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Screening for coronavirus disease 2019 in pregnant women admitted for delivery: an observational study
Ana Nery Melo Cavalcante1,2,3, Rosa Lívia Freitas de Almeida2, Denise Nunes Oliveira3
1Gonzaga Mota of Messejana Hospital, Department of Obstetrics and Neonatology - Fortaleza (CE), Brazil.
Insights
Symptom-based screening for coronavirus disease 2019 in pregnant women identified cases and reduced perinatal transmission. This approach is effective, especially in low-prevalence areas, optimizing resource allocation for neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Neonatal Care
Background:
- Neonatal coronavirus disease 2019 (COVID-19) poses risks to newborns.
- Effective screening strategies are crucial for pregnant women during delivery admission.
Purpose of the Study:
- To evaluate the impact of symptom-based screening for COVID-19 on prevalence and outcomes in neonates born to infected mothers.
- To assess the effectiveness of symptom-based screening versus universal screening.
Main Methods:
- Retrospective observational study of pregnant women admitted for delivery between June and August 2020.
- Symptom-based screening for COVID-19, with confirmatory Reverse transcription-polymerase chain reaction (RT-PCR) or immunology assays.
- RT-PCR testing for all newborns of symptomatic mothers to determine neonatal COVID-19 status.
Main Results:
- 5.4% of pregnant women reported symptoms, and 4.8% tested positive for COVID-19.
- Cough was the most frequent symptom (46%) among positive cases.
- 14% of newborns born to symptomatic mothers tested positive for COVID-19, with no serious complications observed.
Conclusions:
- Universal screening of pregnant women can decrease perinatal transmission of COVID-19.
- Symptom-based screening is a viable alternative for resource allocation in low-prevalence settings.
- This strategy aids in managing neonatal COVID-19 and ensuring better maternal-fetal health outcomes.
Objective:
The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery.
Methods:
A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019.
Results:
A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications.
Conclusion:
Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary.
