Maternal and Neonatal Outcomes Associated With COVID-19 Infection: A Case-Control Study

Background and aims: Pregnant women are a high-risk group requiring special attention during the COVID-19 pandemic. This study aimed to compare maternal and neonatal outcomes between pregnant women with and without COVID-19. Methods: A total of 210 hospitalized pregnant women and their newborns were evaluated at Hajar hospital, Shahrekord, Iran, between July 16, 2022, and March 20, 2023. The case group included 70 women with confirmed COVID-19, while the control group consisted of 140 COVID-negative women matched by age and parity. Data on maternal history, pregnancy complications, and neonatal outcomes were extracted and analyzed using t-tests, Chi-square, and Fisher’s exact tests in SPSS 22 (P<0.05). Results: Adverse maternal outcomes were significantly more common in the case group, including preeclampsia (P=0.03), preterm labor (P=0.002), fetal distress (P=0.01), reduced fetal movements (P=0.01), and cesarean delivery (P<0.001). Neonates born to infected mothers had lower birth weight (2881±314 g vs. 3088±384 g, P<0.001) and higher rates of respiratory distress (18.6% vs. 2.9%, P<0.001), neonatal intensive care unit admission (15.7% vs. 2.9%, P=0.001), gastrointestinal issues (8.6% vs. 0%, P=0.001), feeding problems (14.3% vs. 4.3%, P=0.01), neonatal fever (17.1% vs. 0%, P<0.001), and positive polymerase chain reaction (17.1% vs. 0%, P<0.001). Eventually, the non-reactive non-stress test was more prevalent in the case group (18.6%, P<0.001). Conclusion: COVID-19 infection during pregnancy was associated with increased maternal and neonatal complications, highlighting the need for enhanced monitoring and care.