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

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 periods. 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 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 (PTB) occurred during the prepandemic period, and 207 live births, 2 (1%) stillbirths, and 33 (15.9%) PTB occurred during the Omicron wave. There was no statistically significant difference in the rates of PTB, stillbirths, medically indicated PTB, and cesarean delivery between the two cohorts. Severe acute respiratory syndrome coronavirus 2 (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 an increased NICU admission rate among neonates born to SARS-CoV-2 positive mothers.