A comparison of maternal and neonatal outcomes of pregnant women with and without evidence of SARS-CoV-2 infection in the Western Cape, South Africa
type: CreativeWork
description: Background: SARS-CoV-2 infection in pregnancy has been associated with poor pregnancy and neonatal outcomes. While SARS-CoV-2 infection itself could partly account for high maternal mortality rates observed in the Western Cape, indirect effects of the pandemic such as movement restrictions and health service pressure may also have played a role. There is limited data on the impact of having a SARS-CoV-2 diagnosis during pregnancy on maternal and neonatal outcomes in this setting. Objectives: We compared the characteristics and outcomes of pregnant women with and without a SARS-CoV-2 diagnosis with pregnancy outcomes between 1 March 2020 and 31 January 2022 within the Western Cape public healthcare sector. Methods: A retrospective cohort analysis was conducted using routine electronic data collated from public health sources. We compared demographic and clinical characteristics, pregnancy and maternal outcomes and neonatal outcomes by SARS-CoV-2 diagnosis status, gestational timing of diagnosis and by timing of pregnancy outcome during a COVID-19 wave to account for both direct and indirect effects of the pandemic. We used descriptive statistics, Chi-squared tests, Fisher Exact tests, and logistic regression models for analysis. Results: We included 226,336 pregnancies with 193,195 linked live births. Prevalence of a maternal SARS-CoV-2 diagnosis was 2.5%. Increased odds of SARS-CoV-2 diagnosis or hospitalization were associated with age categories ≥25 years compared to 15-24 years, pre- existing and gestational hypertension compared to no hypertension, pre-existing and gestational diabetes compared to no diabetes, current and previous tuberculosis compared to no tuberculosis and HIV positive status compared to HIV negative or unknown status. These factors would likely be more common in admitted patients where testing coverage was higher. In analyses adjusted for these factors, the odds of maternal death were higher in women with a SARS-CoV-2 diagnosis (aOR=11.42; 95…
abstract: Background: SARS-CoV-2 infection in pregnancy has been associated with poor pregnancy and neonatal outcomes. While SARS-CoV-2 infection itself could partly account for high maternal mortality rates observed in the Western Cape, indirect effects of the pandemic such as movement restrictions and health service pressure may also have played a role. There is limited data on the impact of having a SARS-CoV-2 diagnosis during pregnancy on maternal and neonatal outcomes in this setting. Objectives: We compared the characteristics and outcomes of pregnant women with and without a SARS-CoV-2 diagnosis with pregnancy outcomes between 1 March 2020 and 31 January 2022 within the Western Cape public healthcare sector. Methods: A retrospective cohort analysis was conducted using routine electronic data collated from public health sources. We compared demographic and clinical characteristics, pregnancy and maternal outcomes and neonatal outcomes by SARS-CoV-2 diagnosis status, gestational timing of diagnosis and by timing of pregnancy outcome during a COVID-19 wave to account for both direct and indirect effects of the pandemic. We used descriptive statistics, Chi-squared tests, Fisher Exact tests, and logistic regression models for analysis. Results: We included 226,336 pregnancies with 193,195 linked live births. Prevalence of a maternal SARS-CoV-2 diagnosis was 2.5%. Increased odds of SARS-CoV-2 diagnosis or hospitalization were associated with age categories ≥25 years compared to 15-24 years, pre- existing and gestational hypertension compared to no hypertension, pre-existing and gestational diabetes compared to no diabetes, current and previous tuberculosis compared to no tuberculosis and HIV positive status compared to HIV negative or unknown status. These factors would likely be more common in admitted patients where testing coverage was higher. In analyses adjusted for these factors, the odds of maternal death were higher in women with a SARS-CoV-2 diagnosis (aOR=11.42; 95…
author: Mudaly, Vanessa
language: en
keywords: SARS-CoV-2, Infection, Pregnancy
date published: 2025
date modified: 2026-07-22T22:22:57Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Public Health and Family Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/41807