ACOG: Is Universal Testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Needed on All Labor and Delivery Units?

As the coronavirus disease 2019 (COVID-19) pandemic evolves across the globe, there is increasing interest in screening and surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to cause COVID-19 infection. The experience from two New York City hospitals at the epicenter of the pandemic in the United States has largely driven obstetric practice. These hospitals reported a 15% prevalence of SARS-CoV-2 infection among laboring women, with the majority presenting without symptoms.1 Based on these data, many centers have implemented screening protocols in which all pregnant women are tested for SARS-CoV-2 at the time of admission for labor regardless of symptoms. In this context, SARS-CoV-2 polymerase chain reaction (PCR) testing is being employed as a screening tool for COVID-19 infection among both symptomatic and asymptomatic women. In this issue of Obstetrics & Gynecology (see pages 229, 232, and 235), there is a series of Research Letters related to universal screening focusing on how screening can be tailored,2 as well as the differential prevalence of COVID-19 infection by region.3,4 These articles raise questions as to the utility of universal screening of all laboring women in the United States with SARS-CoV-2 PCR.
doi: 10.1097/AOG.0000000000003972