Date of Award

9-2025

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Midwifery (MSc-APM)

First Advisor

Dr Horatius Musembi

Second Advisor

Dr Abednego Ongeso

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A quantitative retrospective record review research approach was conducted using 120 maternity files that matched the inclusion criteria and were selected using convenience sampling technique. Descriptive statistics were used to summarize baseline characteristics. Chi-square tests and logistic regression were used to assess the associations between COVID-19 and outcomes, while adjusting for maternal age, comorbidities, gestational age, and parity.

Results: Most women were aged 30-34years with varied clinical presentations, attained primary level of education (n=86, 71.7%, p=0.039). Low socioeconomic status (n=70, 58.3%, p=0.008), indicating a limited understanding of COVID-19 transmission and preventive measures. The findings demonstrated a clear relationship between COVID-19 status and key maternal and neonatal outcomes. COVID-19 positive mothers showed higher odds of adverse maternal outcomes Birth outcomes demonstrated an increased cesarean delivery rate of (n=66,55% p=0.002). Obstetric complications (n=94,78.3%p=0.000), ICU admission (n=75,9.8% p=0.006), and use of mechanical ventilation (n=50,66.7% p=0.009), hospital stay for more than five days (n=40,53.3, p=0.015) and death status on discharge (n=50,55% p=0.001). Adverse neonatal outcomes were also recorded, including low Apgar score of < 7 and 8 at 10 minutes (n=58,48.3% p=0.002), NICU admission (n=65,54.2% p=0.001), and increased death rate to neonates born to COVID-19 positive women. Logistic regression confirmed COVID-19 positivity as an independent predictor of both adverse maternal and neonatal outcomes Conclusion and Recommendations: COVID-19 in pregnancy is associated with adverse maternal and neonatal outcomes resulting from immunological and physiological changes. These findings may provide a fundamental reference for clinical decision-making, improve health system preparedness, and augment the limited existing literature.

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1

Last Page

125

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