Maternal and Immediate Neonatal Morbidity and Mortality Associated with COVID-19: A Retrospective Cohort Study at Georgetown Public Hospital Corporation

Introduction: Previous outbreaks of coronavirus (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV) have been associated with unfavorable pregnancy outcomes. With SARS-CoV-2 infection, emerging data suggest that pregnancy may be associated with increased maternal morbidity and mortality. This study describes maternal and immediate neonatal outcomes among COVID-19-positive pregnant women delivering at Georgetown Public Hospital Corporation. Material & Methods: A retrospective cohort study was conducted on 301 pregnant patients diagnosed with COVID-19 and their neonates who delivered at GPHC during the study period. Maternal demographic variables, comorbidities, clinical features, and neonatal outcomes were extracted from medical records. Data were analyzed using SPSS version 23. Descriptive statistics and measures of association were calculated. Results: COVID-19-related maternal complications occurred in 2.9% of patients. The maternal case fatality rate was 1.6% (5 out of 301 cases), with all deaths occurring in patients admitted to the ICU. The mean maternal age was 24.9 years (S.D. 6.8 years). Most patients had no comorbidities (76.3%); Pregnancy-induced hypertension was the most common comorbidity, 11.7% (n=35). Fever was the most frequently reported symptom (65.1%), while 26.3 % were asymptomatic. Neonatal outcomes were generally favorable; 85.0% experienced no complications. No statistically significant association was found between maternal COVID-19-related complications and neonatal complications. Conclusions: COVID-19-related complications were uncommon in this cohort; however, a small yet significant burden of maternal mortality was observed, particularly among critically ill patients requiring ICU care. Neonatal outcomes remained largely favorable. These findings highlight the need for vigilance and timely management of severe maternal COVID-19 infection. Keywords: Georgetown Public Hospital Corporation, Guyana, COVID-19 in pregnancy, SARS-CoV-2, maternal mortality, neonatal mortality, Developing countries, pregnancy