Determinants of Pregnancy Complications during the COVID-19 Pandemic: Evidence from Primary Health Care Services

Abstract

Pregnancy complications remain a leading contributor to maternal and neonatal morbidity and mortality worldwide. The COVID-19 pandemic has disrupted maternal health services, potentially increasing the risk of pregnancy-related complications due to reduced antenatal care utilization, limited health facility accessibility, and heightened psychological distress among pregnant women. This study aimed to analyze factors associated with pregnancy complications during the COVID-19 pandemic, focusing on antenatal care attendance, accessibility of health facilities, and maternal attitudes toward COVID-19. A quantitative cross-sectional study was conducted among 166 pregnant women receiving maternal health services at a primary health care center. Data were collected using structured questionnaires and medical record reviews. Independent variables included antenatal care (ANC) visit frequency, perceived accessibility of health facilities, and maternal attitudes toward COVID-19, while the dependent variable was the occurrence of pregnancy complications. Data were analyzed using chi-square tests with a significance level of p < 0.05. The prevalence of pregnancy complications was 31.3%. Significant associations were found between irregular ANC visits and pregnancy complications (p = 0.013), limited accessibility to health facilities and pregnancy complications (p = 0.005), and negative maternal attitudes toward COVID-19 and pregnancy complications (p = 0.004). Reduced utilization of antenatal care services, barriers to accessing health facilities, and negative maternal attitudes during the COVID-19 pandemic were significantly associated with increased pregnancy complications. Strengthening maternal health service continuity and improving risk communication are essential to mitigate adverse pregnancy outcomes during public health crises.