Objective: To analyze the differences in maternal perinatal outcomes between confirmed and unconfirmed COVID-19 cases in Dr. Kariadi General Hospital Medical Center Semarang.

Methods: This is an analytic observational study with a case-control design. The unpaired case-control sample size formula was used for sampling. A total of 135 samples were divided into two groups. The case group consists of 42 confirmed COVID-19 pregnant women and the control group of 93 unconfirmed COVID-19 pregnant women. The data were analyzed using univariate tests, bivariate tests, and multivariate tests by logistic regression test or multiple linear regression test.

Results: Maternal outcomes of multiple organ dysfunction were significantly higher in the confirmed COVID-19 case group (11.9% vs 1.1%), a higher significant difference was also found in the use of mechanical ventilators in the case group (9.5% vs. 1.1%), maternal mortalities was significantly higher in the case group (9.5% vs. 1.1%). Mothers with multiple organ function failure based on the calculation of the maximum SOFA score. Anemia were more common in the case group (66.7%) compared to the control group (49.5%) with P= 0.063. Pregnant women with kidney disease were more common in the case group (4.8%) than the control group (3.2%) P=0.496. The severity of COVID-19 and thromboembolic prophylactic therapy have a significant effect on multiple organ failure. Postpartum bleeding complications were only found in the case group (2.4%) P=0.311). Sepsis was higher in the case group (9.5%) than in the control group (3.2%) P= 0.135. COVID-19 complication ARDS were significantly higher in the case group, (7.1%) compared to the control group (1, 1%) with P= 0.089. DIC complications were only found in the case group (2.4%) with P=0.311. Preterm delivery was higher in thecase group (19%), compared to the control group (16.1%) with P= 0.676. The perinatal outcome of asphyxia and fetal distress was higher in the case group. Perinatal COVID-19 status was checked only in confirmed COVID-19 mothers with a positive 18.9% of infants with confirmed COVID-19 status in the case group. There were five cases of perinatal death entirely caused by fetal death in utero, which were more common in the case group (7.1%) than the control group (2.1%).

Conclusions : There are differences in maternal and perinatal outcomes between confirmed and non-confirmed COVID-19 pregnant women, namely multiple organ failure, use of mechanical ventilators, and maternal mortality.

Keywords : COVID-19, maternal outcomes, perinatal outcomes