Should pregnant women be screened for SARS‐CoV‐2 infection? A prospective multicenter cohort study

Abstract

Objective The coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), ranges from asymptomatic to severe infection. We aimed to compare the prevalence of COVID‐19 in asymptomatic pregnant vs. non‐pregnant women in order to establish recommendations for a COVID‐19 screening strategy. Methods A prospective multicenter cohort study was conducted. Asymptomatic pregnant or non‐pregnant women after March 2020 (the time when COVID‐19 was first detected in north Israel) were tested for SARS‐CoV‐2 using nasopharyngeal reverse‐transcription polymerase chain reaction test, anti‐nucleocapside‐IgG and anti‐spike‐IgG. Diagnosis was made if at least one test was positive. Pregnant women were tested between 34‐42 weeks, mostly at birth. Results Among the 297 participating women, 152 were pregnant and 145 were non‐pregnant. The prevalence of asymptomatic COVID‐19 was similar between the groups (4 (2.6%) and 8 (5.5%), respectively, p=0.2). All women with COVID‐19 delivered at term, healthy appropriate‐for‐gestational‐age babies without malformations. Conclusions The rate of asymptomatic COVID‐19 in pregnant women is low and comparable to the rate among non‐pregnant women. Pregnancy outcomes are favorable. Future screening programs should consider that 1 of 25 screened asymptomatic women will be positive.