Becker's Clinical Quality & Infection Control

13 PATIENT SAFETY & OUTCOMES US preterm birth rate dropped in 2020 for 1st time in 6 years By Gabrielle Masson T he U.S. preterm birth rate declined slightly for the first time in six years, dropping from 10.2 percent in 2019 to 10.1 percent in 2020, according to a March of Dimes Report Card 2021 executive summary accessed in November. Despite the decline, the nation has kept its "C-" grade, according to the March of Dimes. Six report takeaways: 1. irty-three states and Washington, D.C., reported a decline in preterm birth rates, while 13 states saw an increase and four remained flat. 2. Preterm birth rates rose for Black and American Indian/Alaska Native women, who are 60 percent more likely to give birth preterm than white women. 3. e infant mortality data show a slight decline from 5.7 deaths per 1,000 live births in 2018 to 5.6 deaths per 1,000 in 2019. Disparities persist, with Black and American Indian/Alaskan native babies twice as likely as white babies to die before their first birthday. 4. Severe maternal morbidity rates have doubled over the last 20 years, according to CDC data. Each year, about 60,000 U.S. wom- en experience morbidity tied to pregnancy. 5. Pregnancy-related death has more than doubled over the last 30 years, with more than 700 U.S. women dying per year. 6. e 2021 Report Card highlights policy actions, legislation and programs that should be adopted to change the course of this crisis, including the passage of the Black Maternal Health Momnibus Act of 2021, extending Medicaid postpartum coverage, funding maternal mortality review committees and perinatal quality collaboratives, and expanding access to doula and midwifery support. n Omicron patients less likely to be hospitalized, have shorter stays: 6 study findings By Gabrielle Masson O micron rapidly overtook COVID-19 cases at Hous- ton Methodist in late 2021, causing 90 percent of all new COVID-19 cases only three weeks after the variant was first identified within the health system. On Jan. 1, researchers at Houston Methodist released preliminary findings about some of the differences be- tween omicron, delta and alpha patients. The findings were published on the preprint server MedRxiv and have yet to be peer-reviewed. A com- prehensive genome sequencing study in the Houston Methodist system identified 862 symptomatic patients with COVID-19 infections caused by omicron from late November through Dec. 18, 2021. Six things to know: 1. Patients with omicron infections were significantly less likely to be hospitalized compared to those with alpha or delta infections. Of the 862 total symptomatic patients with sequencing data available, 15.5 percent of individ- uals with omicron required hospitalization, compared to 54.5 percent of individuals with alpha and 43 percent of individuals with delta infections. 2. Compared to patients infected with either alpha or delta variants at Houston Methodist, omicron patients had a significantly shorter median hospital length of stay. Omicron patients had a median stay of 2.8 days, com- pared to 5.4 days for delta patients and 5.1 for patients with alpha infections. 3. Compared to patients with either alpha or delta vari- ants, omicron patients were significantly younger. The median age at hospitalization was 38.9 years for omicron patients, compared to 50 for the alpha variant and 48.2 for delta. 4. Omicron patients required less intense respiratory sup- port, consistent with decreased disease severity. 5. Omicron patients who were fully vaccinated, excluding a third booster dose, had significantly increased vaccine breakthrough rates compared to patients with alpha or delta. Overall, 49.9 percent of all omicron patients (430 of 862) met the CDC definition of breakthrough cases, compared to 3.2 percent for alpha patients and 24.1 percent for delta. 6. Analysis of individuals with breakthrough cases after receiving a third booster dose of either the Pfizer-BioNTech or Moderna vaccine found that 9.9 percent (85) of the 862 omicron patients met this criteria. n

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