Maternal, fetal and neonatal outcomes of pregnant women with COVID-19 referred to Semnan hospitals; a historical cohort study

Abstract

Introduction: Considering the risks of infectious diseases, especially COVID-19 in pregnant women and the existence of ambiguous results related to this disease on the health of mothers and babies, this study aims to determine the maternal, fetal, and neonatal consequences of COVID-19 in pregnant women. Methods: In this retrospective cohort study, 233 pregnant women (113 infected and 120 not infected with COVID-19) ≥ 18 years of age were referred to Kausar and Amirul Mominin (AS) hospitals in Semnan from April 2018 until May 2023. They were selected by the convenience method. Inclusion criteria included: age ≥ 18 years and access to clinical records. Women with chronic diseases, diabetes and gestational hypertension, eclampsia and pre-eclampsia, other infectious diseases, and people with disorders in pregnancy screening tests were excluded from the study. Demographic information and maternal, fetal, and neonatal outcomes of the two groups were compared using clinical records and phone calls. Results: In women with COVID-19 compared to non-infected, the prevalence of hospitalization in the intensive care unit (P = 0.003), premature rupture of the amniotic sac (P = 0.039), gestational diabetes (P = 0.003), pregnancy hypertension (P = 0.016), preterm labour (P = 0.006), cesarean section (P < 0.001), intrauterine fetal growth restriction (P = 0.032), abortion (P = 0.038), fetal death (P = 0.042) and hospitalization of the newborn in the intensive care unit (P = 0.006) were significantly higher. Apgar score of one minute (8.34 ± 1.54 vs. 8.65 ± 0.87 and P = 0.048) and five minutes (9.61 ± 1.12 vs. 9.74 ± 0.68 and P = 0.039) in the neonates of affected women were less than the other group. Conclusion: Health policies based on the education of the symptoms and risks of the disease, as well as screening and faster identification of pregnant women with COVID-19 at higher risk and providing appropriate facilities to control their risk factors and planning to make effective decisions in prevention and clinical management with quick diagnosis and timely treatment in the early stages, is necessary, which is recommended.