Maternal and neonatal outcomes associated with COVID-19 infection in Chaiyaphum

Abstract

Objective: To study the clinical outcomes of neonates and mothers who delivered with COVID-19 infection, including the comparison of the results between the women groups with or without vaccination against the disease.

Method: This was a retrospective descriptive study with data from all singleton pregnant women tested positive for SARS-CoV-2, and neonates born from those mothers in Chaiyaphum Hospital from April 2021 to May 2022. A total of 64 cases were enrolled in the study using the hospital’s record and divided into vaccinated and unvaccinated groups. The Chi-square test or Fisher exact inference statistics were used for categorical data; the independent t-test and Mann-Whitney-U test for quantitative variables with normal and abnormal distributions, respectively.

Results: Of 64 pregnant women who underwent delivery with COVID-19 infection, 85.71% had labor as the first symptom. Others were prelabour rupture of membranes (81.48%), preeclampsia (7.40%), decrease fetal movement and antepartum hemorrhage (1.85%). Symptomatic COVID-19 infections were present in 37.50%, and pneumonia in 28.12%. More than three-quarters (76.56%) of the women had delivery by a cesarean section and two non-vaccinated women were dead. Regarding the infants, 18.75% were pre-term, 17.19% were low birth weight (<2,500 g), 1 minute Apgar score <7 was found in 9.38 % and one was stillbirth due to obstetrics complication. The unvaccinated pregnant women group had significantly higher respiratory rates, lower blood oxygenation (SpO2), and more pneumonia cases than the vaccinated group. However, infants born to both groups of women had no difference in clinical outcomes and no vertical transmission.

Conclusion: The COVID-19-positive pregnant women who delivered but were immunized with at least one dose of the vaccine had a reduced mortality rate, less severe respiratory symptoms, high blood oxygenation level, and a low incidence of pneumonia. Therefore, pregnant women should be vaccinated against COVID-19 to reduce the potential severity and mortality.