Abstract:
This study aimed to analyze maternal outcomes in pregnant women infected with
COVID-19, focusing on the impact of disease severity, timing of medical intervention, and the effect
of different SARS-CoV-2 variants. A retrospective analysis was conducted on 9,288 pregnant women
diagnosed with COVID-19. Disease severity was classified as mild (30%), moderate (52%), severe
(17%), and critical (2%). The study also examined the timing of medical care, with 41.6% of women
seeking care within 7 days of symptom onset and 58.4% after 7 days. The average gestational age
was 271.8 days, with the majority (93.8%) at full-term pregnancy. Results indicated that 88.2% of
women continued their pregnancies during treatment, while 11.9% experienced pregnancy
termination, including preterm deliveries and miscarriages. The study found a significant (p<0.01)
association between COVID-19 severity and adverse outcomes, such as preterm birth and maternal
mortality. Severe and critical cases demonstrated increased risks of uteroplacental insufficiency
(52.1% and 85.5%, respectively), the need for intensive respiratory support, and ICU admission. The
differences in outcomes between the Delta and Omicron variants are also highlighted. The Delta
variant was associated with more severe disease and higher rates of complications, including a
higher need for cesarean sections, compared to the Omicron variant. The overall 30-day survival rate
was 98.05%, with a noticeable drop to 43.59% in critically ill patients. This study underscores the
importance of early medical intervention and continuous monitoring in managing COVID-19 in
pregnant women. The findings also emphasize the need to consider the variant-specific effects of
SARS-CoV-2 on maternal and neonatal outcomes, which can guide clinical decision-making and
improve the prognosis for both mother and child.
