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Use of diagnostics for serosurveillance studies in pregnant individuals during the SARS-CoV-2 pandemic
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  • Naomi Whyler CA,
  • Marziya Kadir,
  • Stella Meimei Ho,
  • Joanne Said M,
  • Helen Megow,
  • Kirsten Palmer R,
  • Sushena Krishnaswamy,
  • Suellen Nicholson,
  • Megan Wieringa,
  • Tony Korman,
  • M. Giles
Naomi Whyler CA
Monash University

Corresponding Author:naomicawhyler@doctors.org.uk

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Marziya Kadir
Casey Hospital
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Stella Meimei Ho
Casey Hospital
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Joanne Said M
The University of Melbourne Department of Obstetrics and Gynaecology
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Helen Megow
Western Health
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Kirsten Palmer R
Monash University
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Sushena Krishnaswamy
Monash University
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Suellen Nicholson
Victorian Infectious Diseases Reference Laboratory
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Megan Wieringa
Monash Health
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Tony Korman
MMC Monash Infectious Diseases
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M. Giles
Monash University
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Abstract

Pregnant individuals are known to be at increased risk of worse outcomes from COVID-19 infection. Recent data suggests that they are also more likely to exhibit milder symptoms and have higher rates of asymptomatic infection. The health impacts of milder disease are less well-described but may include adverse perinatal outcomes. Serosurveillance can help describe accurately background rates of seropositivity in populations with high rates of asymptomatic infection. The seroprevalence of SARS-CoV-2 infection prior to vaccine availability was assessed in two large maternity centres. Of 437 pregnant individuals, seven were positive on initial screening, with one false positive identified on subsequent confirmatory testing. An overall seropositivity rate of 1.4% was found. No adverse pregnancy outcomes were identified. Confirmatory testing was performed with four commercial antibody-based assays and an in-house microneutralisation assay. Wantai SARS-CoV-2 receptor-binding-domain total antibody performed best, similar to previous reports. Serological surveillance can estimate infection rates not captured by acute PCR testing, and may assist with contact tracing, estimation of immunity rates and inform public health policy in at-risk groups. Evaluation of serological assays should be integrated into serosurveillance initiatives.