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Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points

Background Although mass vaccination against COVID-19 may prove to be the most efficacious end to this deadly pandemic, there remains concern and indecision among the public towards vaccination. As pregnant and reproductive-aged women account for a large proportion of the population with particular concerns regarding vaccination against COVID-19, this survey aims at investigating their current attitudes and beliefs within our own institution. Objective To understand vaccine acceptability among pregnant, non-pregnant and breastfeeding respondents and elucidate factors associated with COVID-19 vaccine acceptance. Methods We administered an anonymous online survey to all women (including patients, providers and staff) at our institution assessing rates of acceptance of COVID-19 vaccination. Respondents were contacted in one of three ways: by email, advertisement flyers and distribution of QR codes at virtual townhalls regarding the COVID-19 vaccine. Based on their responses, respondents were divided into three mutually exclusive groups: (1) non-pregnant respondents (2) pregnant respondents and (3) breastfeeding respondents. The primary outcome was acceptance of vaccination. Prevalence ratios were calculated to ascertain the independent effects of multiple patient-level factors on vaccine acceptability. Results The survey was administered from January 7, 2021 to January 29, 2021 with 1,012 respondents of whom 466 (46.9%) identified as Non-Hispanic White, 108 (10.9%) as Non-Hispanic Black, 286 (28.8%) as Hispanic, and 82 (8.2) as Non-Hispanic Asian. The median age was 36 (IQR 25-47) years. Of all the respondents, 656 respondents (64.8%) were non-pregnant, 216 (21.3%) were pregnant and 122 (12.1%) were breastfeeding. There was no difference in chronic comorbidities when evaluated as a composite variable (Table 1). 390 respondents (39.2%) reported working in healthcare. Non-pregnant respondents were most likely to accept vaccination (457 respondents, 76.2%, p

To characterise medical, obstetric and demographic risk factors associated with nulliparous, term, singleton, vertex (NTSV) caesarean birth.Cross-sectional study.United States delivery hospitalisations.NTSV births in 2016-18 US natality data.This study analysed a national sample of natality data generated by the United States National Vital Statistics System. NTSV deliveries were identified. The primary outcome was caesarean birth. Risk factors including maternal age, body mass index (BMI) and pregestational diabetes were analysed. Multivariable log-linear regression models analysed factors associated with NTSV caesarean with adjusted risk ratios (aRR) as measures of effect.Of 11 622 400 deliveries, 3 764 707 met NTSV criteria, and their caesarean section rate was 25.9%. Maternal age 35-39 years (aRR 1.51, 95% CI 1.50-1.52) and 40-54 years (aRR 2.03, 95% 2.00-2.05) compared with age 19-34 years; BMI 25 to30 kg/m2 (aRR 1.32, 95% CI 1.31-1.33), 30 to35 kg/m2 (aRR 1.57 95% CI 1.56-1.58), 35 to40 kg/m2 (aRR 1.82, 95% CI 1.80-1.83) and ≥40 kg/m2 (aRR 2.17, 95% CI 2.15-2.19) compared with BMI 18.5-24.9 kg/m2; and pregestational diabetes (aRR 1.54, 95% CI 1.51-1.57) were all associated with increased risk. Risk factors allowed stratification of patients into high-risk versus low-risk groups. The NTSV caesarean rate was 37.9% in women who had one or more of the following characteristics: age ≥35 years, BMI ≥30 kg/m2 or pregestational diabetes. In comparison, the NTSV caesarean rate was 20.8% among women without any of these three risk factors (P0.01).Among NTSV births, BMI, maternal age and medical conditions are important risk factors for caesarean delivery.