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.
ABSTRACT
BACKGROUND: Oxygen may damage the lung directly via generation of reactive oxygen species (ROS) or indirectly via the recruitment of inflammatory cells, especially neutrophils. Overexpression of extracellular superoxide dismutase (EC-SOD) has been shown to protect the lung against hyperoxia in the newborn mouse model. The CXC-chemokine receptor antagonist (Antileukinate) successfully inhibits neutrophil influx into the lung following a variety of pulmonary insults. In this study, we tested the hypothesis that the combined strategy of overexpression of EC-SOD and inhibiting neutrophil influx would reduce the inflammatory response and oxidative stress in the lung after acute hyperoxic exposure more efficiently than either single intervention. METHODS: Neonate transgenic (Tg) (with an extra copy of hEC-SOD) and wild type (WT) were exposed to acute hyperoxia (95% FiO2 for 7 days) and compared to matched room air groups. Inflammatory markers (myeloperoxidase, albumin, number of inflammatory cells), oxidative markers (8-isoprostane, ratio of reduced/oxidized glutathione), and histopathology were examined in groups exposed to room air or hyperoxia. During the exposure, some mice received a daily intraperitoneal injection of Antileukinate. RESULTS: Antileukinate-treated Tg mice had significantly decreased pulmonary inflammation and oxidative stress compared to Antileukinate-treated WT mice (p < 0.05) or Antileukinate-non-treated Tg mice (p < 0.05). CONCLUSION: Combined strategy of EC-SOD and neutrophil influx blockade may have a therapeutic benefit in protecting the lung against acute hyperoxic injury.
