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SARS-CoV-2 Testing and Detection During Peripartum Hospitalizations Among a Multi-center Cohort of Pregnant Persons, March 2020–February 2021

Louise Hadden, Mary Juergens, Gabriella Newes-Adeyi, and Lawrence Reichle, Abt Global; Nickolas Ferguson, formerly of Abt Global, currently at U.S. Census Bureau; Miranda J. Delahoy, Carmen Sofia Arriola, Michael Daugherty, Margaret Snead, and Fatimah S. Dawood, Centers for Disease Control and Prevention; Flor Munoz, Nanette Lee Bond, Venkatesh Kancharla, Erin Nicholson, and Mo Sanyang, Baylor College of Medicine; De-Kun Li, Jeannette Ferber, and Roxana Odouli, Kaiser Permanente Northern California; Jillian T. Henderson, Stephanie A. Irving, and Allison Naleway, Kaiser Permanente Northwest


August 30, 2022

Understanding SARS-CoV-2 testing practices and infection burden for hospitalizations at the end of pregnancy (i.e., peripartum hospitalization) can help to apply infection prevention strategies and guide care.  

A study that Abt Global co-authored, funded by the Centers for Disease Control and Prevention, reviewed electronic health records of 17,858 pregnant persons in Texas, Oregon, Washington, and California with expected due dates from March 1, 2020 to February 28, 2021. 10,863 (60.8 percent) of participants had SARS-CoV-2 testing when the pregnancy ended, and 222 (2 percent) had positive results. 

Factors associated with higher SARS-CoV-2 testing were Asian race, Hispanic or Latina ethnicity, Medicaid coverage, and preterm hospitalization. The variations may indicate that biases in testing practices exist despite universal testing protocols for hospitalization at the end of pregnancy. The testing biases suggest that persons who test positive may not be representative of all persons with SARS-CoV-2 infections at the end of pregnancy.

The study noted that researchers need to consider testing practice variations when interpreting studies relying on non-randomly selected samples of pregnant persons testing positive for SARS-CoV-2. Efforts to address testing differences by, for example, adoption of universal testing, could produce more equitable testing practices for pregnant persons with SARS-CoV-2 infections. While universal testing can be challenging to implement, the practice allows for better prevalence estimates of SARS-CoV-2 among hospitalized pregnant persons and can improve resource allocation, infection prevention, and patient management.