Impact of COVID-19 on Pregnancy Outcomes: A Phase-Based Analysis from a Spanish Tertiary Hospital (2020-2023).

Publication date: Jul 19, 2025

Background/Objectives: Pregnancy has been considered a risk factor for severe SARS-CoV-2 infection, as well as for adverse maternal and neonatal outcomes. This study aimed to assess the clinical impact of COVID-19 on pregnant women managed at a Spanish tertiary care hospital across different phases of the pandemic. Methods: A retrospective observational study was conducted at Dr. Balmis General University Hospital (Alicante, Spain) between March 2020 and May 2023. All pregnant women who received hospital care with confirmed SARS-CoV-2 infection were included. Maternal and neonatal outcomes were analyzed and compared with the 6120 total births recorded during the same period. Results: A total of 249 pregnant women with COVID-19 were included, with 30. 8%, 25. 0%, and 7. 9% hospitalized during each respective pandemic phase. The overall incidence of infection was 41 cases per 1000 births. Hospitalized pregnant women showed significantly higher rates of preterm birth, labor induction (70. 4% vs. 47. 0%; OR: 2. 67; 95% CI: 1. 12-6. 43), and cesarean delivery (46. 9% vs. 24. 9%, OR: 2. 60; 95% CI: 1. 27-5. 50). Neonatal outcomes included lower Apgar scores, increased admission to the neonatal unit (25. 8% vs. 8. 2%, p = 0. 007), and a higher rate of neonatal complications (23. 3% vs. 7. 7%, p = 0. 015). Maternal obesity and non-Spanish nationality were associated with more severe maternal disease. Vaccination against SARS-CoV-2 significantly reduced the risk of hospitalization due to the infection (OR: 0. 30; 95% CI: 0. 13-0. 69). Conclusions: Pregnant women admitted with COVID-19 had increased risks of adverse obstetric and neonatal outcomes, underscoring the importance of preventive strategies, such as vaccination.

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Concepts Keywords
Hospitalization cesarean delivery
Obesity COVID-19
Pregnant maternal outcomes
Spanish neonatal outcomes
pregnancy
risk factors
SARS-CoV-2
vaccination

Semantics

Type Source Name
disease MESH COVID-19
disease MESH Pregnancy Outcomes
pathway REACTOME SARS-CoV-2 Infection
disease MESH infection
disease MESH preterm birth
disease MESH complications
disease MESH Maternal obesity
disease IDO history
disease MESH gestational diabetes
disease MESH preterm labor
disease MESH postpartum hemorrhage
disease MESH emergency
disease IDO country
disease MESH hypertension
disease MESH spontaneous abortion
disease MESH sore throat
disease MESH dyspnea
disease MESH anosmia
drug DRUGBANK Oxygen
disease MESH pneumonia
disease MESH maternal death
disease MESH anomalies
disease IDO blood
disease MESH neonatal death
disease IDO process
drug DRUGBANK Methionine

Original Article

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