✅ شایعترین زمان برای ابتلا به کووید-۱۹ در زنان باردار در سه ماه اول بارداری با علائم بالینی تب و سابقۀ آسم و دیابت گزارش شده بود؛ لذا یافتههای این پژوهش اهمیت توجه به زنان باردار را بهعنوان یکی از مهمترین گروههای در معرض خطر در ایپدمی کووید-۱۹برجسته مینماید. مدیران و سیاستگذران بهداشتی میتوانند با استفاده از یافتههای این پژوهش و پیامدهای گزارششده، پروتکلهای بهداشتی مناسبی را در جهت مراقبت از زنان باردار در اپیدمی کووید-۱۹ تدوین نمایند.
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.
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.
The authors declared no conflict of interest.
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