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.