Patient Characteristics Associated with SARS-CoV-2 Infection in
Parturients Admitted for Labor and Delivery in Massachusetts: A
Prospective Cohort Study
Abstract
Objective: Little is known about the demographic and clinical factors
associated with SARS-CoV-2 infection in pregnant women in the United
States. The objective of this study was to evaluate the factors
associated with SARS-CoV-2 infection in women admitted for labor and
delivery, in the context of universal screening. Design: Prospective
cohort study. Setting: Four Boston-area hospitals. Population:
Convenience sample of all women admitted for delivery (n= 1,153).
Methods: We reviewed the health records of all women admitted for
delivery at the largest health system in Massachusetts between April
19-May 16, 2020. Factors evaluated for potential association with
SARS-CoV-2 infection included age, BMI, race, co-morbidities, zip code,
infection in a household member, number of children in the household,
occupation, and insurance type. Main Outcome Measures: Risk of
SARS-CoV-2 infection and associations between SARS-CoV-2 infection and
clinical characteristics. Results: A total of 32 patients (2.8%, 95%
confidence interval 1.9-3.9) tested positive for SARS-CoV-2 infection on
admission for delivery; 24 (75.0%) of the patients who tested positive
were asymptomatic. Factors associated with SARS-CoV-2 infection
included: younger age, obesity, African-American or Hispanic
race/ethnicity, residence in heavily affected communities, household
member with known infection, essential worker occupation, and Medicaid
insurance. 93.5% of patients testing positive for SARS-CoV-2 had one or
more factors associated with disease acquisition. Conclusions: In this
large sample of deliveries, SARS-CoV-2 infection was largely
concentrated in patients with distinct demographic characteristics.
Understanding factors associated with infection may inform public health
efforts directed towards at risk populations and serve in counseling
pregnant women.