Retrospective Cohort Study of Pregnancy Maternal Outcomes of Women With COVID-19 in King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia.

AIM: This study aimed to evaluate the adverse maternal and neonatal outcomes among pregnant women with COVID-19 at King Salman Armed Forces Hospital in Tabuk and examine the relationship between the severity of COVID-19 infection and these outcomes.

METHODS

This retrospective cohort study enrolled COVID-19-positive pregnant women. Demographic and obstetric information, clinical characteristics (including symptoms and preexisting comorbid conditions), and maternal and neonatal outcomes were collected from medical records, reviewed, and analyzed.

RESULTS

The study included 138 COVID-19-positive women, with the majority of cases diagnosed in the third trimester (85.5%). Assessment of the severity of COVID-19 infection showed that a large proportion were asymptomatic (39.1%) or had mild disease (39.9%), while 14.5% had moderate disease and 6.5% experienced severe illness. Adverse maternal and neonatal outcomes included preeclampsia (5.1%), gestational diabetes (4.3%), placental abruption, premature rupture of membranes (2.9% each), maternal intensive care unit (ICU) admission (1.4%), preterm births (12.3%), low birth weight (15.2%), and neonatal ICU admission (10.1%). Additionally, the incidences of preeclampsia and maternal ICU admission were significantly higher in women with severe COVID-19 compared to those with milder or asymptomatic cases (p = 0.004 each). Neonatal ICU admission showed the highest incidence (33.3%) among severe cases (p = 0.031). Asthma was significantly linked to a higher risk of neonatal ICU admission (23.1% vs. 7.1%). Diabetes mellitus was associated with an increased rate of maternal ICU admission (13.3% vs. 0%). Hypertension showed significant associations with elevated rates of preeclampsia (35.7% vs. 1.6%), maternal ICU admission (14.3% vs. 0%), and neonatal ICU admission (35.7% vs. 7.3%).

CONCLUSION

COVID-19 infection during pregnancy was associated with several adverse maternal and neonatal outcomes, including preeclampsia, gestational diabetes, preterm birth, low birth weight, and increased ICU admissions. Severe maternal disease and existing comorbidities further elevated the risks of complications for both mother and newborn.