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Mahin Najafian , Mahvash Zargar , Najmieh Saadati , Seyedeh Raziyeh Mousavi

Abstract

Introduction:

In December 2019, pneumonia of unknown etiology was reported to the World Health Organization (WHO) in Wuhan, China. Coronaviruses (CoV) have many hosts, causing respiratory and gastrointestinal diseases. Pregnant women are more susceptible to infections and viral diseases such as coronaviruses. However, all the consequences of this virus on the pregnant mother and the fetus have not been investigated. Therefore, due to the importance of mother and baby health during and after pregnancy, examining the characteristics of this disease is essential in developing the principles of treatment, monitoring, and disease control in pregnant women with COVID-19 infection and their fetuses.

Materials and methods

This retrospective cross-sectional descriptive research examined the cases of pregnant women with confirmed COVID-19 referred to Razi Hospital, Ahwaz, Iran, between spring 2019 and March 2022. Based on the confirmed positive or negative test of COVID-19, participants were divided into case and control groups (n=208/each). A questionnaire was received from participants that included demographic information and underlying diseases. Clinical findings, laboratory findings, maternal outcomes, fetal outcomes, and vertical transfer from mother to fetus were extracted from their medical records. All of this data was then examined and analyzed.

Results

The average age of pregnant mothers was 31.14 and 30.84 in the case and control groups, respectively. In terms of all the laboratory parameters, there are significant differences between the two studied groups (p-value<0.05). Among the participants in the study, the most underlying diseases were related to thyroid diseases, followed by diabetes, high blood pressure, lung diseases, and heart diseases, respectively. There are significant differences in hospitalization and the presence of thyroid diseases, diabetes, high blood pressure, and lung diseases in the case group (p-value<0.05). Among the case group, the most clinical signs are cough-related and radiographic involvement; most maternal outcomes are related to preterm delivery and maternal death; most fetal outcomes are related to fetal distress and intrauterine death. There are significant differences between the two studied groups in terms of all clinical symptoms, preterm delivery, maternal death, intrauterine death, and fetal distress (p-value<0.05). Infection with COVID-19 caused an increase in cesarean section and hospitalization related to at least one underlying disease (p-value<0.05). In the case group, despite the mother's positive PCR test, none of the babies had a positive PCR test, and vertical transmission from the infected mother to the fetus was negative in all cases.

Conclusion:

The symptoms of pregnant women with COVID-19 pneumonia are diverse. Infection with covid-19 caused an increase in cesarean section, preterm delivery, maternal death, intrauterine death, and respiratory distress of the fetus in these women. However, no evidence of vertical transmission from mother to fetus was found. The results of this study can be used to improve prenatal counseling for pregnant women with a COVID-19 infection‎.