Laboratory predictors of obstetric and neonatal outcomes in pregnant women with COVID-19

Background. Pregnant women with COVID-19 are at increased risk of adverse obstetric and neonatal outcomes. This study aimed to identify routine laboratory markers that could predict these complications. Methods. We conducted a retrospective analysis of 460 pregnant women diagnosed with COVID-19 at a tertiary care center in Iran between June 2020 and October 2021. Demographic data, pregnancy complications, and laboratory values upon admission were extracted from patient records. Partial correlation and comparative statistical analyses were performed to evaluate associations between laboratory markers and adverse outcomes. Results. Several routine laboratory markers showed significant associations with adverse outcomes. Elevated white blood cell (WBC) count was associated with low birth weight (p = 0.006), preeclampsia (p = 0.007), and hypertension (p = 0.025). Lymphocyte (LYM) count was inversely correlated with mechanical ventilation (p < 0.001), pneumonia (p < 0.001), and ICU admission (p < 0.001), and positively correlated with gestational diabetes (p = 0.009). Prolonged prothrombin time (PT) was associated with severe neonatal asphyxia (p = 0.008). Decreased platelet (PLT) count was linked to intrauterine growth restriction (p = 0.012), preeclampsia (p = 0.025), and preterm delivery (p = 0.027). Elevated levels of ferritin, fasting blood sugar (FBS), erythrocyte sedimentation rate (ESR), D-dimer, C-reactive protein (CRP), and lactate dehydrogenase (LDH) were also associated with various pregnancy complications. Conclusion. Readily available laboratory markers – including WBC, LYM, PT, PLT, ferritin, FBS, ESR, D-dimer, CRP, and LDH – are significantly associated with adverse obstetric and neonatal outcomes in pregnant women with COVID-19. These biomarkers may support early risk stratification and guide timely intervention to improve perinatal outcomes.