Majority of Pregnant Women Who Tested Positive for COVID-19 Were Asymptomatic, Study Finds
The majority of pregnant women who tested positive for COVID-19 on arrival to the delivery room were asymptomatic, according to a paper by Mount Sinai researchers published in PLOS One on Thursday, December 10. The pregnant patients who tested positive for the coronavirus were also more likely than those who tested negative to identify as Hispanic and report their primary language as Spanish.
In a retrospective cross-sectional study of universal screenings for SARS-Cov-2, the virus that causes COVID-19, implemented in the labor and delivery unit of Elmhurst Hospital in Queens, New York, during March and April, the researchers found that more than one-third of almost 130 pregnant women tested positive for the coronavirus. This is a much higher proportion than reported at other hospitals in New York City during the pandemic surge, and likely related to social inequities experienced by the surrounding population. Elmhurst Hospital is a public hospital that serves a diverse, largely immigrant and low-income patient population that was severely affected by the COVID-19 pandemic in the spring. The majority, or 72 percent, of the pregnant patients who tested positive were asymptomatic, meaning they did not display any symptoms associated with COVID-19. These findings add to the evidence that there was early and rampant asymptomatic spread of the disease at a time when most community and hospital testing was limited to symptomatic individuals.
“This study is instructive for other labor and delivery units and hospitals across the world as we continue to refine pandemic preparedness,” says Sheela Maru, MD, MPH, Assistant Professor of Global Health, and Obstetrics, Gynecology and Reproductive Science, at the Icahn School of Medicine at Mount Sinai. “In future epidemics, it may be prudent to look at labor and delivery screening numbers much earlier on, as pregnant women continue to seek essential care despite social distancing measures and also represent the general young and healthy community population.”
Dr. Maru said universal screening in the labor and delivery unit ensured safety of patients and staff during an acute surge in COVID-19 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their status and were provided postpartum counseling and follow-up protocols tailored to their specific social needs.
In addition to their status for COVID-19, the study reviewed patients’ demographic data including age, ethnicity, primary language, zip code, marital status, and health insurance status, and clinical data including the mode of delivery, length of stay, and comorbidities such as chronic hypertension, preeclampsia, prepregnancy obesity, asthma, diabetes, depression, and anxiety.
The study was developed through participation in the COVID-19 Unit for Research at Elmhurst (CURE-19) partnership, an initiative by Mount Sinai’s Arnhold Institute for Global Health and NYC Health + Hospitals/Elmhurst to research the global pandemic and root causes of health disparities in New York City.
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Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.