Objective. The aim of the study was to compare maternal and neonatal outcomes of the COVID-19 in Omicron and Delta wave. Materials and Methods.In this prospective observational multicenter study, we included unvaccinated patients who were hospitalized to deliver and who gave birth while infected.

The aim of this study was to assess the maternal and fetal outcomes in pregnant women with COVID-19 infection at birth and the impact of the mode of delivery on the prognosis of these patients. Material and Methods:This is a multicenter observational study including pregnant women delivering while infected with COVID-19 from January 2021 to June 2022 in 3 regions in the south of Tunisia. To assess the impact of the mode of delivery among patients included, they were divided into 2 groups:• Group 1: included patients who had cesarean delivery.• Group 2: included patients who had vaginal delivery.The maternal and fetal outcomes were compared between the 2 groups. Multivariable logistic regression was performed to assess the association between the mode of delivery and maternal and fetal adverse outcomes. Results:We included 201 patients: 129 cesarean deliveries and 72 vaginal deliveries.Demographic parameters and the severity of COVID-19 signs before delivery were comparable in both groups. We noted higher rates of increased need for oxygen, maternal complications, and intensive care unit referral in the cesarean group (p<0.001).Cesarean birth was significantly associated with the risk of clinical deterioration (aOR=12.9, 95% CI: 4.89 -34.4, p<0.001), maternal death (aOR= 3.84, 95% CI: 0.839 -17.5, p=0.042), and an increased risk of neonatal intensive care unit admission (aOR=3.72; 95%CI: 1.63 -8.48, with p= 0.001). Conclusions:Cesarean delivery may worsen the prognosis of pregnant women with COVID-19.It was also associated with adverse fetal outcomes.