key: cord-0725852-hk24oa2m
authors: Waghmare, Rakesh; Gajbhiye, Rahul; Mahajan, Niraj; Modi, Deepak; Mukherjee, Sanjay; Mahale, Smita
title: Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India
date: 2020-09-23
journal: Eur J Obstet Gynecol Reprod Biol
DOI: 10.1016/j.ejogrb.2020.09.030
sha: 23a66643c8ee0fae12cae13b038a35c01adce85d
doc_id: 725852
cord_uid: hk24oa2m

nan

Asymptomatic women with coronavirus disease 2019 are at risk of infecting their newborns and also pose a risk to healthcare providers and other patients [1] [2] [3] . Considering this, Indian Council of Medical Research (ICMR) recommended universal testing for SARS-CoV-2 in pregnant women [4] . Maharashtra is the worst-hit state in India and universal screening strategy for pregnant women was implemented in several public hospitals during this time. Herein, we report the outcome of implementation of this strategy.

Women presenting in labour or likely to deliver in next 5 days were screened for SARS-CoV-2 as per ICMR guidelines [4] . Data from 25 th April to 20 th May, 2020 was collected from 15 participating hospitals of PregCovid registry network (https://pregcovid.com/). In all, 141/1140 pregnant women were tested positive for SARS-CoV-2 resulting in a prevalence of 12.3% (Mean 9.4, 95% CI 6.6 -12.1) in Maharashtra, India [ Figure 1B) . The prevalence of symptomatic pregnant women is 11.5 % (Mean 6.8, 95% CI 2.4-11.2) while that of asymptomatic pregnant women is 88.5% (Mean 79.8, 95% CI 75.7-83.9) [ Figure   1B ]. The proportion of symptomatic to asymptomatic individuals varied greatly across the different cities (not shown). Our results estimate presence of one symptomatic to every nine asymptomatic pregnant women. This is in concordance to the number proposed based on mathematical calculations and some observational data [5] .

3 This data on undocumented or "steady state" infections in pregnant women is useful for ensuring safe obstetric and neonatal services and assessing the burden of COVID-19 in the region to plan strategies on strengthening or relaxing mass social distancing measures. We strongly recommend that the strategy of universal testing of pregnant women admitted for delivery is essential and must be implemented rigorously not just to protect the women and their newborns; but also, the healthcare workers and curb spread of the infection in the community.

All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Disclosure statement: All authors report no conflict of interest.

The support of the PregCOVID registry network (Appendix 1) is gratefully acknowledged. 

Universal Screening for SARS-CoV-2 in Women Admitted for Delivery

Universal SARS-CoV-2 testing of pregnant women admitted for delivery in two Italian regions

Persistence of SARS-CoV-2 in the first trimester placenta leading to vertical transmission and fetal demise from an asymptomatic mother

Strategy for COVID19 testing for pregnant women in India (Version 1

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2)

Participants of PregCovid Registry Network as on 18.08.2020 1