tetano
Editor, Senior Moderator
Am J Perinatol
. 2021 Feb 21.
doi: 10.1055/s-0041-1723938. Online ahead of print.
SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes
Haley A Steffen[SUP] 1 [/SUP], Samantha R Swartz[SUP] 1 [/SUP], J Brooks Jackson[SUP] 2 [/SUP], Kimberly A Kenne[SUP] 3 [/SUP], Patrick P Ten Eyck[SUP] 4 [/SUP], Abbey S Merryman[SUP] 3 [/SUP], Claire N Castaneda[SUP] 1 [/SUP], Katharine Marsden[SUP] 1 [/SUP], Timothy Maxwell[SUP] 1 [/SUP], Anna E Merrill[SUP] 2 [/SUP], Matthew D Krasowski[SUP] 2 [/SUP], Mary B Rysavy[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy.
Study design: This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births.
Results: In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26-33 years) and body mass index was 31.75 kg/m[SUP]2[/SUP] (IQR 27.7-37.5 kg/m[SUP]2[/SUP]). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic/Latino, 3.3% as Native Hawaiian/Pacific Islander, and only 27.9% as White (p < 0.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p = 0.0243). Adverse maternal and/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period.
Conclusion: In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes.
Key points: ? SARS-CoV-2 seroprevalence rate in pregnant population in Iowa is 5.8%.. ? Infections are higher among minorities, non-English speakers, and patients without private insurance.. ? No increased adverse maternal/neonatal outcomes observed for SARS-CoV-2 infected mothers..
. 2021 Feb 21.
doi: 10.1055/s-0041-1723938. Online ahead of print.
SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes
Haley A Steffen[SUP] 1 [/SUP], Samantha R Swartz[SUP] 1 [/SUP], J Brooks Jackson[SUP] 2 [/SUP], Kimberly A Kenne[SUP] 3 [/SUP], Patrick P Ten Eyck[SUP] 4 [/SUP], Abbey S Merryman[SUP] 3 [/SUP], Claire N Castaneda[SUP] 1 [/SUP], Katharine Marsden[SUP] 1 [/SUP], Timothy Maxwell[SUP] 1 [/SUP], Anna E Merrill[SUP] 2 [/SUP], Matthew D Krasowski[SUP] 2 [/SUP], Mary B Rysavy[SUP] 3 [/SUP]
Affiliations
- PMID: 33611783
- DOI: 10.1055/s-0041-1723938
Abstract
Objective: This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy.
Study design: This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births.
Results: In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26-33 years) and body mass index was 31.75 kg/m[SUP]2[/SUP] (IQR 27.7-37.5 kg/m[SUP]2[/SUP]). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic/Latino, 3.3% as Native Hawaiian/Pacific Islander, and only 27.9% as White (p < 0.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p = 0.0243). Adverse maternal and/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period.
Conclusion: In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes.
Key points: ? SARS-CoV-2 seroprevalence rate in pregnant population in Iowa is 5.8%.. ? Infections are higher among minorities, non-English speakers, and patients without private insurance.. ? No increased adverse maternal/neonatal outcomes observed for SARS-CoV-2 infected mothers..