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Am J Perinatol
DOI: 10.1055/a-2347-3608
Original Article

Pregnancy-related and Neonatal Outcomes during Omicron Variant-Dominant COVID-19 Pandemic among the Black-Dominant Population

Daniel D. Min
1   Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, New York
,
Jae H. Min
2   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, New York
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Abstract

Objective This study aimed to determine the effect of the Omicron variant on pregnancy-related and neonatal outcomes among the Black-dominant population.

Study Design We performed a single-center, retrospective cohort study during the prepandemic period from December 1, 2019, to February 29, 2020, and the Omicron surging period from December 1, 2021, to February 28, 2022. A total of 518 pregnant women were admitted for delivery during the study period. Multiple gestations (n = 21) and deliveries at less than 20 weeks of gestation (n = 5) were excluded. We analyzed and compared the sociodemographic and clinical data from mothers and their neonates between the two cohorts as well as between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positive and negative mothers during the Omicron surge. Subgroup analyses were also conducted specifically among the Black-only population.

Results The cohorts were predominantly Black (88.6%), with smaller proportions of Hispanic (8.9%), Asian (0.8%), White (0.8%), and other ethnicities (0.8%). Of 492 singleton deliveries, 275 live births, 8 (2.8%) stillbirths, and 31 (11.3%) preterm births (PTBs) occurred during the prepandemic period, and 207 live births, 2 (1%) stillbirths, and 33 (15.9%) PTBs occurred during the Omicron wave. There was no statistically significant difference in the rates of PTBs, stillbirths, medically indicated PTBs, and cesarean delivery between the two cohorts. SARS-CoV-2-positive mothers were not at an increased risk of adverse outcomes. However, neonatal intensive care unit (NICU) admission rate significantly increased among neonates born to SARS-CoV-2 positive mothers compared with negative mothers (32.3 vs. 16.5%, p = 0.038). In subgroup analyses among Black individuals, this difference was not observed.

Conclusion There was no significant difference in pregnancy-related or neonatal outcomes in the Black-dominant population between the two cohorts. SARS-CoV-2 infection did not alter these findings except for an increased NICU admission rate among neonates born to SARS-CoV-2-positive mothers.

Key Points

  • Most pregnant women infected with SARS-CoV-2 during the Omicron wave were asymptomatic.

  • The Omicron wave did not increase the risk of pregnancy-related or neonatal adverse outcomes when compared with the prepandemic period.

  • Maternal SARS-CoV-2 infection increased NICU admission rate.

  • Among Black individuals, no significant increase in adverse outcomes was observed during the Omicron pandemic.

Keywords

COVID-19 - Omicron - Black-dominant population - neonatal outcome - pregnancy outcome

Supplementary Material



Publication History

Received: 10 February 2024

Accepted: 13 June 2024

Accepted Manuscript online:
18 June 2024

Article published online:
11 July 2024

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Allotey J, Stallings E, Bonet M. et al; for PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370: m3320
    CrossrefPubMedGoogle Scholar
  • 2 Ko JY, DeSisto CL, Simeone RM. et al. Adverse pregnancy outcomes, maternal complications, and severe illness among US delivery hospitalizations with and without a coronavirus disease 2019 (COVID-19) diagnosis. Clin Infect Dis 2021; 73 (Suppl. 01) S24-S31
    CrossrefPubMedGoogle Scholar
  • 3 Cheung PY, Alshaikh B, Yang C. COVID-19 pandemic: different associative relationships of city lockdown with preterm births in three cities - an ecological study. Front Pediatr 2021; 9: 644771
    CrossrefPubMedGoogle Scholar
  • 4 Calvert C, Brockway MM, Zoega H. et al. Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries. Nat Hum Behav 2023; 7 (04) 529-544
    CrossrefPubMedGoogle Scholar
  • 5 Grobman WA, Sandoval GJ, Metz TD. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network*. The temporal relationship between the coronavirus disease 2019 (COVID-19) pandemic and preterm birth. Obstet Gynecol 2023; 141 (06) 1171-1180
    CrossrefPubMedGoogle Scholar
  • 6 Tandon P, Leibner ES, Hackett A, Maguire K, Mashriqi N, Kohli-Seth R. The third wave: comparing seasonal trends in COVID-19 patient data at a large hospital system in New York City. Crit Care Explor 2022; 4 (03) e0653
    CrossrefPubMedGoogle Scholar
  • 7 Oliver SE, Gargano JW, Marin M. et al. The Advisory Committee on Immunization Practices' Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine - United States, December 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (50) 1922-1924
    CrossrefPubMedGoogle Scholar
  • 8 Stock SJ, Moore E, Calvert C. et al. Pregnancy outcomes after SARS-CoV-2 infection in periods dominated by delta and omicron variants in Scotland: a population-based cohort study. Lancet Respir Med 2022; 10 (12) 1129-1136
    CrossrefPubMedGoogle Scholar
  • 9 NYC Health. Omicron Variant: NYC report for January 13, 2022. Accessed June 18, 2024 at: https://www.nyc.gov/assets/doh/downloads/pdf/covid/omicron-variant-report-jan-13-22.pdf
    PubMed
  • 10 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371 (9606) 75-84
    CrossrefPubMedGoogle Scholar
  • 11 Emeruwa UN, Spiegelman J, Ona S. et al. Influence of race and ethnicity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and clinical outcomes in pregnancy. Obstet Gynecol 2020; 136 (05) 1040-1043
    CrossrefPubMedGoogle Scholar
  • 12 Preis H, Mahaffey B, Heiselman C, Lobel M. Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic. Soc Sci Med 2020; 266: 113348
    CrossrefPubMedGoogle Scholar
  • 13 Mackey K, Ayers CK, Kondo KK. et al. Racial and ethnic disparities in COVID-19-related infections, hospitalizations, and deaths: a systematic review. Ann Intern Med 2021; 174 (03) 362-373
    CrossrefPubMedGoogle Scholar
  • 14 NYC Health. COVID-19 Data. 2023 . Accessed June 18, 2024 at: https://www.nyc.gov/site/doh/covid/covid-19-data-vaccines.page#people
    PubMedGoogle Scholar
  • 15 NYU Furman Center. East Flatbush Neighborhood Profile. 2020 . Accessed June 18, 2024 at: https://furmancenter.org/neighborhoods/view/east-flatbush
    PubMedGoogle Scholar
  • 16 Iuliano AD, Brunkard JM, Boehmer TK. et al. Trends in disease severity and health care utilization during the early omicron variant period compared with previous SARS-CoV-2 high transmission periods—United States, December 2020–January 2022. MMWR Morb Mortal Wkly Rep 2022; 71 (04) 146-152
    CrossrefPubMedGoogle Scholar
  • 17 Favre G, Maisonneuve E, Pomar L. et al; French and Swiss COVI-PREG group. Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry. Lancet Reg Health Eur 2023; 26: 100569
    CrossrefPubMedGoogle Scholar
  • 18 Pugni L, Crippa BL, Raimondi F. et al. SARS-CoV-2 perinatal transmission and neonatal outcomes across four different waves of COVID-19 pandemic: a nationwide prospective cohort study from the Italian Society of Neonatology. Int J Infect Dis 2024; 140: 17-24
    CrossrefPubMedGoogle Scholar
  • 19 Ledford H. How severe are Omicron infections?. Nature 2021; 600 (7890) 577-578
    CrossrefPubMedGoogle Scholar
  • 20 Jassat W, Abdool Karim SS, Murada C. et al Clinical Severity of COVID-19 in patients admitted to hospitals during the omicron wave in South Africa: a retrospective observational study. Lancet Glob Health 2022; 10 (07) e961-e969
    CrossrefPubMedGoogle Scholar
  • 21 Suzuki R, Yamasoba D, Kimura I. et al; Genotype to Phenotype Japan (G2P-Japan) Consortium. Attenuated fusogenicity and pathogenicity of SARS-CoV-2 Omicron variant. Nature 2022; 603 (7902) 700-705
    CrossrefPubMedGoogle Scholar
  • 22 Metz TD, Clifton RG, Hughes BL. et al; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Disease severity and perinatal outcomes of pregnant patients with coronavirus disease 2019 (COVID-19). Obstet Gynecol 2021; 137 (04) 571-580
    CrossrefPubMedGoogle Scholar
  • 23 Vousden N, Bunch K, Morris E. et al. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS). PLoS ONE 2021; 16 (05) e0251123
    CrossrefPubMedGoogle Scholar
  • 24 Mohammed I, Nauman A, Paul P. et al. The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: a systematic review. Hum Vaccin Immunother 2022; 18 (01) 2027160
    CrossrefPubMedGoogle Scholar
  • 25 Lipkind HS, Vazquez-Benitez G, DeSilva M. et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth - Eight Integrated Health Care Organizations, United States, December 15, 2020-July 22, 2021. MMWR Morb Mortal Wkly Rep 2022; 71 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 26 Abu-Raddad LJ, Chemaitelly H, Ayoub HH. et al. Effect of mRNA vaccine boosters against SARS-CoV-2 Omicron infection in Qatar. N Engl J Med 2022; 386 (19) 1804-1816
    CrossrefPubMedGoogle Scholar
  • 27 Barros FC, Gunier RB, Rego A. et al; INTERCOVID-2022 International Consortium. Maternal vaccination against COVID-19 and neonatal outcomes during Omicron: INTERCOVID-2022 study. Am J Obstet Gynecol 2024; S0002 -9378(24)00078-4
    PubMedGoogle Scholar
  • 28 NYC Health. Racial Inequities in COVID-19 Hospitalizations During the Omicron Wave in NYC. 2022 . Accessed June 18, 2024 at: https://www.nyc.gov/assets/doh/downloads/pdf/covid/black-hospitalizations-omicron-wave.pdf
    PubMedGoogle Scholar
  • 29 Okwandu IC, Anderson M, Postlethwaite D, Shirazi A, Torrente S. Racial and ethnic disparities in cesarean delivery and indications among nulliparous, term, singleton, vertex women. J Racial Ethn Health Disparities 2022; 9 (04) 1161-1171
    CrossrefPubMedGoogle Scholar
  • 30 Jeganathan K, Paul AB. Vertical transmission of SARS-CoV-2: a systematic review. Obstet Med 2022; 15 (02) 91-98
    CrossrefPubMedGoogle Scholar
  • 31 Zamaniyan M, Ebadi A, Aghajanpoor Mir S, Rahmani Z, Haghshenas M, Azizi S. Preterm delivery in pregnant woman with critical COVID-19 pneumonia and vertical transmission. Prenat Diagn 2020; 40 (13) 1759-1761
    CrossrefPubMedGoogle Scholar
  • 32 Kirtsman M, Diambomba Y, Poutanen SM. et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. CMAJ 2020; 192 (24) E647-E650
    CrossrefPubMedGoogle Scholar
  • 33 Salvatore CM, Han JY, Acker KP. et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study. Lancet Child Adolesc Health 2020; 4 (10) 721-727
    CrossrefPubMedGoogle Scholar
  • 34 Ying L, Mengmeng L, Lan Z, Hao Y, Hui J, Shanshan S. COVID-19 Omicron variant infection has minimal impact on maternal and neonatal outcomes: a cross-sectional cohort study. Nurs Open 2024; 11 (01) e2072
    CrossrefPubMedGoogle Scholar