Mentality of pregnant women and obstetric healthcare workers about prenatal SARS‐CoV‐2 testing: A regional survey over the first wave of the COVID‐19 pandemic in Japan

Abstract

Aim To clarify the mentality of pregnant women and obstetric healthcare workers about prenatal severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) screening testing. Methods A multicenter questionnaire survey about prenatal SARS‐CoV‐2 screening testing was conducted among pregnant women, midwives and nurses (M&Ns), and obstetricians at all delivery facilities in Fukui Prefecture between June 30, 2020 and July 22, 2020. Results Of 297 pregnant women, 150 (50.5%) underwent prenatal polymerase chain reaction (PCR) testing, and 107 of them (71.3%) answered that because of prenatal PCR tests, they could give birth with relief. One hundred forty‐five (48.8%) were concerned about the disadvantages of receiving positive prenatal PCR results. Of 287 M&Ns, 151 (52.6%) answered that prenatal PCR screening testing could reduce anxiety about infection to themselves; this belief was more common among M&Ns working at the nonreception facility than among those at COVID‐19 reception facilities (60.7% vs. 47.1%, P = 0.02). Of 57 obstetricians, 31 (54.4%) agreed to prenatal SARS‐CoV‐2 PCR screening testing, the rate of which was significantly higher among obstetricians at nonreception facilities than those at reception facilities (70.3% vs. 25.0%, P < 0.01). Fourteen obstetricians (24.6%) were concerned about excessive medical treatment for asymptomatic pregnant women with false‐positive PCR results. Conclusions Pregnant women experience anxieties during the COVID‐19 pandemic, and prenatal SARS‐CoV‐2 screening may reduce their anxiety to some extent. However, obstetrics staff at COVID‐19 reception facilities are aware of the limits of prenatal screening and are concerned about excessive medical intervention due to false‐positive results.

Knowledge, Attitudes, and Behavior Related to COVID-19 Testing: A Rapid Scoping Review

“…Eight studies [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ] targeted participants of pilot testing programs (e.g., a telehealth system for testing [ 21 ] or the introduction of mass asymptomatic testing on a university campus [ 23 ]). Other target populations included patients or users of a specific health service or clinic [ 21 , 28 , 29 ] or health-related online app [ 30 , 31 ]; age-based populations [ 32 ]; health workers [ 33 , 34 , 35 , 36 , 37 ]; students and/or staff based at universities [ 23 , 24 , 25 , 26 , 27 , 38 ]; employment groups, such as police officers or industry workers [ 39 , 40 ]; and groups deemed especially vulnerable to COVID-19, such as homeless populations [ 41 ], refugee populations [ 42 ], or pregnant women attending clinical settings [ 34 , 35 , 43 ].…”

“…Lateral flow testing is less widely represented in the evidence base and is more likely to feature in articles and preprints based on more recently collected data [ 22 , 38 ]. The characteristics of all studies included in the review are summarized in Table 1 [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 …”

“…Studies that explored facilitating factors included research on participants’ knowledge and awareness of testing types and how they work [ 36 , 44 ] and research on people’s identification and interpretation of COVID-19 symptoms, including how this affects test-seeking behavior [ 30 , 45 , 46 , 47 ]. Multiple studies in this research area gathered data on people’s self-reported motivations for undergoing or avoiding testing [ 22 , 23 , 24 , 26 , 27 , 29 , 30 , 32 , 35 , 37 , 38 , 40 , 41 , 42 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. Some of these studies sought to gather data on people’s trust in the government and/or medical systems in relation to COVID-19 testing [ 24 , 41 , 54 , 55 ] or piloted ways to improve people’s levels of trust in testing [ 42 ].…”

“…Studies that focused on testing effects and post-testing behaviors included those concerned with the impact of testing—or the perceived availability of testing—on people’s wellbeing and anxiety levels [ 23 , 24 , 27 , 33 , 34 , 35 , 38 , 39 , 40 , 59 ]; they also included those examining adherence to guidelines following test results, whether in terms of compliance with self-isolation guidelines in the case of a positive result or of maintaining protective behaviors in the case of a negative result [ 22 , 23 , 28 , 31 , 33 , 38 , 39 , 41 , 45 , 51 , 52 , 57 , 60 , 61 ]. All of the studies under this theme were based on self-reporting; no studies in the review undertook observational research on the impact of testing on compliance with guidelines.…”

“…In many cases, research participants also identified personal benefits from testing, including lower risk of being personally responsible for spreading the virus to others [ 38 , 40 , 52 ]; knowing their disease status [ 22 , 47 ]; preventing the spread of disease to family members [ 23 , 40 , 61 ], their unborn fetus [ 35 ], or workplace colleagues [ 39 ]; and being able to return to work [ 33 ]. The personal benefits of testing were especially prominent for people who saw themselves as personally more at risk from COVID-19, including because of age, health status, or ethnicity [ 38 , 53 , 55 ].…”