Table 2.
Summary of studies reviewing the outcome of universal testing and the prevalence of asymptomatic pregnant women with positive SARS-CoV-2.
| No | First Author | Country | Title | Universally tested pregnant women N | COVID-19 Infection | Study design | RoB | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Negative n (%) | Positive | |||||||||
| Total n (%) | Asymptomatic n (%) | Symptomatic n (%) | ||||||||
| 1 | Prabhu et al. (11) | United States (New York) | Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study | 675 | 605 (89.6) | 70 (10.4) | 55 (78.6) | 15 (21.4) | Prospective cohort | ++ |
| 2 | Fassett et al. (12) | United States (Los Angeles) | Universal SARS-CoV-2 screening in women admitted for delivery in a large managed care organization | 3,923 | 3,906 (99.6) | 17 (0.4) | 17 (100.0) | 0 (0.0) | Retrospective cohort | + |
| 3 | Vintzileos et al. (13) | United States (New York) | Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019 | 161 | 129 (81.1) | 32 (19.9) | 21 (65.6) | 11 (34.4) | Retrospective cohort | ++ |
| 4 | Campbell et al. (14) | United States (New York) | Prevalence of SARS-CoV-2 among patients admitted for childbirth in Southern Connecticut | 770 | 740 (96.1) | 30 (3.9) | 22 (73.3) | 8 (26.7) | Retrospective cohort | + |
| 5 | LaCourse et al. (15) | United States (Washington) | Low prevalence of SARS-CoV-2 among pregnant and postpartum patients with universal screening in Seattle, Washington | 188a | 182 (97.3) | 5 (2.7) | 1 (20.0) | 4 (80.0) | Retrospective cohort | ++ |
| 6 | Miller et al. (16) | United States (Chicago) | Clinical implications of universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in pregnancy | 635 | 612 (96.4) | 23 (3.6) | 10 (43.5) | 13 (56.5) | Research letter | ++ |
| 7 | London et al. (17) | United States (New York) | The relationship between status at presentation and outcomes among pregnant women with COVID-19 | 75 | 65 (86.7) | 10 (13.3) | 10 (100.0) | 0 (0.0) | Retrospective cohort | ++ |
| 8 | Goldfarb et al. (18) | United States (Boston) | Universal SARS-CoV-2 testing on admission to the labor and delivery unit: low prevalence among asymptomatic obstetric patients | 757 | 737 (97.4) | 20 (2.6) | 9 (45.0) | 11 (55.0) | Retrospective cohort | + |
| 9 | Ochiai et al. (19) | Japan | Universal screening for SARS-CoV-2 in asymptomatic obstetric patients in Tokyo, Japan | 52 | 49 (94.2) | 3 (5.8) | 3 (100.0) | 0 (0.0) | Retrospective cohort | ++ |
| 10 | Bianco et al. (20) | United States (New York) | Testing of patients and support persons for coronavirus disease 2019 (COVID-19) infection before scheduled deliveries | 155 | 131 (84.5) | 24 (15.5) | 24 (100.0) | 0 (0.0) | Retrospective cohort | ++ |
| 11 | Ferrazzi et al. (21) | Italy | SARS-CoV-2 infection testing at delivery: a clinical and epidemiological priority | 1,566 | 1,517 (96.9) | 49 (3.1) | 27 (55.1) | 22 (44.9) | Retrospective cohort | + |
| 12 | Herraiz et al. (22) | Spain (Madrid) | Universal screening for SARS-CoV-2 before labor admission during COVID-19 pandemic in Madrid | 203a | 199 (99.0) | 2 (1.0) | 1 (50.0) | 1 (50.0) | Retrospective cohort | ++ |
| 13 | Sutton et al. (23) | United States (New York) | Universal screening for SARS-CoV-2 in women admitted for delivery | 215a | 181 (84.7) | 33 (15.3) | 29 (87.9) | 4 (12.1) | Research letter | +++ |
| 14 | Gagliardi et al. (24) | Italy (Tuscany and Liguria) | Universal severe acute respiratory syndrome coronavirus 2 testing of pregnant women admitted for delivery in 2 Italian regions | 533 | 530 (99.4) | 3 (0.6) | 2 (66.7) | 1 (33.3) | Research letter | ++ |
| 15 | Yassa et al. (25) | Turkey | Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study | 296 | 273 (92.2) | 23 (7.8) | 12 (52.2) | 11 (47.8) | Retrospective cohort | ++ |
| 16 | Berkowitz et al. (26) | United States (Ohio) | Implementation of universal testing for SARS-CoV-2 in pregnant women with intended admission for delivery | 518b | 482 (98.1) | 10 (1.9) | 7 (70.0) | 3 (30.0) | Research letter | +++ |
| 17 | Santos et al. (27) | Portugal | Prevalence of SARS-CoV-2 infection in asymptomatic pregnant women and their partners in a tertiary care hospital in Portugal | 428 | 426 (99.5) | 2 (0.5) | 2 (100.0) | 0 (0.0) | Research letter | +++ |
| 18 | Abeysuriya et al. (28) | United Kingdom | Universal screening for SARS-CoV-2 in pregnant women at term admitted to an East London maternity unit | 180c | 171 (96.1) | 7 (3.9) | 6 (85.7) | 1 (14.3) | Retrospective cohort | ++ |
| 19 | Buckley et al. (29) | United States (New York) | Universal testing of patients and their support persons for severe acute respiratory syndrome coronavirus 2 when presenting for admission to labor and delivery at Mount Sinai Health System | 307 | 257 (83.7) | 50 (16.3) | 50 (100.0) | 0 (0.0) | Research letter | +++ |
| 20 | Doria et al. (30) | Portugal | COVID-19 during pregnancy: a case series from an universally tested population from the north of Portugal | 103 | 91 (88.4) | 12 (11.6) | 11 (91.7) | 1 (8.3) | Case series | +++ |
| 21 | Bender et al. (31) | United States (Pennsylvania) | Universal testing for severe acute respiratory syndrome coronavirus 2 in 2 Philadelphia hospitals: carrier prevalence and symptom development over 2 weeks | 318 | 310 (97.5) | 8 (2.5) | 8 (100.0) | 0 (0.0) | Retrospective cohort | +++ |
| 22 | Vinuela et al. (32) (2020) | Spain (Madrid) | SARS-CoV-2 screening of asymptomatic women admitted for delivery must be performed with a combination of microbiological techniques: an observational study | 100 | 91 (91.0) | 9 (9.0) | 9 (100.0) | 0 (0.0) | Retrospective cohort | +++ |
| 23 | Tanacan et al. (33) | Turkey (Ankara) | The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: experience of a pandemic center in Turkey | 206 | 203 (98.5) | 3 (1.5) | 3 (100.0) | 0 (0.0) | Prospective cohort | +++ |
| 24 | Saviron-Cornudella et al. (34) | Spain (Madrid) | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) universal screening in gravids during labor and delivery | 266 | 260 (97.7) | 6 (2.3) | 4 (66.7) | 2 (33.3) | Retrospective cohort | ++ |
| 25 | Reale et al. (35) | United States (Massachusetts) | Patient characteristics associated with SARS-CoV-2 infection in parturients admitted for labor and delivery in Massachusetts during the spring 2020 surge: a prospective cohort study | 2,945 | 2,852 (96.8) | 93 (3.2) | 80 (86.0) | 13 (14.0) | Prospective cohort | + |
| 26 | Pineles et al. (36) | United States (Texas) | Racial-ethnic disparities and pregnancy outcomes in SARS-CoV-2 infection in a universally-tested cohort in Houston, Texas | 935 | 858 (91.8) | 77 (8.2) | 66 (85.7) | 11 (14.3) | Retrospective cohort | ++ |
| 27 | Naqvi et al. (37) | United States (Los Angeles) | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) universal testing experience on a Los Angeles labor and delivery unit | 82 | 81 (98.8) | 1 (1.2) | 0l (0.0) | 1 (100.0) | Prospective cohort | ++ |
| 28 | Mei-Dan et al. (38) | Canada (Toronto) | Questionnaire-based vs universal PCR testing for SARS-CoV-2 in women admitted for delivery | 446 | 442 (99.1) | 4 (0.9) | 3 (66.7) | 1 (33.3) | Prospective cohort | + |
| 29 | Maru et al. (39) | United States (New York) | Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York | 124 | 78 (62.9) | 46 (37.1) | 33 (71.7) | 13 (28.3) | Retrospective cohort | ++ |
| 30 | Hcini et al. (40) | French Guiana | Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: a single-center prospective comparative study | 507 | 370 (73.0) | 137 (27.0) | 103 (75.2) | 34 (24.8) | Prospective cohort | + |
| 31 | Figueiredo et al. (41) | Portugal (Porto) | Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery in a Portuguese maternity | 184 | 173 (99.9) | 11 (0.1) | 9 (81.8) | 2 (18.2) | Prospective cohort | + |
| 32 | Waghmare et al. (42) | India (Maharashtra) | Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India | 1,140 | 999 (87.6) | 141 (12.4) | 284 (73.8) | 37 (26.2) | Prospective cohort | ++ |
| 33 | Diaz-Corvillon et al. (43) | Chile | Routine screening for SARS CoV-2 in unselected pregnant women at delivery | 583 | 546 (93.7) | 37 (6.3) | 16 (43.2) | 21 (56.8) | Prospective cohort | + |
| 34 | Blitz et al. (44) | United States (New York) | Universal testing for coronavirus 2019 in pregnant women admitted for delivery: prevalence of peripartum infection and rate of asymptomatic carriers at four New York hospitals within an integrated healthcare system | 382 | 318 (83.3) | 64 (16.7) | 45 (70.3) | 19 (29.7) | Retrospective cohort | ++ |
| TOTAL | 19,958 | 18,896 (94.7) | 1,062 (5.3) | 802 (75.5) | 260 (24.5) | |||||
N, Pregnant women who were universally tested; a, Asymptomatic and inconclusive (n = 1); b, Results were not obtained within clinically relevant time frame (n=26); c, Two women (n = 2) excluded as one was previously suspected and other one declined testing; RoB, Risk of bias; +, Low risk of bias; ++, Medium risk of bias; +++, Serious risk of bias.