Respiratory Assessment among Pregnant Individuals for Detecting febrile infections in Ottawa, Ontario

Respiratory infections during pregnancy, linked to viruses like respiratory syncytial virus (RSV), influenza, and coronaviruses, including SARS-CoV-2, have raised concerns, especially amid the COVID-19 pandemic. Contracting these infections during pregnancy is associated with increased risk of maternal and birth complications. Vaccines are now available for all three viruses, but data is lacking regarding the burden of each virus and the maternal benefit of RSV vaccination. Despite the availability of swab testing that can identify these illnesses, screening among pregnant patients has not been fully implemented across Canadian hospitals. Through a new respiratory illness screening assessment - the Respiratory Illness Screening (RIS) - and swab testing, our study aims to understand how frequently these viruses occur in pregnant people and their impact on the overall maternal-fetal health. We will assess how well RIS identifies RSV, influenza, and SARS-CoV-2 and understand the variation in symptoms across these viruses. Our study will use RIS to screen pregnant patients attending The Ottawa Hospital during the peak respiratory virus season (mid-October to mid-March). For RIS-positive patients, those with respiratory illness symptoms or history of travelling or contact with a symptomatic person, a nasopharyngeal swab will be collected to test for RSV, influenza, and/or SARS-CoV-2. Using electronic medical records, we will capture birth outcomes including preterm delivery, birthweight, and labour complications. We will also test a portion of asymptomatic patients to estimate the prevalence of each virus in the overall pregnant population. Our results will contribute to global public health initiatives, and our exploration of symptomatology will help guide healthcare providers in implementing more effective and targeted interventions during pregnancy. Further, it will help determine whether screening for these illnesses should be mandatory across hospitals in Canada.