Comparing SARS-CoV-2 Positive Rates Among Pregnant vs Non-Pregnant Patients in New York State
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
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
Week of admission | Pregnancy status | SARS-CoV-2 testing status (on admission, during hospitalization or postpartum)
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
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)
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
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