(133) Wild type through Omicron: Maternal outcomes across COVID-19 waves

SARS-CoV-2 has been associated with poor maternal complications. Few studies exist that specifically compare maternal outcomes across the waves and variants of the pandemic. We sought to determine if maternal complication of COVID differ across COVID-19 waves.

Study Design:

Retrospective study of pregnant patients diagnosed with SARS-CoV-2 between 3/6/20 and 2/28/22 at a single academic center. Three distinct waves of the pandemic were identified that correlated to the following variants: Wild type (3/6/20-12/31/20), Alpha/Delta (1/1/21-12/14/21), and Omicron (12/15/21-2/28/22). Baseline demographics and clinical outcomes were collected. The primary outcome was development of maternal COVID-19 complications (venous thromboembolism, pneumonia, acute respiratory failure, stroke, myocardial infarction, acute renal or hepatic failure, and transaminitis). Statistical analysis was performed using Chi square tests, student T-tests, and logistic regression modeling, with significance defined as p< 0.05.

Results:

There were 654 patients included in the analysis with 190 (29%) in the wild type wave, 207 (31%) in the Alpha/Delta wave, and 257 (39%) in the Omicron wave. Women diagnosed during the wild type wave (OR 22.9 (95% CI 2.9-177.4)) or the Alpha/Delta wave (OR 10.6 (95% CI 1.3-85.1)) had significantly higher odds of maternal complications compared to those diagnosed during the Omicron wave. Pneumonia was the most common complication, and the incidence differed across waves: 7.4% during the wild type, 4.3% during the Alpha/Delta, and 0.4% during the Omicron wave (p < 0.001). Rates of other maternal complications across waves are shown in Figure 1. There were no cases of stroke, MI, acute renal or hepatic failure. Women diagnosed during Omicron were more likely to be AMA and have co-morbidities, whereas parity, Hispanic ethnicity, GA at diagnosis and government insurance were greater during the wild type wave (p < 0.05) [Table 1].

Conclusion:

Maternal complications of COVID were higher during the Wild type and Alpha/Delta waves compared to the Omicron wave.