Introduction
With over 1,500 documented severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) cases per 100,000 residents as of June 22,
2020,1 the Commonwealth of Massachusetts has the third
highest rate of infection per capita in the United
States.2 Mass General Brigham is the largest network
of hospitals in Massachusetts. All birth hospitals within the network
implemented universal SARS-CoV-2 testing of all women admitted for labor
and delivery using polymerase chain reaction (PCR) testing for
SARS-CoV-2 on April 19, 2020.
While studies from large cities affected by coronavirus disease 2019
(COVID-19), including this population, have reported on the prevalence
of SARS-CoV-2 in the context of universal testing during admission for
delivery, little is known about the patient demographic, social, and
clinical factors associated with SARS-CoV-2 infection in pregnant women
in the United States.3-9 Understanding factors
associated with SARS-CoV-2 infection at the time of labor and delivery
is important for several reasons. First, it can highlight subgroups of
pregnant patients who are at particular risk for infection and can
inform the counseling of these women throughout pregnancy and as they
approach term, with the goal of implementing preventative strategies
needed to decrease the risk of infection. Second, in settings where
universal rapid testing is limited or not available, it can be used to
direct prevention efforts and inform which patients should be
prioritized for testing and the types of precautions that should be used
while testing is pending.
The aim of this study was therefore to determine the prevalence of, and
factors associated with, SARS-CoV-2 infection in patients admitted for
labor and delivery at four Boston-area hospitals.