Background:- Fever in pregnancy is a common clinical problem worldwide. The risk to the mother and fetus is significantly increased in pregnancy complicated by infection and fever.

Aim and objective:- To determine etiological spectrum of febrile illnesses in pregnancy and its association with maternal & fetal outcomes.

Methodology :- Prospective observational study was conducted in the Department of obstetrics and gynecology in a tertiary care center in western Maharashtra. A total 105 pregnant women reported with fever during the study periods, out of which 37 were followed up longitudinally till delivery and were included in the study analysis.

Results:- In the present study, Fever of unknown origin(32.43%), Dengue(24.32%), COVID-19 (24.32%), Urinary tract infections(16.21%) Malaria(2.7%) were the common cause of febrile illness. Out of 37 pregnant women with febrile illness, 31 (83.8%) had live births, 5 (13.5%) had intrauterine death (IUD) and there was one case of abortion. In 10 (27%) patients, there was a requirement for NICU admission. It was observed that more is the number of febrile episodes higher is the chance of neonatal morbidity and mortality.

Conclusion :- High grade fever with multiple febrile episodes due to any underlying etiology in pregnancy is harmful to the fetal-maternal health.