Association of COVID-19 Infection with Pregnancy and Fetal Outcomes among Unvaccinated Women in the City of Manila, the Philippines: a Multicenter Prospective Cohort Study

The influence of COVID-19 on maternal-fetal outcomes is a growing area of research yet understudied in the Philippines. This study analyzed associations between COVID-19 status and maternal, fetal, and pregnancy complications and outcomes among unvaccinated women in the City of Manila, the Philippines. This multicenter prospective cohort study ascertained the pregnancy status with sonographic studies, the presence of SARS-CoV-2 with reverse transcriptase polymerase chain reaction, and sociodemographic and medical information with a validated health questionnaire. Crude and adjusted generalized linear models with a Poisson distribution were fitted to estimate the influence of COVID-19 status and maternal, fetal, and pregnancy outcomes. COVID-19 infection appears correlated with higher absolute risks of gestational hypertension, fetal growth restriction, maternal preterm births, fetal prematurity, and COVID-19-associated complications, and a lower risk of anesthesia-associated complications, obstetric hemorrhages, and NICU admissions. Cesarean section was more frequently done to infected patients, yet the disease showed little association with poor maternal- fetal outcomes. COVID-19 has some association with gestational and neonatal complications but has little association with poor maternal, pregnancy, and fetal outcomes.