Throughout the pandemic, public health officials have strongly advised pregnant women and other high-risk people to take extra precautions and avoid contracting COVID-19. But the rise of the Omicron variant — described as "mild" by many — has left plenty of people wondering what it means if you’re pregnant.
How does the Omicron variant affect pregnant women? Should you still try to protect yourself from COVID-19, or is it less of a threat to you and your baby now?
Experts stress that it’s crucial to continue to have your guard up. "It’s very frustrating that Omicron has been messaged globally as a milder variant," says Melissa Simon, M.D., an OB/GYN at Northwestern Medicine in Chicago. "There are still certainly serious illnesses and deaths occurring due to Omicron and especially in more vulnerable populations — that includes pregnant people."
Here’s what you need to know about Omicron variant, its subvariants and how they can impact pregnant women.
What do pregnant women need to know about the BA.5 subvariant?
The World Health Organization (WHO) first identified Omicron as a variant of concern in late November 2021 before it spread rapidly across the world. Since then, health agencies have tracked several subvariants within the Omicron family.
BA.1 made up most of the COVID cases back in December, January and February. In the spring, the subvariant BA.2 took its place as the dominant strain. Now, the BA.4 and BA.5 variants account for more than 90 percent of cases in the U.S.[1]
Experts say it's normal for new variants of viruses to occur, and the best way to protect yourself remains the same: get vaccinated and boosted against COVID-19. The U.S. Department of Health and Human Services (HHS) has procured booster shots that specifically target BA.4 and BA.5 Omicron subvariants.[2]
More About COVID-19
These multi-strain Omicron boosters were approved for emergency use authorization by the FDA in August 2022, after which they got the green light from the CDC, and they're now available in the U.S.[3] Kids ages 12 and older and adults can get the one made by Pfizer, while everyone ages 18 and older can receive the Moderna version.
Those who want the so-called "updated boosters" can get them at least two months after primary or booster vaccination, according to the FDA. These new bivalent vaccines contain two mRNA components of COVID-19, one of the original strain of the virus and the other one in common between the BA.4 and BA.5 lineages of the Omicron variant, the agency says.
What are the symptoms of the Omicron variant in pregnant women?
Regardless of the strain, the Centers for Disease Control and Prevention (CDC) maintains that these are the main symptoms of COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This set of symptoms applies to pregnant women too. "At present, there is no data to suggest that presenting symptoms differ between pregnant folks, and those who aren’t pregnant," says Kjersti Aagaard, M.D., Ph.D., professor of obstetrics and gynecology at Baylor College of Medicine in Texas.
Michael Cackovic, M.D., a maternal-fetal medicine physician at the Ohio State University Wexner Medical Center in Ohio, agrees. "With Omicron, the symptoms are pretty much the same as in other groups: cough, congestion, sore throat, headache, muscle pains."
Does the Omicron variant cause more severe disease in pregnant women?
It can, and doctors say that there are a few reasons why. "Because pregnant women have an aspect of immunosuppression that allows them to carry what amounts to a baby that is one-half genetically different than themselves, any illness has a potentially more dangerous effect on the pregnant woman," Dr. Cackovic says. "Pregnancy additionally carries the risk of preterm birth, and we are seeing exceptionally high rates with COVID in general."
"Regardless of the variant, pregnant persons have a higher chance than non-pregnant persons of getting admitted to the hospital with COVID symptoms and needing to be transferred to the intensive care unit," Dr. Simon says.
Experts say vaccination status matters too when it comes to the severity of the disease. A Nature Medicine study out of Scotland found that 98 percent of pregnant patients who were admitted to the ICU for critical care due to COVID-19 were unvaccinated.
"Most people who are vaccinated and boosted do not get COVID," says Dr. Simon. "And if they are to get an infection, regardless of the variant, they have a much lower chance of getting hospitalized, an even more substantially lower chance of getting intubated, and an almost zero chance of dying."
Though one study found that pregnant women are almost twice as likely to get a breakthrough COVID-19 infection (meaning a case contracted in a vaccinated person) than those who aren't pregnant, the COVID-19 vaccine signficantly lowers the risks of serious illness and hospitalization, whether you're pregnant or not.
Research has also shown the COVID-19 vaccine is safe during pregnancy and has not been linked to preterm births or babies with lower birth weights.
Dr. Simon says it’s extremely concerning that many pregnant women haven’t gotten the COVID-19 vaccine for that precise reason.
"We have a vaccine that’s considered very safe in pregnancy and, thus, COVID is a preventable disease. Anyone who is pregnant should be getting the vaccine or booster if they are eligible," she says.
How can pregnant women protect themselves from the Omicron variant?
One of the biggest things, experts say, is to get vaccinated against COVID-19 and to receive your booster shot when you’re eligible. Major medical associations — including the CDC, American College of Obstetrics and Gynecologists (ACOG) and the Society of Maternal Fetal Medicine — recommend the COVID vaccine for women who are considering becoming pregnant, are pregnant or are breastfeeding.
"It has a proven safety profile in all areas of the reproductive life cycle and is our best weapon to prevent the severe complications of the disease," says Dr. Cackovic. "Additionally, the booster itself offers the best protection for Mom, baby and family from the Omicron variant."
Dr. Aagaard recommends that other family members who are eligible, like your partner if you have one and other children in the house, also get vaccinated against COVID-19 to protect both you and your baby. "It is important," she says.
Dr. Simon stresses how critical it is to follow CDC guidance and make sure to wear a proper, fitted mask when you’re out in public, particularly in crowds and indoor spaces. "Don’t let your guard down," she advises.
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