Pregnancy and delivery outcomes among pregnant women infected with COVID-19 in tertiary hospitals in Northeastern Thailand: A case-control study
Keywords:
COVID-19 infection, pregnancy outcome, birth outcome, pregnant womenAbstract
This analytical study employed an unmatched case- control epidemiological approach to compare pregnancy and delivery outcomes among pregnant women infected with COVID- 19 who delivered at Khon Kaen Hospital and Maharat Nakhon Ratchasima Hospital. Data were collected from medical record systems of the delivery registers at both hospitals between July 1, 2021, and December 31, 2022. The sample was divided into two groups: 1) the study group, which included 312 pregnant women or those who delivered with COVID-19 infection, and 2) the comparison group of 312 pregnant women or those who delivered without COVID-19 infection. Data collection utilized a checklist tool covering general information, pregnancy and delivery outcomes, and fetal and neonatal outcomes. The instrument demonstrated a content validity index of 0.96. Pregnancy and delivery outcomes were analyzed using logistic regression statistics.
The findings revealed that mothers infected with COVID- 19 during pregnancy or delivery were more likely to have cesarean section deliveries (OR = 1.70, 95% CI = 1.23-2.36) and preterm births ( OR = 1. 74, 95% CI = 1. 10- 2. 76) . They were also more likely to experience amnionitis (OR = 3. 47, 95% CI = 1. 47- 8. 20) , ICU admission (OR = 8. 18, 95% CI = 1. 02- 65. 83) , mechanical ventilation ( OR = 11. 37, 95% CI = 1. 46- 88. 58) , and longer hospital stays ( OR = 1. 68, 95% CI = 1.50-1.88) compared to mothers without COVID-19. Neonates born to infected mothers showed higher likelihoods of low birth weight ( less than 2,500 grams; OR = 1. 58, 95% CI = 1. 00- 2. 52, not receiving breast milk while hospitalized (OR = 46.27, 95% CI = 28.93-73.99), and longer neonatal hospital stays (OR=1.06, 95% CI=1.03-1.10).
This study highlights the impact of COVID-19 infection on pregnancy and delivery outcomes. Therefore, close monitoring and care for pregnant women with COVID- 19 are essential, particularly during the third trimester, to prevent adverse outcomes. Healthcare facilities should also ensure adequate resources, trained personnel, equipment, and service systems to effectively manage potential complications arising from COVID-19 infection in pregnant women.
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