Background Identifying SARS-CoV-2 infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden. Methods This cross-sectional analysis used electronic health record data from hospitalizations during which pregnancies ended (peripartum hospitalizations) among a cohort of pregnant persons at 3 U.S. integrated healthcare networks (Sites 1–3). Maternal demographic, medical encounter, SARS-CoV-2 testing, and pregnancy and neonatal outcome information was extracted for persons with estimated delivery and pregnancy end dates during March 2020–February 2021 and ≥1 prenatal care record. Site-stratified multivariable logistic regression was used to identify factors associated with testing and compare pregnancy and neonatal outcomes among persons tested. Results Among 17,858 pregnant persons, 10,863 (60.8%) had peripartum SARS-CoV-2 testing; 222/10,683 (2.0%) had positive results. Testing prevalence varied by site and was lower during March–May 2020. Factors associated with higher peripartum SARS-CoV-2 testing odds were Asian race (adjusted odds ratio [aOR]: 1.36; 95% CI: 1.03–1.79; referent: White) (Site 1), Hispanic or Latina ethnicity (aOR: 1.33; 95% CI: 1.08–1.64) (Site 2), peripartum Medicaid coverage (aOR: 1.33; 95% CI: 1.06–1.66) (Site 1), and preterm hospitalization (aOR: 1.69; 95% CI: 1.19–2.39 [Site 1]; aOR: 1.39; 95% CI: 1.03–1.88 [Site 2]). Conclusions Findings highlight potential disparities in SARS-CoV-2 peripartum testing by demographic and pregnancy characteristics. Testing practice variations should be considered when interpreting studies relying on convenience samples of pregnant persons testing positive for SARS-CoV-2. Efforts to address testing differences between groups could improve equitable testing practices and care for pregnant persons with SARS-CoV-2 infections.

中文翻译：

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2020 年 3 月至 2021 年 2 月多中心孕妇队列围产期住院期间的 SARS-CoV-2 检测和检测

背景 在围产期住院期间识别 SARS-CoV-2 感染对于指导护理、实施预防措施和了解感染负担很重要。方 为预计分娩和妊娠结束日期在 2020 年 3 月至 2021 年 2 月期间且有≥1 项产前检查记录的人提取了孕产妇人口统计、医疗遭遇、SARS-CoV-2 检测以及妊娠和新生儿结局信息。站点分层多变量逻辑回归用于确定与测试相关的因素，并比较测试人员的妊娠和新生儿结果。结果 在 17 个中，858 名孕妇中有 10,863 人 (60.8%) 进行了围产期 SARS-CoV-2 检测；222/10,683 (2.0%) 有积极的结果。检测流行率因地点而异，在 2020 年 3 月至 5 月期间较低。与较高的围产期 SARS-CoV-2 检测几率相关的因素是亚洲种族（调整后的优势比 [aOR]：1.36；95% CI：1.03-1.79；参考对象：白人)（站点 1）、西班牙裔或拉丁裔（aOR：1.33；95% CI：1.08–1.64）（站点 2）、围产期医疗补助覆盖率（aOR：1.33；95% CI：1.06–1.66）（站点 1）和早产住院（aOR：1.69；95% CI：1.19–2.39 [站点 1]；aOR：1.39；95% CI：1.03–1.88 [站点 2]）。结论 研究结果强调了 SARS-CoV-2 围产期检测在人口统计学和妊娠特征方面的潜在差异。在解释依赖 SARS-CoV-2 检测呈阳性的孕妇的便利样本的研究时，应考虑检测实践的差异。努力解决不同群体之间的检测差异可以改善对感染 SARS-CoV-2 的孕妇的公平检测做法和护理。