Article Current Status of Nosocomial COVID-19 Cases in Delivery Facilities in Japan

Abstract

Background: In Japan, there are more than 2000 maternity facilities that provide delivery services for approximately 860 thousand deliveries per year. More than half of all deliveries are managed in private clinics which medical resources are limited and maternal transport is often required. In such condition, we aimed to identify the characteristics of and measures taken by Japanese medical facilities providing maternity services that have recorded cases of nosocomial infection with SARS-CoV-2, which causes (COVID-19).Methods: A nationwide questionnaire survey about nosocomial COVID-19 was conducted in July 2020. A case-control study was conducted by including medical facilities with (Cases) and without (Control) nosocomial COVID-19.Findings: Responses from 1,418 medical facilities were assessed (65% of all delivery facilities in Japan). Seventy-five COVID-19-positive pregnant women were treated in 48 facilities. Nosocomial infection was reported in 4.1% of the facilities. Nine patients developed a nosocomial infection in the maternity ward or obstetric department. Variables that contributed to nosocomial COVID-19 were chest CT on admission (adjusted odds ratio [95% confidence interval], 4.76 [2.44–9.27]), PCR test for SARS-CoV-2 before delivery (2.27 [1.21–4.25]), transfer of pregnant women with fever to another hospital (0.21 [0.06–0.71]), and private clinics (0.17 [0.05–0.60]).Interpretation: Nosocomial infection is likely to occur in large hospitals that treat a higher number of patients than private clinics do. Nosocomial infection can occur even in medical facilities performing COVID-19 screening tests, such as chest CT and PCR test.Funding Statement: Nationwide survey associated with COVID-19 infection, The Japan Association of Obstetricians and Gynecologists (JAOG).Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: This study was approved by the JAOG (No. 80, July 1st, 2020). This investigation was conducted according to the principles of the Declaration of Helsinki. Informed consent was not obtained from patients or their families because this study was based on the analysis of facility forms, and the patient records/information was anonymized prior to the analysis.