Universal COVID-19 Testing Among Hospitalized Pregnant Women during the Initial COVID-19 Period in Thailand

Keerati Chiengthong; Wilasinee Areeruk; Somsook Santibenchakul; Shina Oranratanaphan; Tarinee Manchana

Authors

Keerati Chiengthong Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand https://orcid.org/0000-0002-3783-0687
Wilasinee Areeruk Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand https://orcid.org/0000-0002-6524-2911
Somsook Santibenchakul Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Thailand https://orcid.org/0000-0001-9888-2264
Shina Oranratanaphan Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand https://orcid.org/0000-0003-3738-7061
Tarinee Manchana Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand https://orcid.org/0000-0001-7088-628X

Keywords:

asymptomatic, COVID-19, pregnancy, SAR-COV-2, screening

Abstract

OBJECTIVE To determine the prevalence of COVID-19 infection among hospitalized pregnant women during the initial COVID-19 period in Thailand.
METHODS Before admission, symptoms and risks of COVID-19 infection of pregnant women were assessed by using a self-administered questionnaire. Nasopharyngeal and oropharyngeal swab tests were collected by trained obstetrics and gynecology residents and analyzed using the real-time fluorescence reverse transcription-polymerase chain reaction technique (RT-PCR). Electronic medical records of the patients were extracted for this study.
RESULTS Among 570 women admitted to the Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital from April 16 to June 6, 2020, most (99.6%, 568/570) had a negative COVID-19 test. Results of the other two women (0.4%, 2/570) were missing. Eleven women (1.9%, 11/570) had traveled to or from COVID-19 endemic regions. Thirteen women (2.3%, 13/570) were healthcare personnel. None of the women reported signs or symptoms of COVID-19 infection at admission. Their maternal and neonatal outcomes were comparable to the pre-COVID-19 period, i.e., the incidence of preterm delivery was 27.4% (156/570), and the cesarean section rate was 51.1% (271/530). Eighteen newborns (3.2%, 18/567) had 5-minute Apgar scores of less than 7. Twenty-four (4.2%, 24/567) newborns required neonatal intensive care due to very low or extremely low birth weight, low Apgar scores, or multiple fetal anomalies.
CONCLUSIONS Pre-admission universal testing for COVID-19 infection in asymptomatic pregnant women with a history of low risk for COVID19 infection during the low prevalence period in Thailand showed negative results. Consideration of implementing universal testing should be adapted to based on the epidemiological situation.

References

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:157-60.

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumo-nia in China, 2019. N Eng J Med. 2020;382:727-33.

Jia HP, Look DC, Shi L, Hickey M, Pewe L, Netland J, et al. ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection de-pend on differentiation of human airway epithelia. J Virol. 2005;79:14614-21.

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diag-nosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324:782-93.

Kim GU, Kim MJ, Ra SH, Lee J, Bae S, Jung J, et al. Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect. 2020;26:948.e1-.e3.

Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COV-ID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222:521-31.

Department of disease control. [Online]. 2020 [cited 2020 Oct 22]. Aviable from: https://covid19.th-stat.com/api/open/timeline.

Papageorghiou AT, Deruelle P, Gunier RB, Rauch S, García-May PK, Mhatre M, et al. Preeclampsia and COVID-19: results from the INTERCOVID pro-spective longitudinal study. Am J Obstet Gynecol. 2021;225:289.e1-.17.

Gajbhiye RK, Mahajan NN, Waghmare RB, Zala S, Chaaithanya IK, Kuppusamy P, et al. Clinical char-acteristics, outcomes, & mortality in pregnant women with COVID-19 in Maharashtra, India: Re-sults from PregCovid registry. Indian J Med Res. 2021;153:629-36.

COVID Surg Collaborative; GlobalSurg Collabora-tive. SARS-CoV-2 infection and venous thrombo-embolism after surgery: an international prospective cohort study. Anaesthesia. 2022;77:28-39.

Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: a review. Fetal Pediatr Pathol. 2020;39:246-50.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine verti-cal transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet (London, England). 2020;395(10226):809-15.

Centers for Disease Control and Prevention (CDC). Overview of testing for SARS-CoV-2 (COVID-19). [online]. 2020 [cited 2020 Nov 2]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html.

Sutton D, Fuchs K, D’Alton M, Goffman D. Univer-sal screening for SARS-CoV-2 in women admitted for delivery. N Eng J Med. 2020;382:2163-4.

Fassett MJ, Lurvey LD, Yasumura L, Nguyen M, Colli JJ, Volodarskiy M, et al. Universal SARS-Cov-2 screening in women admitted for delivery in a large managed care organization. Am J Perinatol. 2020;37:1110-4.

The Royal Thai College of Obstetricians and Gy-necologists (RTCOG). Management of covid-19 infection in pregnancy. [online]. 2020 [cited 2020 Oct 10]. Avaiable from: http://covid19.dms.go.th/backend///Content/Content_File/Covid_Health/Attach/25630324214133PM_CPG-Covid-Preg-20Mar20.pdf.

Abeysuriya S, Wasif S, Counihan C, Shah N, Ilio-dromiti S, Cutino-Moguel MT, et al. Universal screening for SARS-CoV-2 in pregnant women at term admitted to an East London maternity unit. Eur J Obstet Gynecol Reprod Biol. 2020;252:444-6.

Herraiz I, Folgueira D, Villalaín C, Forcén L, Del-gado R, Galindo A. Universal screening for SARS-CoV-2 before labor admission during Covid-19 pandemic in Madrid. J Perinat Med. 2020;48:981-4.

The government public relations department. Thailand ranks first in the global covid-19 re-covery index. [Online]. 2020 [cited 2020 Oct 26]. Avaiable from: https://thailand.prd.go.th/mo-bile_detail.php?cid=4&nid=9902.

Aksornphusitaphong A, Phupong V. Risk factors of early and late onset pre-eclampsia. J Obstet Gynaecol Res. 2013;39:627-31.

Siricharoenthai P, Phupong V. Diagnostic accuracy of HbA1c in detecting gestational diabetes melli-tus. J Matern Fetal Neonatal Med. 2020;33:3497-500.

Manchana T, Panyavaranant P, Tantbironj P, Sir-ayapiwat P, Lertkachonsuk R, Triratanachat S. Prevalence of nonreactive non-stress test in low versus high risk pregnancy. Integr Gyn Obstet J. 2019;2:1-4.

Lother SA. Preoperative SARS-CoV-2 screening: can it really rule out COVID-19? Can J Anaesth. 2020;67:1321-6.

Poljak M, Korva M, Knap Gašper N, Fujs Komloš K, Sagadin M, Uršič T, et al. Clinical evaluation of the cobas SARS-CoV-2 test and a diagnostic plat-form switch during 48 hours in the midst of the COVID-19 pandemic. J Clin Microbiol. 2020;58: e00599-20.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumo-nia in Wuhan, China. JAMA. 2020;323:1061-9.