Prevalence of SARs-CoV-2 Infection Among Pregnant Patients in Rural North Carolina

Objectives: In the spring of 2020, Chatham County of North Carolina became a COVID-19 rural epicenter for SARS-CoV-2 infection. During this time seroprevalence of SARS-CoV-2 among adults in Chatham County was as high as 9%.5 The objective of this study was to measure the incidence of SARS-CoV-2 viral infection among pregnant patients seeking care at two rural federally qualified health centers in Chatham County. 
 
Methods: This was a retrospective cohort study of mothers and neonates who (1) received prenatal care at the above-mentioned medical clinics between March 2020 and July 2020 and (2) received nasopharyngeal SARS-CoV-2 PCR testing as a part of their prenatal care. Data were collected from outpatient and inpatient records beginning at first prenatal visit until first postpartum visit. Neonatal data were collected from time of birth until first well child visit. Descriptive Statistics are reported. 
 
Results: Fifty-one patients who received prenatal care at the study sites were tested for SARS-CoV-2. Hospital records were available from 48 deliveries. A total of 17 (33%) of 51 women tested positive for SARS-CoV-2 virus. Eleven patients had positive tests at prenatal testing; 3 tested positive at delivery, and 3 tested positive during the postpartum period, within 6 weeks of delivery. Two out of the three neonates born to mothers who tested positive at delivery were tested at 24-48 hours of life and neither tested positive. Two of three infants tested after hospital discharge but prior to the first well child visit had positive test results. 
Race/ethnicity were as follows: Hispanic/Latina (90.0%), Non-Hispanic white (2.0%), Black/African American (3.9%) and Asian (3.9%). Thirty-five women (68.6%) were identified as having no insurance, 10 women (19.6%) had Medicaid or other federal or state supported program, and 5 (9.8%) had private insurance. 
 
Conclusions: One-third of this cohort of pregnant patients in a rural setting in a COVID pandemic hotspot in NC tested positive for SARs-CoV-2 infection, significantly higher than the population seroprevalence at the time. 