The impact of covid-19 pandemic on pregnancy outcome

BMC Pregnancy Childbirth. 2023 Nov 22;23(1):811. doi: 10.1186/s12884-023-06098-z.

Abstract

Background: The acute respiratory disease caused by the coronavirus (COVID-19) has spread rapidly worldwide yet has not been eliminated. The infection is especially deadly in vulnerable populations. The current studies indicate that pregnant women are at greater risk of getting seriously ill. Even though fetuses protect against disease, the additional finding showed that the COVID-19 pandemic could increase fetal and maternal morbidities. In a situation where COVID-19 and new strains of the virus are still not controlled, scientists predicted that the world might experience another pandemic. Consequently, more research about the effects of COVID-19 infection on pregnancy outcomes is needed. This study aimed to compare the pregnancy outcomes of Iranian pregnant women in the first year of the pandemic with the previous year.

Methods: This prospective cross-sectional study was performed to compare the pregnancy outcome during the COVID-19 pandemic among Iranian pregnant women who gave birth during the pandemic and one year before the pandemic (2019-2020 and 2020-2021). The sample size was 2,371,332 births registered at hospitals and birth centers platforms. The studied variables include stillbirth, congenital anomaly, birth weight, preeclampsia, gestational diabetes, cesarean section, ICU admission, mean of the gestational age at birth, preterm births, NICU admission, neonatal mortality and the percentage of deliveries with at least one complication such as blood transfusion and postpartum ICU admission. Analyzing data was done by using SPSS version 25 software.

Results: We found statistical differences between pregnancy and birth outcomes during the COVID-19 pandemic compared to one year before. The risk of preeclampsia, gestational diabetes, cesarean section, preterm birth and NICU admission were clinically significant. Also, there was a significant decrease in mean gestational age.

Conclusion: The COVID-19 pandemic has affected the pregnancy outcome by increasing morbidities and complications during pregnancy, birth, and postpartum. In addition, extensive quarantine outbreaks disrupted the healthcare system and hindered access to prenatal services. It is necessary to develop preventive and therapeutic care protocols for similar pandemic conditions.

Keywords: COVID-19; Cesarean section; Gestational diabetes; NICU admission; Preeclampsia; Pregnancy outcome; Preterm birth.

MeSH terms

  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Cesarean Section / adverse effects
  • Cross-Sectional Studies
  • Diabetes, Gestational* / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Iran / epidemiology
  • Pandemics
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Prospective Studies