COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2023 Feb 8;76(3):e51-e59. doi: 10.1093/cid/ciac657.
Identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden.
This cross-sectional analysis used electronic health record data from hospitalizations during which pregnancies ended (peripartum hospitalizations) among a cohort of pregnant persons at 3 US integrated healthcare networks (sites 1-3). Maternal demographic, medical encounter, SARS-CoV-2 testing, and pregnancy and neonatal outcome information was extracted for persons with estimated delivery and pregnancy end dates during March 2020-February 2021 and ≥1 antenatal care record. Site-stratified multivariable logistic regression was used to identify factors associated with testing and compare pregnancy and neonatal outcomes among persons tested.
Among 17 858 pregnant persons, 10 863 (60.8%) had peripartum SARS-CoV-2 testing; 222/10 683 (2.0%) had positive results. Testing prevalence varied by site and was lower during March-May 2020. Factors associated with higher peripartum SARS-CoV-2 testing odds were Asian race (adjusted odds ratio [aOR]: 1.36; 95% confidence interval [CI]: 1.03-1.79; referent: White) (site 1), Hispanic or Latino ethnicity (aOR: 1.33; 95% CI: 1.08-1.64) (site 2), peripartum Medicaid coverage (aOR: 1.33; 95% CI: 1.06-1.66) (site 1), and preterm hospitalization (aOR: 1.69; 95% CI: 1.19-2.39 [site 1]; aOR: 1.39; 95% CI: 1.03-1.88 [site 2]).
Findings highlight potential disparities in SARS-CoV-2 peripartum testing by demographic and pregnancy characteristics. Testing practice variations should be considered when interpreting studies relying on convenience samples of pregnant persons testing positive for SARS-CoV-2. Efforts to address testing differences between groups could improve equitable testing practices and care for pregnant persons with SARS-CoV-2 infections.
在围产期住院期间识别严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染对于指导护理、实施预防措施和了解感染负担非常重要。
本横断面分析使用了美国 3 个综合医疗网络（站点 1-3）中妊娠结束时（围产期住院）的妊娠人群的电子健康记录数据。对于在 2020 年 3 月至 2021 年 2 月期间有估计分娩和妊娠结束日期的且有≥1 次产前保健记录的人群，提取了产妇人口统计学、医疗接触、SARS-CoV-2 检测以及妊娠和新生儿结局信息。采用站点分层多变量逻辑回归来确定与检测相关的因素，并比较检测人群的妊娠和新生儿结局。
在 17858 名孕妇中，有 10863 名（60.8%）进行了围产期 SARS-CoV-2 检测；10683 名中有 222 名（2.0%）检测结果为阳性。检测的流行率因站点而异，在 2020 年 3 月至 5 月期间较低。与围产期 SARS-CoV-2 检测几率较高相关的因素是亚洲种族（调整后的优势比 [aOR]：1.36；95%置信区间 [CI]：1.03-1.79；参考：白人）（站点 1）、西班牙裔或拉丁裔血统（aOR：1.33；95% CI：1.08-1.64）（站点 2）、围产期医疗补助覆盖（aOR：1.33；95% CI：1.06-1.66）（站点 1）和早产住院（aOR：1.69；95% CI：1.19-2.39 [站点 1]；aOR：1.39；95% CI：1.03-1.88 [站点 2]）。
研究结果突出了 SARS-CoV-2 围产期检测在人口统计学和妊娠特征方面的潜在差异。在解释依赖 SARS-CoV-2 检测阳性的孕妇便利样本的研究时，应考虑检测实践的差异。努力解决不同群体之间的检测差异，可以改善 SARS-CoV-2 感染孕妇的公平检测实践和护理。
