Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing and Detection During Peripartum Hospitalizations Among a Multicenter Cohort of Pregnant Persons: March 2020-February 2021

Identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden. This cross-sectional analysis used electronic health record data from hospitalizations du...

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Bibliographic Details
Published in:Clinical infectious diseases 2023-02, Vol.76 (3), p.e51-e59
Main Authors: Delahoy, Miranda J, Munoz, Flor, Li, De-Kun, Arriola, Carmen Sofia, Bond, Nanette Lee, Daugherty, Michael, Ferber, Jeannette, Ferguson, Nickolas, Hadden, Louise, Henderson, Jillian T, Irving, Stephanie A, Juergens, Mary, Kancharla, Venkatesh, Greenberg, Mara, Odouli, Roxana, Newes-Adeyi, Gabriella, Nicholson, Erin G, Reichle, Lawrence, Sanyang, Momodou, Snead, Margaret, Dawood, Fatimah S, Naleway, Allison L
Format: Article
Language:English
Subjects:
COVID-19 - diagnosis
COVID-19 - epidemiology
COVID-19 Testing
Cross-Sectional Studies
Female
Hospitalization
Humans
Infant, Newborn
Peripartum Period
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Pregnancy Complications, Infectious - epidemiology
SARS-CoV-2
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Summary:Identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden. This cross-sectional analysis used electronic health record data from hospitalizations during which pregnancies ended (peripartum hospitalizations) among a cohort of pregnant persons at 3 US integrated healthcare networks (sites 1-3). Maternal demographic, medical encounter, SARS-CoV-2 testing, and pregnancy and neonatal outcome information was extracted for persons with estimated delivery and pregnancy end dates during March 2020-February 2021 and ≥1 antenatal care record. Site-stratified multivariable logistic regression was used to identify factors associated with testing and compare pregnancy and neonatal outcomes among persons tested. Among 17 858 pregnant persons, 10 863 (60.8%) had peripartum SARS-CoV-2 testing; 222/10 683 (2.0%) had positive results. Testing prevalence varied by site and was lower during March-May 2020. Factors associated with higher peripartum SARS-CoV-2 testing odds were Asian race (adjusted odds ratio [aOR]: 1.36; 95% confidence interval [CI]: 1.03-1.79; referent: White) (site 1), Hispanic or Latino ethnicity (aOR: 1.33; 95% CI: 1.08-1.64) (site 2), peripartum Medicaid coverage (aOR: 1.33; 95% CI: 1.06-1.66) (site 1), and preterm hospitalization (aOR: 1.69; 95% CI: 1.19-2.39 [site 1]; aOR: 1.39; 95% CI: 1.03-1.88 [site 2]). Findings highlight potential disparities in SARS-CoV-2 peripartum testing by demographic and pregnancy characteristics. Testing practice variations should be considered when interpreting studies relying on convenience samples of pregnant persons testing positive for SARS-CoV-2. Efforts to address testing differences between groups could improve equitable testing practices and care for pregnant persons with SARS-CoV-2 infections.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciac657