Background: This study aimed to investigate the relationship between coronavirus disease 2019 (COVID-19) disease and maternal and neonatal outcomes. Methods: This is a retrospective cohort study. This study analyzed 3615 participants from Fujian Provincial Maternity and Child Health Hospital Fujian Obstetrics and Gynecology Hospital from November 1, 2022, to January 31, 2023. All pregnant women must provide a 24-hour nucleic acid test report when they are admitted to the hospital to deliver babies. Chi-square test and linear regression analyses were used to evaluate the risk of COVID-19 infection with the maternal outcome and neonatal outcomes. Results: Finally, 3615 patients were included in the cohort study. 549 (15.2%) were diagnosed with COVID-19 infection. The most common symptom is fever, cough, sore throat. 51 (9.2%) newborns had positive test results. In addition, the mother with COVID-19 infection were significantly associated with a higher rate of premature rupture of membranes (PPROM) and postpartum hemorrhage. Furthermore, a mother with COVID-19 infection was significantly associated with a higher rate of low birth weight infant (LBW) and macrosomia in newborns, higher rate of respiratory distress syndrome (RDS), higher rate of intro-ventricular hemorrhage (IVH), higher rate of neonatal pneumonia, and a higher rate of aspiration of amniotic fluid and meconium syndrome (AAFMS) (all p 0.05). Conclusions: This study proves that COVID-19 infection is a potential risk factor for adverse pregnancy outcomes. The COVID-19 epidemic continues, requiring targeted public health measures to reduce the infection rate in pregnant women and the poor prognosis of mothers and children.