Maternal and Fetal Outcomes of COVID-19 According to the Trimester of Diagnosis: A Cross-Sectional Prospective Study in a Tertiary University Hospital

<b>Objectives:</b> Pregnant women are considered a high-risk group because they may be particularly susceptible to COVID-19. Our study tried to relate fetomaternal outcomes and trimester-specific infection. <b>Methods:</b> A prospective study on 224 pregnant women with confirmed antenatal infections at a tertiary hospital. Data from the antenatal clinic records, admission files, labor ward and neonatal notes, lab results, respiratory consultations, and ICU admission were analyzed using Jamovi 2.2.5, with <i>p</i> < 0.05 indicating significance. <b>Results:</b> A total of 224 patients were included-10, 32, and 182 patients were diagnosed in the first, second, and third trimesters, respectively. Neonatal NICU admissions were significantly higher among those with infections in the third trimester compared to those in the first trimester (<i>p</i> = 0.008). Significant differences in Apgar scores at 1 and 5 min emerged between the second and third trimesters (<i>p</i> = 0.014 and <i>p</i> = 0.037, respectively). However, no significant differences were observed in Apgar scores between the first and second trimesters (<i>p</i> = 0.341, <i>p</i> = 0.108) or the first and third trimesters (<i>p</i> = 0.545, <i>p</i> = 0.755). Complications of pregnancy, including maternal mortality and various conditions (respiratory, obstetrical, sepsis, DIC), neonatal outcomes, ICU admission, and cesarean section indications, showed no significant differences related to the trimester of infection (<i>p</i>-values: 0.989, 0.892). Study limitations include sample size impacting generalization, higher COVID-19 cases in the third trimester than other trimesters, and potential historical data availability and accuracy issues. <b>Conclusions:</b> In the third trimester, COVID-19 caused more neonatal ICU admissions than the first trimester, with lower Apgar scores at 1 and 5 min compared to the second trimester, indicating an increasing susceptibility and vulnerability to COVID-19 infection with an increasing pregnancy age. Other fetal and maternal outcomes showed no significant differences in infection timing.