Adverse Neonatal Outcomes Associated with COVID-19: A Case-Control Study in Pregnant Women

Abstract

Background: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, particularly affecting vulnerable populations such as pregnant women. This study aims to investigate the impact of COVID-19 on maternal and neonatal outcomes among pregnant women admitted to Ali-Ibn-Abi-Taleb Hospital in Zahedan, Iran, from September 2020 to September 2021. Objectives: To assess the impact of COVID-19 on gestational age at delivery, Apgar scores, neonatal intensive care unit (NICU) admissions, low birth weight (LBW), and neonatal respiratory symptoms among pregnant women. Methods: A total of 180 pregnant women were included in this case-control study, with 90 COVID-19-positive cases and 90 matched controls. Key outcomes assessed included gestational age at delivery, Apgar scores, NICU admissions, LBW, and neonatal respiratory symptoms. Results: The study found that COVID-19 significantly increased the risk of preterm birth (< 37 weeks) (P = 0.048), lower Apgar scores at 1 and 5 minutes (P < 0.001), NICU admissions (P < 0.001), and LBW (P < 0.001). Additionally, neonatal respiratory symptoms were more frequent in the COVID-19 group (P = 0.007). While there was a higher incidence of neonatal mortality in the COVID-19 group, the difference was not statistically significant (P = 0.051). The timing of maternal COVID-19 infection also played a critical role, with second-trimester infections being significantly associated with congenital anomalies (P = 0.002). Conclusions: This study reveals the increased risks associated with COVID-19 during pregnancy and underscores the need for targeted strategies to mitigate these risks in affected populations. Further research is essential to understand the mechanisms driving these outcomes and to inform clinical practice and public health policies.