85 - Pregnancy-related and Neonatal outcomes during Omicron variant-dominant COVID pandemic among inner-city African Americans

Poster Number: 85
Publication Number: 85.371

Background: Previous studies have shown that COVID-19 is associated with an increased risk for adverse pregnancy outcomes and neonatal complications. In the US, racial and ethnic minority groups have been disproportionately affected by the COVID-19 pandemic. Studies exploring adverse outcomes during omicron wave are lacking, especially in black dominant populations.

Objective: To determine the omicron variant’s effects on pregnancy-related and neonatal outcomes among the inner-city black dominant population.

Design/Methods: We performed a single center retrospective cohort study during the prepandemic period from December 1, 2019 to February 29, 2020 and the omicron variant-dominant pandemic 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 the sociodemographic and clinical data from the pregnant women and their neonates between the two cohorts.

Results: Of 492 singleton deliveries, 275 live births, 31 (11.3%) preterm births, and 8 (2.8%) stillbirths occurred during the prepandemic period, and 207 live births, 33 (15.9%) preterm births, and 2 (1%) stillbirths occurred during the pandemic period. There was no significant difference in preterm births (p=0.14) and stillbirths (p=0.41) between the two cohorts, and SARS-CoV-2 positive mothers were not at increased risk of PTB (p=1.0) or stillbirths (0% vs 2.4%; p=1.0) compared to SARS-CoV-2 negative mothers. Rates of low birth weight and intrauterine growth restriction between the prepandemic and the omicron pandemic periods and between SARS-CoV-2 positive and negative maternal subgroups were similar. During the omicron wave, 31 (15.9%) mothers and 3 (1.5%) neonates tested positive for SARS-CoV-2. Two thirds of SARS-CoV-2 positive mothers and all SARS-CoV-2 positive neonates were asymptomatic. No maternal or neonatal death, nor admissions to intensive care unit occurred during the study periods. An increase in NICU admission rate was observed in SARS-CoV-2 positive maternal group compared to SARS-CoV-2 negative group (32.3% vs 16.5%; p=0.047).

Conclusion(s): Contrary to previous studies, our data demonstrates that there was no significant difference in pregnancy related or neonatal adverse outcomes in the black dominant population between the prepandemic and the omicron variant pandemic periods. We speculate that these results are attributed to the widespread vaccination and relatively low virulence of the omicron variant.