeks in New York – American Journal of Obstetrics & Gynecology

Related ObG Topics:

Coronavirus and Pregnancy: CDC Guidance and Professional Recommendations

COVID-19: The SMFM/SOAP Guidelines for Labor and Delivery

43 Pregnant Women with COVID-19: Clinical Course and Outcomes