ABSTRACT

Background and Aim: The obstetrical complications of pregnant women might elevate to a severe stage due to ongoing severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). Limited study focused on association between COVID-19 and pregnant women adverse outcomes. The present study was carried out to evaluate the severity of COVID-19 among pregnant women and risk of adverse maternal outcome.

Materials and Methods: This cross-sectional study was carried out on 242 pregnant women of confirmed COVID-19 cases hospitalized in Aziz Fatimah Hospital, Faisalabad and Holy Family hospital Rawalpindi for six months duration from 5^th December 2020 to 5^th May 2021. Pregnant women demographic details, obstetric characterizations, adverse maternal outcomes, and laboratory findings were noted. Positive tested pregnant women through RT-PCR regardless of clinical symptoms and signs were enrolled as confirmed cases while negative tested pregnant women were excluded. Hypertensive disorders, preexisting pulmonary, obesity, renal, nulliparity, and cardiovascular disease were the maternal risk factors. Different variables were assessed through fisher’s test and regression logistics model.

Results: Of the total 242 pregnant women, the prevalence of mild to moderate symptoms, and severe disease were 187 (77.3%) and 43 (17.7%) respectively. About 12 (5%) had a critical stage of the disease. During this study period, about 31 (12.8%) were admitted to the intensive care unit (ICU) and 9 (3.7%) died. Mode of delivery, maternal age, underlying conditions, parity, and admission to ICU were the important demographic factors in severe COVID-19 disease. Other severe maternal outcomes were fever, cough, breath shortness and anosmia. Increase ICU admission and cesarean section delivery were significantly associated with disease severity. 

Conclusion: Our study founds a mortality rate of 3.7% among pregnant women with COVID-19. A higher prevalence of intensive care admission and cesarean delivery were reported in acute and severe COVID-19disease. The obstetrical and neonatal outcomes significantly affected by the severity of maternal disease; neonatal prematurity, ICU admission, and cesarean sections complications.