{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:08:05Z","timestamp":1782731285655,"version":"3.54.5"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy.<\/jats:p><jats:p>\n            Study Design\u2003This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births.<\/jats:p><jats:p>\n            Results\u2003In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26\u201333 years) and body mass index was 31.75\u2009kg\/m2 (IQR 27.7\u201337.5\u2009kg\/m2). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic\/Latino, 3.3% as Native Hawaiian\/Pacific Islander, and only 27.9% as White (p\u2009&lt;\u20090.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p\u2009=\u20090.0243). Adverse maternal and\/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period.<\/jats:p><jats:p>\n            Conclusion\u2003In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1723938","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T23:35:52Z","timestamp":1613950552000},"page":"614-621","source":"Crossref","is-referenced-by-count":20,"title":["SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes"],"prefix":"10.1055","volume":"38","author":[{"given":"Haley A.","family":"Steffen","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R.","family":"Swartz","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Brooks","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Kenne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick P.","family":"Ten Eyck","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbey S.","family":"Merryman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire N.","family":"Castaneda","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Marsden","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Maxwell","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Merrill","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Krasowski","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7657-5746","authenticated-orcid":false,"given":"Mary B.","family":"Rysavy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,2,21]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/S0140-6736(20)30365-2","article-title":"What are the risks of COVID-19 infection in pregnant women?","volume":"395","author":"J Qiao","year":"2020","journal-title":"Lancet"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3390\/v12020194","article-title":"Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections","volume":"12","author":"D A 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