A Case-Control Study on the Mode of Delivery in Pregnant Women With and Without Covid-19 and Inflammatory Markers CRP and Ferritin

Objective: This study aimed to evaluate the association between COVID-19 infection, inflammatory biomarkers, and the mode of delivery in pregnant women, identifying potential markers associated with obstetric outcomes. Methods: A paired case-control study was conducted with 152 pregnant women (76 cases with confirmed COVID-19 infection and 76 age-matched controls). Sociodemographic, clinical, and laboratory data (serum ferritin and C-reactive protein - CRP) were collected from institutional records. Statistical analysis included Chi-square, G, Z, and Mann-Whitney tests. Odds Ratios (OR) were calculated to assess the likelihood of clinical outcomes and the impact of comorbidities.Results: A significant association was observed between COVID-19 infection and the mode of delivery, with cesarean sections being significantly more frequent in the infected group (OR = 3.0; p = 0.0008). Pregnant women with pre-existing comorbidities had a 63-fold higher likelihood of COVID-19 infection (p < 0.001). While CRP levels showed no significant difference (p = 0.2060), serum ferritin levels were significantly higher in the COVID-19 group (p = 0.0131). Subgroup analysis demonstrated that hyperferritinemia remained a significant finding among cesarean deliveries in the COVID-19 group (p = 0.0185 and p = 0.0406). Conclusions: COVID-19 infection in pregnancy is strongly associated with an increased probability of cesarean delivery. Serum ferritin, rather than CRP, serves as a robust inflammatory biomarker for identifying infected patients and may assist in the clinical stratification of gestational outcomes.