The COVID-19 Ontario Pregnancy Event (COPE) Network: Assessing the impact of COVID-19 in pregnancy on maternal, fetal and newborn health

Data collection and research on COVID-19 in pregnancy are urgently needed to fill the many knowledge gaps about the impact of COVID-19 on maternal, fetal and newborn health. We propose to leverage Ontario's birth registry, and the COVID-19 Ontario Pregnancy Event (COPE) Network - a collaboration of 12 obstetrical hospitals in 5 of Ontario's largest cities - to launch a series of seroprevalence, vertical transmission and surveillance investigations that will generate rapid, rigourous evidence on the impacts of COVID-19 in pregnancy. We will achieve this by (1) implementing universal screening of all pregnant women to assess the prevalence of symptomatic and asymptomatic SARS-CoV-2 infection; (2) generating complete infection and antibody profiles of maternal and newborn tissues to assess the mother-to-infant transmission potential of SARS-CoV-2 among mothers affected by COVID-19; and (3) generating in-depth obstetrical profiles of pregnancies affected by COVID-19 to assess clinical characteristics, case management and maternal and neonatal outcomes associated with infection during pregnancy. Our multi-disciplinary, high-qualified team has an established track-record in pregnancy and birth cohorts, molecular virology and infectious diseases, and are well-positioned to fulfill these objectives. Our findings will inform strategies to optimize processes in care, patient counselling and health systems management specific to the obstetrical and neonatal population, and will lay the foundation for follow-up studies to assess the longer-term health implications of COVID-19 on infant health. The relevance of our findings will not be limited to Ontario but will be of value to clinicians and families across Canada and globally.