Background: COVID-19 has been documented to affect pregnancy outcomes. Therefore, this study evaluated and compared pregnancy and perinatal outcomes, complications and risk factors among COVID-19 infected and noninfected Saudi pregnant women. Methods: A retrospective case-control study was conducted in Maternal and Children Hospital, Abha. One COVID-19 infected patient was matched with 2 uninfected patients (controls). Data were collected using a researchers-generated standardized report form. The t-test and Fisher test were used to compare groups. Logistic regression was used to determine the associations between exposure to COVID-19 and adverse maternal and neonatal outcomes. Results: We recorded data from 150 patients (50 cases and 100 controls). COVID-19 positive women had a significantly increased likelihood of developing complications and having poor maternal and neonatal outcomes. Among factors associated with poor maternal and neonatal outcomes among women with COVID, the cesarean section has the strongest association (aOR=20.1, CI 6.8-54.64), followed by preterm delivery (aOR=6.71, CI 2.27-19.87), and hypertension (aOR=6.55, CI 1.63-26.33), while Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score had the weakest association (aOR=3.51, CI 1.11-11.16). Conclusions: COVID-19 was associated with poor maternal and neonatal outcomes. Therefore, there is a need to closely monitor pregnant women with COVID-19 and their babies during delivery and perinatal period to mitigate short-term and long-term health adverse effects.
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