Comparison of maternal and fetal outcomes between COVID-19 and non-COVID-19 patients in a tertiary government hospital: A retrospective cohort study

Abstract

INTRODUCTION: Although it is likely that outcomes in pregnancy differ between regions due to differences in health-care delivery, resources, and health protocols, the rampant increase in COVID-19 cases has proven its effects on the maternal and fetal outcomes. But to what extent does COVID-19 in pregnancy affect adverse maternal and neonatal outcomes compared to non-COVID-19 pregnant patients? OBJECTIVES: This study aims to compare maternal outcomes (morbidity, mortality, intensive care unit [ICU] admissions, and cesarean section [CS] rate) and fetal outcomes (prematurity, APGAR score, neonatal ICU [NICU] admission, and mortality) between COVID-19 and non-COVID-19 cases. METHODOLOGY: A retrospective cohort study was done through chart review of 240 patients, 120 for the COVID-19 group and 120 for the non-COVID-19 group. Demographic data, as well as maternal outcomes (i.e., morbidity, mortality, ICU admissions, and emergency CS), and adverse fetal outcomes (i.e., prematurity, low APGAR, NICU admission, and mortality) were gathered. These outcomes were also classified according to disease severity for the COVID-19 group. The effect of using investigational drugs to outcomes was also determined. RESULTS: This study shows that adverse maternal outcomes were significantly increased with COVID-19 infection. Mortality was increased by 10% while morbidities (acute respiratory distress syndrome, disseminated intravascular coagulation, hemorrhage, and sepsis) were increased by 35%. ICU admission for COVID-19 patients was 10.8% higher, and the emergency CS rate was also increased by 10% in the COVID-19 group. Results also showed increased adverse fetal outcomes for the COVID-19 group, with a 10.8% increase in neonates being born prematurely, an 11.67% increase in low APGAR score, a 9.16% increase in mortality, and a 10% increase in NICU admission. The use of investigational drugs in cases of severe and critical COVID-19 did not have any significant benefits to the outcomes. CONCLUSION: COVID-19 infection significantly increases both maternal and fetal outcomes, and these adverse effects correspond to the severity of the disease. The use of investigational drugs in severe and critical COVID-19 cases has no significant benefit to maternal and fetal outcomes.