EC Gynaecology

Background: COVID-19 infection has emerged as a major public health crisis with impact on health systems. COVID-19 during pregnancy has direct implications on the pregnancy outcomes, maternal complications, and neonatal outcomes. There have been few studies comparing direct maternal and perinatal outcomes in a cohort of exposed and non-exposed mothers in Low- and Middle-Income Countries (LMICs). The purpose of this study was to provide a description of the features of COVID-19 infection during pregnancy and compare the outcomes among an exposed and unexposed group of women at a tertiary women’s hospital.

Methods: A retrospective cohort study was conducted at the Paropakar Maternity and Women’s Hospital (PMWH), Kathmandu Nepal. The exposed group were the mothers with COVID-19 infection during pregnancy and the unexposed group were the mother without COVID-19 infection. Information on 610 pregnant women who visited the hospital between 26 August 2020 and 21 February 2021 were retrieved from the hospital among which 118 women were tested positive for COVID-19 and 492 women were COVID-19 negative. Chi square test was used to assess the association of the COVID-19 status of the mother with pregnancy outcomes, maternal complications, and neonatal complications with p < 0.05 considered as statistically significant.

Findings: Of 610 pregnant women in the study sample, majority of the women in both the cohort were of age 20 - 35 years and from Janajati ethnicity, however higher percentage of COVID-19 positive mother visited PMWH from outside of Kathmandu valley. The study identified association between COVID-19 status of the mother with pregnancy outcomes (p < 0.001), hypertensive disorders (p = 0.017), and early neonatal death (p = 0.005).

Conclusion: The study has identified association between COVID-19 status of mother and pregnancy outcomes, maternal complication (hypertensive disorder), and neonatal complication (early neonatal death). A national obstetric surveillance system and registry should be developed to collect and analyse information about complications of pregnancy during pandemics and other public health crises.

Keywords: Cohort; Complications; COVID-19; Maternal; Neonatal; Outcomes; Pregnancy; Retrospective

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