 This study aimed to analyze the outcomes of pregnant women with acute SARS-CoV-2 infection caused by the Alpha, Delta and Omicron variants, and found that the Delta variant was associated with a significantly higher incidence of adverse outcomes, such as premature births, maternal intensive care unit admission, intrauterine growth restriction, and small for gestational age infants. Additionally, the Delta variant was linked to lower apgar scores, higher maternal and fetal mortality rates, and increased levels of various biomarkers indicating more severe illness. Finally, the Delta variant also presented a greater possibility of vertical transmission. This article was authored by Josue Giordano Incognito, Rosario Emanuele Carlo Di Stefano, Georgia Campo, and others.