Background: The coronavirus disease-2019 (COVID-19) epidemic has emerged as a significant threat to global maternal health, especially with the increasing risk of serious consequences among a vulnerable population, including admission to the intensive care unit (ICU). Therefore, understanding the nature of outcomes in various populations is crucial for developing effective healthcare strategies. Thus, this study aimed to investigate the epidemiology, risk factors, and acute and long-term outcomes of COVID-19 among pregnant women in Bisha Province, Saudi Arabia. Our specific focus was on the determinants of ICU admission to ensure a thorough understanding of the impact of the disease. Methods: This cohort study was conducted at King Abdalla Hospital from February 2020 to January 2023. This study included 88 pregnant women with COVID-19 admitted to the ICU (cases) and 120 pregnant women with COVID-19 not admitted to the ICU (controls). Electronic medical records (EMRs) were extracted for sociological, maternity, and clinical characteristics, as well as the results. A multivariable logistic regression model was used to identify independent risk factors for ICU admission and adverse outcomes. Results: This indicated that advanced maternal age >35 years; odds ratios (ORs) = 2.5; p < 0.003, third-trimester gestation (ORs = 3.1; p < 0.010), low income (ORs = 2.9; p < 0.010), pre-existing hypertension (ORs = 4.8; p < 0.010), and lower educational level (ORs = 3.6; p < 0.010) were significant independent predictors of ICU admission. Furthermore, survivors of ICU admission experienced 2.5 to 3.2 times greater persistence of cardiovascular, respiratory, neurological, and mental health symptoms at 12 months post-infection compared to non-ICU patients. Conclusions: This research has revealed a convergence of clinical and socioeconomic factors that significantly increases the likelihood of severe COVID-19 during pregnancy. The significant long-term morbidity among ICU survivors highlights the essential requirement for a comprehensive strategy. These findings can specifically help reduce risk for targeted delivery, improve healthcare access, particularly in post-COVID recovery clinics, and increase outcomes for this risk population in future epidemic responses.
Miskeen et al. (Tue,) studied this question.