Of HCVAb+ women, 75% (125/166) were referred postpartum for HCV evaluation and 27% (34/125) were linked to care. Of the remaining 28 women, 6 (21%) had active viremia (HCV RNA +). Only 69% (62/90) of HCVAb+ women in the universal cohort met the criteria for risk-based testing. HCVAb+ women in the risk-based cohort were more likely to have a positive drug screen. A total of 7,039 pregnant women were screened for HCV: 266 with risk-based and 6,773 with universal screening 29% (76/266) were positive HCV antibody screening (HCVAb + ) in the risk-based cohort and 1.3% (90/6,773) in the universal cohort. Results From 2014 to 2018, 16,489 women delivered at our institution, of whom 166 screened positive for HCV. Primary outcomes were the rate of HCV screen positivity and postpartum linkage to care. Screening was performed with ELISA antibody testing and viremia confirmed with HCV ribonucleic acid (RNA) polymerase chain reaction (PCR). We defined two cohorts: women managed with risk-based (January 2014–October 2016) or universal HCV screening (November 2016–December 2018). Study Design This retrospective cohort study included pregnant women screened for HCV at a single tertiary-care center. We hypothesized that universal screening is associated with increased HCV diagnosis and postpartum linkage to HCV care compared with risk-based screening. Preventive Services Task Force (USPSTF) recommending universal hepatitis C virus (HCV) screening in pregnancy Society for Maternal-Fetal Medicine (SMFM) and American College of Obstetricians and Gynecologists (ACOG) continue to endorse risk-based screening for HCV in pregnancy. Objective Despite the Centers for Disease Control and Prevention (CDC) and U.S.
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