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
