Abstract 31 Chagas Disease Screening in Pregnancy: Lessons from Screening Maternal Donors from Publicly Banked Umbilical Cord Blood

Abstract Introduction Screening for Chagas disease in the perinatal setting has the dual benefit of identifying cases in young adults, for whom treatment can reduce morbidity, and providing the opportunity for early intervention in the case of vertical transmission to infants. North Carolina (NC) has experienced substantial growth in populations from Chagas-endemic regions; however, routine perinatal Trypanosoma cruzi antibody screening is not performed in the state. However, T. cruzi antibody screening is performed on all mothers donating their baby’s cord blood to the Carolina Cord Blood Bank (CCBB), an FDA-licensed public cord blood bank in NC. Objectives We aim to identify the prevalence of positive T. cruzi screening serology within a large cohort of maternal cord blood donors in NC. Methods This is a retrospective review of positive screening serology for T. cruzi in all maternal donors of their baby’s cord blood to the CCBB in NC from 7/1/2007–05/31/2023. Screening serology was performed using a chemiluminescent microparticle immunoassay for the qualitative detection of antibodies to T. cruzi. Results Among 26,698 cord blood donations screened over 16 years, 45 samples (0.17%) had a positive T. cruzi antibody screen. Of the 3,787 donations from patients self-identifying as Hispanic or Latino (14% of the cohort), 15 (0.4%) had a positive screen. The prevalence of a positive T. cruzi screen in donated cord blood was 1.7 per 1,000 cord blood donations. Discussion Our data highlight the prevalence of Chagas disease in a non-endemic region and suggest that targeted screening may be a feasible screening strategy for the state. They also demonstrate an additional value to maternal health for donors to public cord blood banks. Further evaluation is needed to determine if these patients had confirmatory testing and whether they were linked to care.