Comparative Study of Pregnancy Outcomes Before and During the COVID-19 Pandemic

Abstract

Background: The COVID-19 pandemic adversely affected pregnant women across multiple dimensions. The present study aimed to compare maternal and neonatal outcomes before and during the pandemic. Methods: This cross-sectional analytical study compared pregnancy outcomes among women admitted to Imam Reza Hospital in Kermanshah, Iran, during two distinct periods: Pre-pandemic (2017 - 2019) and COVID-19 pandemic (2020 - 2022). The study population consisted of 1,500 pregnant women, with 1,000 cases from the pre-pandemic period and 500 from the pandemic period, selected through convenience sampling. Inclusion criteria required participants to have no underlying medical conditions and complete clinical records. The study excluded pregnant women whose medical records were incomplete or inaccessible for data collection. Maternal outcomes assessed included preeclampsia, gestational diabetes, postpartum hemorrhage, placental abruption, miscarriage, preterm delivery, urinary tract infections, and delivery mode (vaginal or cesarean). Fetal and neonatal outcomes analyzed were intrauterine growth restriction (IUGR), Apgar scores, need for resuscitation, stillbirth, birth weight, and congenital anomalies. Data were analyzed using SPSS software (version 25). Results: The study results showed a significant increase in preeclampsia and gestational diabetes, a significant decrease in cesarean section, postpartum hemorrhage, stillbirth, miscarriage, and premature birth, an improvement in the Apgar scores of the newborns at 1 and 5 minutes, a decrease in IUGR cases from 1% to 0%, and no difference in birth weight and congenital anomalies, and the need for neonatal resuscitation. The results of logistic regression showed an increase in miscarriage, vaginal delivery, and gestational diabetes. All results were statistically significant (P < 0.05). Conclusions: COVID-19 appears to influence pregnancy outcomes, with our findings indicating increased rates of gestational diabetes and preeclampsia during the pandemic compared to the pre-pandemic period.