Research Alert

Newswise — Screening all pregnant women who delivered at UW Medicine facilities during the height of the covid pandemic in Washington state showed that remarkably few tested positive for the virus without symptoms, a new report shows.

The study, published this week in Clinical Infectious Diseases, showed that universal testing gave a clear picture of the scope of the disease among women entering the UW Medicine hospitals to give birth, but also informed what type of precautions needed to be deployed in the individual birthing units, as well as postpartum care.

The study came to several conclusions, said Dr. Sylvia LaCourse, an Assistant professor with the University of Washington Department of Medicine, Global Health and Infectious Disease.

“UW medicine has done a remarkable job of early initiation of universal testing for COVID-19 for labor and delivery patients using a combination of on-site rapid testing, high volume centralized testing at the UW Virology lab, and outpatient drive-through screening before admission,” LaCourse said.

This meant that almost all patients had a known COVID-19 status before delivery, and informed personal protective equipment use (PPE) to ensure protection of patients and health care workers, she added.

The rate of infection was low among the mothers coming into UW Medical Center-Montlake and UW Medical Center-Northwest, with an overall positive rate of 2.7 percent. However, if mothers were symptomatic, about 20 percent of this subgroup tested positive for the virus.

“This highlights the importance of continued testing with this population,” said LaCourse. In all, the study looked at 230 mothers between March 2 and April 15 including periods before and after the initiation of universal screening.

The general infection rate among asymptomatic pregnant women was low in Seattle, as compared to early reports from New York City (which was 13-14 percent), likely due to early public health response in the region and widespread testing availability.

Despite low numbers of additional cases identified with universal screening, the continued practice should be supported for now.

“Universal screening of pregnant patients provides important surveillance information due to the representativeness of this population to the greater community, “ LaCourse said, adding that this is a generally healthy population.

LaCourse was co-first author for the study along with Dr. Alisa Kachikis, Assistant Professor in the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine. Drs. Kristina M. Adams Waldorf and Jane Hitti from the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine were co-senior authors

The study included practitioners from the UW Department of Global Health and the Fred Hutchinson Cancer Research Center. Also from the UW Medicine departments and divisions of Allergy and Infectious Diseases, Obstetrics and Gynecology, Maternal-Fetal Medicine, Laboratory Medicine, Anesthesiology and Pain Medicine, Psychiatry, Infection Prevention and Control.

This work was supported by the National Institute of Allergy and Infectious Diseases (grant numbers AI133976, AI145890, AI144938 and AI143265 to KAW and AI120793 to SML). Study data were managed using a REDCap electronic data capture tool hosted by the Institute of Translational Health Sciences at the University of Washington, which was supported by the National Center for Advancing Translational Sciences (UL1TR002319).

 

Journal Link: Clinical Infectious Diseases

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AI133976, AI145890, AI144938 and AI143265; Clinical Infectious Diseases

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