Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019

Vintzileos, William S.; Muscat, Jolene; Hoffmann, Eva; John, Nicole S.; Vertichio, Rosanne; Vintzileos, Anthony M.; Vo, Diep

doi:10.1016/j.ajog.2020.04.024

Cited by 123 publications

(157 citation statements)

References 2 publications

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“…Outpatient antibiotic misuse is widespread in the United States and has been associated with several patient harms, including Clostridioides difficile infections, adverse drug reactions, and rising rates of antibiotic resistance. 1,2 Recent estimates suggest that~30% of the >200 million outpatient antibiotic prescriptions in the United States each year may be inappropriate. [3][4][5] Although outpatient antibiotic misuse is common, it remains difficult to identify and study.…”

Section: Division Of Infectious Diseases Icahn School Of Medicine Atmentioning

confidence: 99%

“…They found that 14% of asymptomatic women tested positive. 1,2 Unidentified, these asymptomatic women were at risk of infecting their newborns following birth, hospital staff, as well as other patients. It is unclear, however, whether the high rate of asymptomatic infections in New York is a reflection of a particularly high prevalence of SARS-CoV-2 during that time period in New York or a more generalizable phenomenon applicable to other high-prevalence areas.…”

mentioning

confidence: 99%

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Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients

Goldfarb

Diouf

Barth

et al. 2020

Infect. Control Hosp. Epidemiol.

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Section: Division Of Infectious Diseases Icahn School Of Medicine Atmentioning

confidence: 99%

mentioning

confidence: 99%

Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients

Goldfarb

Diouf

Barth

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

“…The variation of the monitored laboratory parameters is shown in Table 2. positive for SARS-CoV-2, as well as for pregnant women suspected to be infected (those with travel history, contacts of SARS -Cov-2 positive persons or presenting respiratory symptoms) [2], [3], [10], [11].…”

Section: Laboratory Datamentioning

confidence: 99%

“…The risk of contamination of the newborn seems higher in the immediate postnatal period, from the infected symptomatic or healthy carrier mother, if strict hygienic measures are not respected during skin-to-skin care. Due to COVID − 19 high contagion, obstetricians, neonatologists and infectionists have focused on the implementation of preventive measures in all areas (from the delivery room, to the neonatal, maternity ward and intensive care unit) to limit the risk of viral transmission [3], [7]- [9].…”

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confidence: 99%

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Diagnosis Challenges, Management, and Outcome of Infants Born to Mothers With COVID 19

Zaharie

Hășmășanu

Mureşan

et al. 2020

Preprint

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Background: Severe acute respiratory distress syndrome with Coronavirus 2 (SARS-CoV-2) infection affected the pregnant women during the pandemics. Immunological particularity of this population and the increased need for medical assistance put this population in a high-risk category for SARS-Cov-2 infection.Because of high contamination risk and limited studies about vertical transmission, the labor and delivery of positive women require special conditions. Cesarean section is probably the best option for delivery of infants to reduce the risk of infection during birth.Aim: Our study aims to present the management and outcome of infants born to mothers confirmed with coronavirus disease 2019 (COVID19) before delivery.Material and methods: This is longitudinal, retrospective study, analyzing demographics, laboratory data and management of neonates born of mothers with diagnosis of SARS-Cov -2 infection.Results: 5 neonates were born of SARS-Cov-2 positive mothers , all by C- section and had negative real time –PCR ( RT-PCR) test. None of them was breastfed during hospital stay. The negative RT-PCR test allowed us to reduce the hospital stay of infants and care them in non –isolated area.Conclusion: In our study, vertical or perinatal transmission of the infection was not present. The testing of the pregnant women, their isolation and delivery in safe conditions for the medical staff were possible, using adequate protection equipment to limit their infection and the risk for the newborns.

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Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City

et al. 2021

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IMPORTANCE Limited data on vertical and perinatal transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and health outcomes of neonates born to mothers with symptomatic or asymptomatic coronavirus disease 2019 (COVID-19) are available. Studies are needed to inform evidence-based infection prevention and control (IP&C) policies. OBJECTIVE To describe the outcomes of neonates born to mothers with perinatal SARS-CoV-2 infection and the IP&C practices associated with these outcomes. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort analysis reviewed the medical records for maternal and newborn data for all 101 neonates born to 100 mothers positive for or with suspected SARS-CoV-2 infection from March 13 to April 24, 2020. Testing for SARS-CoV-2 was performed using Cobas (Roche Diagnostics) or Xpert Xpress (Cepheid) assays. Newborns were admitted to well-baby nurseries (WBNs) (82 infants) and neonatal intensive care units (NICUs) (19 infants) in 2 affiliate hospitals at a large academic medical center in New York, New York. Newborns from the WBNs roomed-in with their mothers, who were required to wear masks. Direct breastfeeding after appropriate hygiene was encouraged. EXPOSURES Perinatal exposure to maternal asymptomatic/mild vs severe/critical COVID-19. MAIN OUTCOMES AND MEASURES The primary outcome was newborn SARS-CoV-2 testing results. Maternal COVID-19 status was classified as asymptomatic/mildly symptomatic vs severe/critical. Newborn characteristics and clinical courses were compared across maternal COVID-19 severity. RESULTS In total, 141 tests were obtained from 101 newborns (54 girls [53.5%]) on 0 to 25 days of life (DOL-0 to DOL-25) (median, DOL-1; interquartile range [IQR], DOL-1 to DOL-3). Two newborns had indeterminate test results, indicative of low viral load (2.0%; 95% CI, 0.2%-7.0%); 1 newborn never underwent retesting but remained well on follow-up, and the other had negative results on retesting. Maternal severe/critical COVID-19 was associated with newborns born approximately 1 week earlier (median gestational age, 37.9 [IQR, 37.1-38.4] vs 39.1 [IQR, 38.3-40.2] weeks; P = .02) and at increased risk of requiring phototherapy (3 of 10 [30.0%] vs 6 of 91 [7.0%]; P = .04) compared with newborns of mothers with asymptomatic/mild COVID-19. Fifty-five newborns were followed up in a new COVID-19 Newborn Follow-up Clinic at DOL-3 to DOL-10 and remained well. Twenty of these newborns plus 3 newborns followed up elsewhere had 32 nonroutine encounters documented at DOL-3 to DOL-25, and none had evidence of SARS-CoV-2 infection, including 6 with negative retesting results. CONCLUSIONS AND RELEVANCE No clinical evidence of vertical transmission was identified in 101 newborns of mothers positive for or with suspected SARS-CoV-2 infection, despite most newborns rooming-in and direct breastfeeding practices.

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Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019

Abstract: This communication has been published in the middle of the coronavirus disease 2019 pandemic and is available via expedited publication to assist patients and healthcare providers.

Cited by 123 publications

References 2 publications

Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients

Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients

Diagnosis Challenges, Management, and Outcome of Infants Born to Mothers With COVID 19

Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City

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