BACKGROUND AND PURPOSE:

• Reale et al (JAMA, 2020) assessed whether the number of obstetrical in-person health care visits was associated with the risk of SARS-CoV-2 infection

METHODS:

• Nested case-control study (April 19 and June 27, 2020)
• Setting
  • 4 hospitals in Boston
• Participants
  • All patients delivering at the hospital during the study period
• Study design
  • All obstetrical patients were RT-PCR tested for COVID-19 at time of admission
  • Risk set sampling was used to match patients who tested positive with up to 5 controls that were matched based on a variety of factors
    • Gestational age
    • Race/ethnicity
    • Insurance type
    • Zip code
  • The number of in-person visits from March 10 to diagnosis were determined using medical records
  • Associations between number of in-person visit and odds of positive test were determined using conditional logistic regression
• Primary outcome
  • Positive COVID-19 diagnosis

RESULTS:

• 2963 deliveries
  • COVID-19 positive: 3.7% (95% CI, 3.1% to 4.5%)
    • Positive antenatally: 45 patients
    • Positive at admission for delivery: 66 patients
• 93 cases were matched with 372 controls
• Number of in-person visits
  • Positive patients
    • Mean (SD) number in-person visits: 3.1 (2.2)
    • Range of in-person visits: 0 to 10
  • Control patients
    • Mean (SD) number in-person visits: 3.3 (2.3)
    • Range in-person visits: 0 to 16
• Association between number of in-person visits and infection
  • Odds ratio 0.93 (95% CI, 0.80 to 1.08) per additional visit

CONCLUSION:

• There was no significant association between the number of in-person visits and rate of infection for this group of obstetrical patients
• The authors state

The findings from this obstetrical population who had frequent in-person visits to a health care setting and underwent universal testing for SARS-CoV-2 infection suggest in-person health care visits were not likely to be an important risk factor for infection and that necessary, in-person care can be safely performed

Learn More – Primary Sources:

Association Between Number of In-Person Health Care Visits and SARS-CoV-2 Infection in Obstetrical Patients

Related ObG Topics:

Labor & Delivery: Asymptomatic Patients and Universal COVID-19 Testing

Comparing SARS-CoV-2 Positive Rates Among Pregnant vs Non-Pregnant Patients in New York State

Universal Screening: What Percent of Women Admitted to L&D are Positive for SARS-CoV-2?