OBJECTIVES: There is a scarcity of data comparing the rates of maternal and neonatal outcomes in pregnant women with and without COVID-19 infection. Our aim was to assess the effect of COVID-19 on maternal outcomes (stillbirths and miscarriage) and neonatal outcomes (low birth weight <2500 gm Apgar-1 minute score < 7, and Apgar-5 minute score < 7).

METHODS: This is a multicenter retrospective cohort study that included pregnant women who were followed and delivered at three National Guard health System hospitals between March 2020 and October 2021. A laboratory test confirmed the diagnosis of COVID-19 during pregnancy. Multivariable Logistic regression was conducted to assess the risks of maternal and neonatal outcomes.

RESULTS: The study included 644 pregnant women with a confirmed COVID-19 infection and 654 pregnant women with no COVID-19 infection. There was no statistically significant difference in the risk of stillbirth (adjusted odds ratio, aOR1.93, 95% CI 0.55, 8.12) or miscarriage (aOR 0.52, 95% CI 0.23, 1.10) between COVID-19 infected pregnant women and non-infected pregnant women. COVID-19 infection, on the other hand, was associated with increased odds of low birth weight (aOR 1.5, 95%CI 1.06, 2.14), Apgar score-1 minute <7 (aOR 2.14, 95%CI 1.53, 3.03), and Apgar score-5 Minutes <7 (aOR 2.8, 95%CI 1.91, 4.17).

CONCLUSIONS: Infants born to pregnant women with COVID-19 infection were more likely to have low birth weight and low Apgar scores than those born to uninfected mothers.