Risk Assessment of COVID-19 on Pregnant Women and Pregnancy Outcomes

Background: Pregnant females represent a large category that deserves a meticulous consideration during any pandemics especially COVID-19.
Objectives: To assess maternal and fetal outcomes for 3^rd trimester pregnant women during COVID-19 pandemic.
Patients and Methods: This cohort study was conducted on 85 COVID-19 pregnant women and 85 non-infected pregnant women (control) collected over 1.5 years period, they were followed up till delivery and hospital discharge.
Result: Maternal outcome of COVID-19 cases showed that 80% required blood transfusion vs 14.1% in control group (relative risk (RR)=5.7, 95% confidence interval (CI): 3.3-9.7), 40% needed intensive care unit admission vs 7.1% (RR=5.7, 95% CI: 2.5-12.8), 29.4% needed mechanical ventilation vs 1.2% (RR=25.0, 95% CI: 3.5-180.4), 47.1% had complications vs 7.1% (RR=6.7, 95% CI: 2.9-14.9), maternal mortality was 15.3% vs 1.2% (RR= 13, 95% CI: 1.7-97.2). Neonatal complications represented 41.2% vs 21.2% (RR=1.9, 95% CI: 1.2-3.2) and neonatal mortality was 14.1% vs 5.9% (RR= 2.4, 95% CI: 0.9-6.5). Gestational age, Oxygen saturation (SpO₂) on admission and SpO₂ during hospital stay were significantly lower among complicated cases (33.9±3.0 weeks, 78.5±13.5 % and 93.5±4.7 %, respectively). Multivariate logistic regression showed that gestational age (P=0.002, odds ratio (OR)=0.725, 95% CI=0.551-0.956) and SpO₂ on admission (%) (P=0.001, OR=0.851, 95% CI=0.773-0.936) were independent predictors for COVID-19 complications among pregnant females.
Conclusion: COVID-19 infection is associated with unfavorable maternal and neonatal consequences in 3^rd trimester pregnant females, so comprehensive follow up of both infected mothers and their neonates is highly recommended.