Impact of Different Waves of the COVID-19 Pandemic on Fetomaternal Outcome-A Medical University Experience in Bangladesh

Abstract

Background: The COVID-19 pandemic disrupted maternal healthcare services in Bangladesh, with significant declines in antenatal care coverage and regional disparities in access. The purpose of this study was to analyze the effects of various COVID-19 pandemic waves on maternal and fetal health outcomes. Aim of the study: The aim of the study was to analyze the effects of various COVID-19 pandemic waves on maternal and fetal health outcomes of covid negative pregnant women. Methods: This retrospective study at the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka (March 2020–December 2022), included 2,159 covid negative pregnant women in five pandemic waves. Data on demographics, clinical presentation, and maternal-fetal outcomes were analyzed using chi-square and t-tests (p<0.05) in SPSS v25.0. Results: The mean maternal age was 27.5 ± 4.91 years, with the highest gestational age in the second wave (37.83 ± 2.26 weeks). Delivery complications peaked at 32–40 weeks (91.8%), with intrapartum bleeding most common >40 weeks and meconium-stained liquor at 28–30 weeks (p = 0.001). The second wave showed the highest rate of multiple risk factors (44.7%), while the fourth wave had the most LUCS (41.1%), NVD (34.0%), and NICU admissions (44.9%) (p = 0.001). Fetal deaths were highest in the second wave (35.3%), whereas live births peaked in the fourth wave (40.2%) (p = 0.001). Conclusion: The severity of COVID-19 and its outcomes varied across waves, with worse effects during the 2nd (Delta) wave, compared to 4^th wave. This variation likely due to mass vaccination, and further research is needed to understand its impact on pregnancy.