COVID-19 in pregnancy: Perinatal outcomes and complications.

Background: The risk of severe coronavirus disease 2019 (COVID-19) in pregnant women is elevated.

Aim: To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications, while providing a brief review of current literature.

Methods: The study included pregnant women presenting from April 2020 to February 2022 to the emergency department (ED) of a tertiary hospital. We retrospectively recorded the maternal and perinatal files, including patient epidemiological and clinical characteristics, laboratory values, outcomes, treatment modalities and associations were explored.

Results: Among the 60 pregnant women, 25% required hospitalization, all of whom were symptomatic. Preterm delivery occurred in 30% of cases. Ten percent of neonates required admission to the neonatal intensive care unit, and 5% were classified as small for their gestational age. All mothers survived COVID-19 and pregnancy, with 6.6% requiring invasive mechanical ventilation. Preterm delivery rates did not differ between hospitalized and non-hospitalized pregnant women; composite unfavorable perinatal outcomes, including stillbirth, small for gestational age, or neonatal intensive care unit (ICU) admission, did not significantly increase in the cases hospitalized for COVID-19 (P = 0.09). The odds of hospitalization increased 2.3-fold for each day of delayed ED presentation [adj. OR (95%CI: 1.46-3.624), P < 0.001]. Comorbidity status was an independent predictor of hospitalization, albeit with marginal significance [adj. OR = 16.13 (95%CI: 1.021-255.146), P = 0.048]. No independent predictors of adverse fetal outcome (composite) were identified, and eventual hospitalization failed to reach statistical significance by a slight margin (P = 0.054).

Conclusion: Delayed ED presentation and comorbidities increase hospitalization odds. This study highlights the importance of continuous and specific guidance for managing pregnant COVID-19 patients, including timely and appropriate interventions to minimize maternal and perinatal morbidity and mortality.