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COVID Omicron Variant and Pregnancy

In the last few months, the Omicron variant of the coronavirus has spread across the world and caused a rapid increase in the number of new infections.

According to the Straits Times (Jan 26, 2022) about 70 percent of daily cases are now of that strain, which has become the dominant variant in place of Delta. The proportion could actually be closer to 90 percent. The Omicron peak may exceed that of Delta and hit 20,00 to 25,000 cases a day.

What are the symptoms of Omicron in pregnant patients?

Omicron is highly contagious, spreads very easily, and could evade vaccines as well. It has an incubation period of roughly three days, according to a recent study.

For most people, Omicron appears to cause milder illness. Symptoms are similar in pregnant as well as non-pregnant patients. They include:

  • Sore throat

  • Fever

  • Body pain

  • Running nose

  • Fatigue

  • Cough

  • Sneezing

  • Loss of smell or taste is less common with Omicron

Can Omicron cause more severe disease in pregnant women?

Scientists found that Omicron replicates more rapidly in the upper respiratory tract than in the lungs and thus produces milder infection. Nonetheless, pregnant mothers, being in a “low immunity” state, are more vulnerable to get severe disease.

Unvaccinated pregnant mothers have three times the risk of being hospitalised or needing ICU-level care and twice the risk of needing ECMO [major organ support] or dying if they contract Covid-19. A recently published study in Scotland found that 98 percent of pregnant patients who were admitted to the ICU for critical care were unvaccinated.

Locally, Health Minister Ong Ye Kung, in a Facebook post on Sept 29, said that more than 85 percent of pregnant women hospitalised with Covid-19 were not fully vaccinated. Among them, about 20 per cent needed oxygen supplementation, and another 10 per cent needed high dependency care or care in the intensive care unit (ICU).

With vaccination, researchers found that mothers with Omicron infections were less likely to have medical intervention than those with Delta infections.

What are the maternal and foetal complications of omicron infection?

Regardless of variant, pregnant mothers with Covid-19 are at increased risk of getting complications. They include:

  • Preeclampsia: The high blood pressure usually develops after 20 weeks of pregnancy

  • Eclampsia: A life-threatening condition when convulsions occur in a pregnant woman suffering from high blood pressure, often followed by coma

  • HELLP syndrome: A medical emergency that affects the blood and liver.

  • ICU admission especially if patient has shortness of breath, chest pain, and cough with fever

  • Infections

  • Maternal death

Foetal complications include:

  • Premature birth

  • Foetal growth restriction

  • Stillbirth

  • Neonatal death

How can pregnant women protect themselves from the Omicron variant?

Besides wearing masks, practising good personal hygiene and restricting social interactions, the most important way for pregnant mums to reduce chances of getting serious illness from Omicron is to get vaccinations and booster shots.

There is robust data to show that the vaccines are safe and effective in all stages of pregnancy and have been endorsed by major medical institutions worldwide. Over 170,000 pregnant women in the US have received an mRNA vaccination (either Pfizer BioNTech or Moderna) and there have not been any safety concerns raised.

Booster shots of mRNA vaccines are 90 percent effective against hospitalisation with Omicron, according to the Centres for Disease Control and Prevention (CDC) of the USA.

In summary, though Omicron is messaged globally as a mild variant, it is still a dangerous virus. Pregnant mums, being a vulnerable group, are encouraged to get vaccinated and have booster shots, both to protect themselves and others. Let us not be complacent and let our guards down.

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