Maternal and Neonatal Outcomes of COVID-19 in Pregnancy in Tertiary Care Centers in Saudi Arabia: A Comparative Study

Abstract

Abstract Background: The coronavirus disease 2019 (COVID-19) infection has been linked to increased risks of severe maternal outcomes globally, including intensive care unit admissions and mechanical ventilation. Studies and reports suggest that pregnant women with COVID-19 face higher risks of complications. However, there is limited data directly comparing maternal and neonatal outcomes in pregnant women with and without COVID-19. Objectives: We aimed to compare both maternal and neonatal outcomes in pregnant women with and without COVID-19 infection. Materials and Methods: This is a multicenter retrospective cohort study conducted at two Ministry of National Guard Health Affairs Hospitals in Saudi Arabia, including all pregnant women, who delivered and received follow-up care at either site between March 2020 and October 2021. COVID-19 infection was confirmed by laboratory tests in the infected patients. Descriptive statistics were conducted for the cohort baseline description, and multivariable logistic regression was conducted to assess the associated risks for maternal, and neonatal outcomes. Results: The study included 639 pregnant women with confirmed COVID-19 infection and 644 pregnant women with no COVID-19 infection. There was no statistically significant difference in the risk of stillbirth [adjusted odds ratio (aOR) = 2.88; 95% confidence interval (95% CI) = 0.89, 11.74] or miscarriage (aOR = 0.53, 95% CI = 0.24, 1.09) between COVID-19 infected and noninfected pregnant women. On the other hand, COVID-19 infection was associated with an increased risk of low birth weight (aOR = 1.53, 95% CI = 1.06, 2.20), Apgar score-1 min <7 (aOR = 2.30, 95% CI 1.62, 3.29), and Apgar score-5 min <7 (aOR 2.84, 95% CI 1.92, 4.27). Conclusion: This study concludes that infants born to pregnant women with COVID-19 infection were more likely to have neonatal complications compared with those born to noninfected women. Future prospective studies could include the long-term effects of maternal and neonatal COVID-19 infection.