What is the SARS-CoV-2 Transmission Risk Associated with Prenatal Visits?
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
Nested case-control study (April 19 and June 27, 2020)
4 hospitals in Boston
All patients delivering at the hospital during the study period
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
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
Positive COVID-19 diagnosis
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
Mean (SD) number in-person visits: 3.1 (2.2)
Range of in-person visits: 0 to 10
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
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
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