Volume 29, Issue 3 (Summer 2021)                   Avicenna J Nurs Midwifery Care 2021, 29(3): 256-263 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Sabetsarvestani P, Rahnavard S, Hatami M, Bijani M, Nikrooz L. Investigating the Demographic Characteristics, Clinical Signs, Radiological and Laboratory Findings in Pregnant Women with COVID-19: A Cross-Sectional Study in Southern Iran. Avicenna J Nurs Midwifery Care 2021; 29 (3) :256-263
URL: http://nmj.umsha.ac.ir/article-1-2233-en.html
1- Instructor, Department of Medical-Surgical Nursing, Fasa University of Medical Sciences Fasa, Iran
2- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
3- Associate Professor, Department of Medical-Surgical Nursing, Fasa University of Medical Sciences Fasa, Iran , bizhani _mostafa @yahoo.com
4- Associate Professor, Department of Medical-Surgical Nursing, Fasa University of Medical Sciences Fasa, Iran
Persian Full-Text [PDF 440 kb]   (736 Downloads)     |   Abstract (HTML)  (2925 Views)

✅ According to the results, prolonged stay in an intensive care unit, the elderly, and polypharmacy are the main important factors associated with the occurrence of drug-drug interactions. These results indicate the importance of paying more attention to the monitoring and control of prescribed drugs in these patients.

Extended Abstract:   (522 Views)

Pregnant women are one of the vulnerable groups against COVID-19. Understanding the affected population's characteristics helps identify risk factors and set more effective treatment goals. There are currently few studies on the effect of coronavirus on pregnancy. Considering that studies in this field can play an important role in planning and policy-making of the health system in the diagnosis, prevention and treatment of this disease during pregnancy; therefore, considering the importance and necessity of the issue, the research team decided to conduct a study to investigate the demographic characteristics, clinical signs, radiological and laboratory findings in pregnant women with coronavirus (COVID-19) in southern Iran.


Materials and Methods

This descriptive cross-sectional study was conducted on 30 pregnant women with COVID-19 who were selected from teaching hospitals in Fasa, Jahrom, and Shiraz in Fars province. Sampling was done through the convenience method from March to July 2020. Inclusion criteria included hospitalization due to COVID-19 and no mental disorders. The exclusion criteria were incomplete patient information. A researcher-made checklist was applied to gather the required data which were analyzed using SPSS 22 software (SPSS Inc., Chicago, Ill., USA) and descriptive statistics.



The mean age of patients was 28.30±9.96 years. Of patients, 60% were in the first trimester of pregnancy. The average length of stay in a hospital was 8.47±4.37 days. Fever (46/66 %) was the most common clinical finding, increased C-reactive protein (CRP) levels (50%) was the most common laboratory finding, and Ground Glossy Opacity (GGO) (56/66 %) was the most common radiological finding in both lungs. Of pregnant women, 80% with COVID-19 had an underlying disease. The most common underlying diseases were 36.66% for asthma and 20% for diabetes. Of normal deliveries, 53.33% and 3.33% of neonatal and maternal deaths were reported.



The current state of the COVID-19 pandemic worldwide is severe and alarming, and the number of pregnant women infected with the virus is increasing, challenging the health system to prevent, care for and treat pregnant women during the COVID-19 pandemic [12, 13]. The aim of this study was to investigate the demographic characteristics, clinical signs, radiological and laboratory findings of women hospitalized with COVID-19 in southern Iran. In the study, the most common clinical symptom was fever. The results of a study by Young et al. (2020) on 116 pregnant women with COVID-19 in China also showed that the most common clinical finding in 60% of patients was fever, which is consistent with the results of the present study [14]. The results of Liu's (2020) and Li's (2020) studies also reported fever as the most common clinical finding in pregnant women with COVID-19 [15, 16]. In the study of Sattari et al. (2020) conducted in Iran, the most common clinical symptom in pregnant women with COVID-19 was fever, which is consistent with the results of the present study [17]. According to Ellington's (2020) study the most common clinical findings in pregnant women with COVID-19 was cough (18).
Based on the present study's findings, the most common radiological findings (CT scan) reported in 65% of patients was Grand Glossy Opacity (GGO). The results of the study by Nikpour et al. showed the most common findings reported in CT scans of pregnant women COVID-19 to be GGO (19). The results of the Schwartz study (2020) also reported GGO as the most common radiological finding in women with COVID-19, which is consistent with the present study's findings.
According to the results of the present study, the most laboratory findings were CRP-positive. The results of Zeng (2020) and Yu (2020) studies also showed that the most laboratory findings in pregnant women with COVID-19 were CRP increases. In the present study, a statistically positive relationship was observed between the underlying disease of diabetes and asthma and coronavirus infection in pregnant women.
The results of Chen (2020) study also showed that there was a statistically positive relationship between respiratory infections such as pneumonia and chronic respiratory diseases such as asthma and COVID-19 in pregnant women. This means that having infectious respiratory diseases and inflammatory and chronic lung diseases increases the chances of getting infected by coronavirus in pregnant women and leads to an aggravation of complications [23]. The results of the Zhu (2020) and Monteleo (2020) studies also indicated that the development of chronic diseases such as diabetes, renal failure and chronic respiratory diseases in pregnant women leads to their susceptibility to coronavirus, exacerbation of disease side effects, and there is also a prolongation of the disease process and recovery [24, 25].
Among the limitations of the present study, we can mention the small number of samples, which can be due to few studies in this field; therefore, it is suggested that in future studies, more sample size be used and this study be conducted in other regions of the country. 



The most common time for COVID-19 in pregnant women was reported in the first trimester of pregnancy with clinical signs of fever and a history of asthma and diabetes. Therefore, the findings of this study highlight the importance of paying attention to pregnant women as one of the most at-risk groups in the COVID-19 pandemic. Health policymakers can use the findings of this study and the reported outcomes to develop appropriate health protocols for the health care of pregnant women in the COVID-19 pandemic. 



This study has received the code of ethics (IR.FUMS.REC.1399.093) from the Vice-Chancellor for Research of Fasa University of Medical Sciences. Therefore, the authors appreciate the financial support of the Vice-Chancellor for Research of Fasa University of Medical Sciences and the financial support of the Development and Clinical Research Unit of Vali-e-Asr Hospital in Fasa, Iran.


Conflicts of Interest

The authors declared no conflict of interest.

Type of Study: Original Research | Subject: Midwifery
Received: 2020/09/9 | Accepted: 2020/11/23 | Published: 2021/09/21

1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. [DOI:10.1016/S0140-6736(20)30183-5]
2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] [PMCID]
3. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance, 13 March 2020. World Health Organ;2020. Available at: https://apps.who.int [DOI:10.15557/PiMR.2020.0003]
4. Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ. 2020;368:1-4 [DOI:10.1136/bmj.m1211] [PMID]
5. Wang J, Zhou M, Liu, F. Reasons for health care workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020;105:100-1. [DOI:10.1016/j.jhin.2020.03.002] [PMID] [PMCID]
6. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33 [DOI:10.1056/NEJMoa2001017] [PMID] [PMCID]
7. Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection. Lancet Infect Dis. 2020;20(7):773. [DOI:10.1016/S1473-3099(20)30195-X]
8. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The lancet. 2020 Mar 7;395(10226):809-15. [DOI:10.1016/S0140-6736(20)30360-3]
9. Farnoosh G, Alishiri G, Zijoud SH, Dorostkar R, Farahani AJ. Understanding the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19) based on available evidence - a narrative review. J Mil Med. 2020; 22 (1):1-11
10. Park MH, Kim HR, Choi DH, Sung JH, Kim JH. Emergency cesarean section in an epidemic of the middle east respiratory syndrome: a case report. Korean J Anesthesiol. 2016;69(3):287. [DOI:10.4097/kjae.2016.69.3.287] [PMID] [PMCID]
11. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID‐19 during pregnancy and childbirth. Int J Gynecol Obstet. 2020. [DOI:10.1002/ijgo.13182] [PMID]
12. Poon LC, Yang H, Lee JC, Copel JA, Leung TY, Zhang Y, et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol. 2020; 55(5):700-8. [DOI:10.1002/uog.22013] [PMID] [PMCID]
13. Qiao J. What are the risks of COVID-19 infection in pregnant women? Lancet. 2020; 395(10226):760-2. [DOI:10.1016/S0140-6736(20)30365-2]
14. Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol. 2020; 55(4):435-7 [DOI:10.1002/uog.22006] [PMID] [PMCID]
15. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. Am J Roentgenol. 2020:1-6. [DOI:10.2139/ssrn.3548758]
16. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-207 [DOI:10.1056/NEJMoa2001316] [PMID] [PMCID]
17. Sattari M, Bashirian S, Masoumi SZ, Shayan A, Jenabi E, Ghelichkhani S, et al. Evaluating Clinical Course and risk factors of Infection and demographic characteristics of pregnant women with COVID-19 in Hamadan Province, West of Iran. J Res Health Sci. 2020; 20(3): 1-5 [DOI:10.34172/jrhs.2020.22] [PMID] [PMCID]
18. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-June 7, 2020. Morb Mortal Wkly Rep. 2020;69(25):770-5 [DOI:10.15585/mmwr.mm6925a1] [PMID] [PMCID]
19. Nikpour M, Behmanesh F, Darzipoor M, Haddad Zavareh MS. Pregnancy outcomes and clinical manifestations of Covid-19 in Pregnant Women: a narrative review. J Mil Med. 2020;22(2):177-83
20. Schwartz DA. An Analysis of 38 Pregnant Women with COVID-19, Their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020;144(7):799-805 [DOI:10.5858/arpa.2020-0901-SA] [PMID]
21. Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal early-onset infection with SARSCoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr 2020;174(7):722-5 [DOI:10.1001/jamapediatrics.2020.0878] [PMID] [PMCID]
22. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre,descriptive study. Lancet Infect Dis. 2020;20:559-64 [DOI:10.1016/S1473-3099(20)30176-6]
23. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, Xia S, Zhou W. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9:51-60. [DOI:10.21037/tp.2020.02.06] [PMID] [PMCID]
24. Monteleone PA, Nakano M, Lazar V, Gomes AP, de Martin H, Bonetti TC. A review of initial data on pregnancy during the COVID-19 outbreak: implications for assisted reproductive treatments. JBRA Assist Reprod. 2020; 24(2): 219-25. [DOI:10.5935/1518-0557.20200030] [PMID] [PMCID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Nursing and Midwifery Care

Designed & Developed by : Yektaweb