# Risk factors and outcomes of critically ill pregnant COVID-19 patients: Experience from the first and second waves of the pandemic

## TL;DR

This study examines risk factors and outcomes for pregnant women with severe COVID-19, finding that ICU admission and comorbidities significantly increase mortality.

## Contribution

The study identifies specific risk factors and clinical outcomes for pregnant and postpartum women with severe COVID-19 in ICU settings.

## Key findings

- ICU admission, age, and gestational age significantly influenced clinical outcomes with a 42.11% mortality rate.
- Pre-existing comorbidities like diabetes and heart disease were linked to ICU admission and higher mortality.
- Multidisciplinary management is emphasized to improve maternal and fetal outcomes during severe COVID-19.

## Abstract

Understanding the association between risk factors and clinical outcomes of COVID-19 can lead to identifying suitable management strategies for reducing the mortality rate among maternal COVID-19 patients in the ICU.

This study aims to investigate the clinical outcomes and risk factors associated with pregnant and postpartum women diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between May 2020 and September 2021.

This retrospective cohort study was conducted at the Universitas Indonesia Hospital. Secondary data was collected from the medical records to include all pregnant and postpartum women diagnosed with confirmed COVID-19 admitted to the hospital during the research period.

The study included 113 patients and found that admission to the ICU, age, and gestational age significantly influenced clinical outcomes, with a mortality rate of 42.11% among ICU-admitted patients. Pre-existing comorbidities such as type-2 diabetes mellitus, congestive heart failure, and coronary artery disease were associated with ICU admission. Having at least one comorbidity was found to increase the mortality rate by six-fold.

The study emphasizes the importance of monitoring and evaluating maternal and fetal complications during COVID-19 infection, highlighting the need for multidisciplinary management involving intensivists, obstetricians, anesthesiologists, and infectious disease specialists. The findings underscore the significance of baseline health status in treatment planning and the potential for evidence-based interventions to improve maternal outcomes and pregnancy preservation. Further research is warranted to validate these results and enhance understanding of the underlying pathophysiology.