Questionnaire-based vs universal PCR testing for SARS-CoV-2 in women admitted for delivery.
Adult
Asymptomatic Infections
/ epidemiology
COVID-19
/ diagnosis
COVID-19 Nucleic Acid Testing
/ statistics & numerical data
Carrier State
/ diagnosis
Delivery, Obstetric
Female
Humans
Labor, Obstetric
Mass Screening
/ methods
Nasopharynx
/ virology
Ontario
/ epidemiology
Polymerase Chain Reaction
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Infectious
/ diagnosis
Prospective Studies
SARS-CoV-2
Surveys and Questionnaires
/ statistics & numerical data
COVID-19
SARS-CoV-2
labor and delivery
pregnancy
screening
swab
Journal
Birth (Berkeley, Calif.)
ISSN: 1523-536X
Titre abrégé: Birth
Pays: United States
ID NLM: 8302042
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
revised:
13
08
2020
received:
30
06
2020
accepted:
16
11
2020
pubmed:
3
12
2020
medline:
27
4
2021
entrez:
2
12
2020
Statut:
ppublish
Résumé
It has been suggested that women admitted for delivery should have universal PCR testing for SARS-CoV-2. Yet, the considerable difference in the incidence of COVID-19 between different geographic regions may affect screening strategies. Therefore, we aimed to compare questionnaire-based testing versus universal PCR testing for SARS-CoV-2 in women admitted for delivery. A prospective cohort study of women admitted for delivery at a single center during a four-week period (April 22-May 25, 2020). All women completed a questionnaire about COVID-19 signs, symptoms, or risk factors, and a nasopharyngeal swab for PCR for SARS-CoV-2. Women who were flagged as suspected COVID-19 by the questionnaire (questionnaire-positive) were compared with women who were not flagged by the questionnaire (questionnaire-negative). Overall, 446 women were eligible for analysis, of which 54 (12.1%) were questionnaire-positive. PCR swab detected SARS-CoV-2 in four (0.9%) women: 3 of 392 (0.8%) in the questionnaire-negative group, and 1 of 54 (1.9%) in the questionnaire-positive group (P = .43), yielding a number needed to screen of 92 (95% CI 62-177). In 96% of the cases, the PCR results were obtained only in the postpartum period. No positive PCR results were obtained from neonatal testing for SARS-CoV-2. The sensitivity of the questionnaire was 75.0%, and the negative predictive value was 99.7%. Although the rate of positive PCR results was not significantly different between the groups, the number needed to screen is considerably high. The use of questionnaire-based PCR testing in areas with low incidence of COVID-19 allows for a reasonable allocation of resources and is easy to implement.
Sections du résumé
BACKGROUND
It has been suggested that women admitted for delivery should have universal PCR testing for SARS-CoV-2. Yet, the considerable difference in the incidence of COVID-19 between different geographic regions may affect screening strategies. Therefore, we aimed to compare questionnaire-based testing versus universal PCR testing for SARS-CoV-2 in women admitted for delivery.
METHODS
A prospective cohort study of women admitted for delivery at a single center during a four-week period (April 22-May 25, 2020). All women completed a questionnaire about COVID-19 signs, symptoms, or risk factors, and a nasopharyngeal swab for PCR for SARS-CoV-2. Women who were flagged as suspected COVID-19 by the questionnaire (questionnaire-positive) were compared with women who were not flagged by the questionnaire (questionnaire-negative).
RESULTS
Overall, 446 women were eligible for analysis, of which 54 (12.1%) were questionnaire-positive. PCR swab detected SARS-CoV-2 in four (0.9%) women: 3 of 392 (0.8%) in the questionnaire-negative group, and 1 of 54 (1.9%) in the questionnaire-positive group (P = .43), yielding a number needed to screen of 92 (95% CI 62-177). In 96% of the cases, the PCR results were obtained only in the postpartum period. No positive PCR results were obtained from neonatal testing for SARS-CoV-2. The sensitivity of the questionnaire was 75.0%, and the negative predictive value was 99.7%.
CONCLUSIONS
Although the rate of positive PCR results was not significantly different between the groups, the number needed to screen is considerably high. The use of questionnaire-based PCR testing in areas with low incidence of COVID-19 allows for a reasonable allocation of resources and is easy to implement.
Identifiants
pubmed: 33263210
doi: 10.1111/birt.12520
pmc: PMC7753601
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
96-103Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
BMJ. 1998 Aug 1;317(7154):307-12
pubmed: 9685274
Int J Gynaecol Obstet. 2020 Jul;150(1):124-126
pubmed: 32369613
Eur J Obstet Gynecol Reprod Biol. 2020 Jun;249:100-101
pubmed: 32336661
Am J Obstet Gynecol. 2020 Aug;223(2):284-286
pubmed: 32348743
JAMA. 2020 Jun 23;323(24):2520-2522
pubmed: 32453390
Birth. 2021 Mar;48(1):96-103
pubmed: 33263210
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
N Engl J Med. 2020 May 28;382(22):2163-2164
pubmed: 32283004
Obstet Gynecol. 2020 Jul;136(1):65-67
pubmed: 32332320
Micromachines (Basel). 2020 Mar 14;11(3):
pubmed: 32183357
Can J Anaesth. 2020 Oct;67(10):1315-1320
pubmed: 32495121
Am J Obstet Gynecol. 2020 Jul;223(1):91.e1-91.e4
pubmed: 32376317