Volume 31, Issue 146 (May & June 2023)                   J Adv Med Biomed Res 2023, 31(146): 282-290 | Back to browse issues page


XML Print


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

Hatami R, Najmi Z, Tofighi S, Dabiri Oskoei A, Emami N, Gholami H. Clinical Manifestation, Laboratory Findings and Adverse Outcomes of COVID 19 Infection in Pregnant Women: A Cross-Sectional Study in the West of Iran. J Adv Med Biomed Res 2023; 31 (146) :282-290
URL: http://journal.zums.ac.ir/article-1-6923-en.html
1- Dept. of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran , robabehhatami@yahoo.com
2- Dept. of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Abstract:   (2754 Views)

Background and Objective: Pregnancy is a unique immunological condition in which the immune system is affected and therefore there is a greater risk of severe disease and mortality from COVID-19 disease. The present study aimed to evaluate the clinical manifestation, laboratory findings, and adverse outcomes among a population of pregnant women confirmed with COVID 19 infection.
Materials and Methods: In present cross-sectional study, all pregnant women with COVID-19 referred to Mousavi Hospital in Zanjan City from February 2020 to August 2021 including 232 patients were examined. We used a researcher-made checklist to extract the required information, including socio-demographic data, potential risk factors, clinical manifestations, laboratory parameters, and fetal, and neonatal outcomes of the patients. Comparison of laboratory parameters in women with COVID-19 according to ICU admission was made using independent t-test and Mann-Whitney U test.
Results: 47.4%, of women were 30 to 40 years old, 45.7% were illiterate. Weakness, myalgia, dry cough, and fatigue were the most common clinical symptoms (>90%). Patients had abnormal levels of ALT and AST, whereas the means of other laboratory parameters were in the normal range. Forty- one (17.6%) of patients were admitted to the ICU. The means of C - reactive protein (46.58 vs. 25.87), lactate dehydrogenase (586.31 vs. 480.97), Blood urea nitrogen (9.43 vs. 8.26), and erythrocyte sedimentation rate (62.40 vs. 46.11) were statistically higher in patients admitted to ICU than those who were not in the ICU (P <0.05). Mortality rates among women who had a vaginal delivery and C-section were 3% and 6.1%, respectively.
Conclusion: The most common laboratory findings in COVID-19- infected mothers were lymphopenia and elevated CRP, ALT, D-Dimer, and LDH. An increased hospitalization in ICU and higher rates of mother and fetal death were complications of pregnancy and childbirth in COVID-19- infected women.

Full-Text [PDF 493 kb]   (1606 Downloads) |   |   Full-Text (HTML)  (357 Views)  

 The most common laboratory findings in COVID-19- infected mothers were lymphopenia and elevated CRP, ALT, D-Dimer, and LDH. An increased hospitalization in ICU and higher rates of mother and fetal death were complications of pregnancy and childbirth in COVID-19- infected women. 


Type of Study: Original Article | Subject: Clinical medicine
Received: 2022/09/7 | Accepted: 2023/01/28 | Published: 2023/06/26

References
1. World Health Organization. Weekly operational update on COVID-19.https://www.who.int/publications/m/item/weekly-operational-update-on-covid-19---25-october-2021.
2. Lv D, Peng J, Long R, et al. Exploring the immunopathogenesis of pregnancy with COVID-19 at the vaccination era. Front Immunol. 2021;12:683440. [DOI:10.3389/fimmu.2021.683440] [PMID] [PMCID]
3. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet (London, England). 2020;395(10226):809-15. [DOI:10.1016/S0140-6736(20)30360-3]
4. Dashraath P, Wong JL, Lim MX, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31. [DOI:10.1016/j.ajog.2020.03.021] [PMID] [PMCID]
5. Liu D, Li L, Wu X, et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: A preliminary analysis. Am J Roentgenol. 2020;215(1):127-32. [DOI:10.2214/AJR.20.23072] [PMID]
6. Khalil A, Kalafat E, Benlioglu C, et al. SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. Eclin Med. 2020;25:100446. [DOI:10.1016/j.eclinm.2020.100446] [PMID] [PMCID]
7. Liu H, Shang X, Chen S, Li T, Zhang J. Cautions on the laboratory indicators of COVID-19 patients on and during admission. J Clin Lab Anal. 2021;35(5):e23767. [DOI:10.1002/jcla.23767]
8. Wang J, Zheng Y, Chen Y, et al. Laboratory indicators in COVID-19 and other pneumonias: Analysis for differential diagnosis and comparison of dynamic changes during 400-day follow-up. Comput Struct Biotech J. 2021;19:2497-507. [DOI:10.1016/j.csbj.2021.04.063] [PMID] [PMCID]
9. Wang Q, Cheng J, Shang J, et al. Clinical value of laboratory indicators for predicting disease progression and death in patients with COVID-19: a retrospective cohort study. BMJ Open. 2021;11(10):e043790. [DOI:10.1136/bmjopen-2020-043790] [PMID] [PMCID]
10. Vakili S, Savardashtaki A, Jamalnia S, et al. Laboratory findings of COVID-19 infection are conflicting in different age groups and pregnant women: A literature review. Arch Med Res. 2020;51(7):603-7. [DOI:10.1016/j.arcmed.2020.06.007] [PMID] [PMCID]
11. Yee J, Kim W, Han JM, et al. Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. Sci Rep. 2020;10(1):18126. [DOI:10.1038/s41598-020-75096-4] [PMID] [PMCID]
12. Guo F, Yang X. A comprehensive review of the management of pregnant women with COVID-19: useful information for obstetricians. Infect Drug Resist. 2021;14:3363-78. [DOI:10.2147/IDR.S325496] [PMID] [PMCID]
13. Burke RM, Killerby ME, Newton S, et al. Symptom profiles of a convenience sample of patients with COVID-19-United States, January-April 2020. Morbid Mortal Week Rep. 2020;69(28):904. [DOI:10.15585/mmwr.mm6928a2] [PMID] [PMCID]
14. Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370. [DOI:10.1097/01.aoa.0000744128.44930.48]
15. Chen G, Liao Q, Ai J, et al. Immune response to COVID-19 during pregnancy. Front Immunol. 2021;12:1508. [DOI:10.3389/fimmu.2021.675476] [PMID] [PMCID]
16. Vakili S, Savardashtaki A, Jamalnia S, et al. Laboratory findings of COVID-19 infection are conflicting in different age groups and pregnant women: a literature review. Arch Med Res. 2020;51(7):603-7. [DOI:10.1016/j.arcmed.2020.06.007] [PMID] [PMCID]
17. Sahin O, Aktoz F, Bagci H, Vurgun E. The role of laboratory parameters in predicting severity of COVID-19 disease in pregnant patients. J Obst Gynaecol. 2022:1-5. [DOI:10.1080/01443615.2022.2054681] [PMID]
18. Wei LS, Trostle ME, Limaye MA, Friedman S, Penfield CA, Roman AS. The association of inflammatory markers in pregnant women with COVID-19 disease severity. Am J Obstet Gynecol. 2022;226(1):S747-S8. [DOI:10.1016/j.ajog.2021.11.1229] [PMCID]
19. Yu D, Du Q, Yan S, et al. Liver injury in COVID-19: clinical features and treatment management. Virol J. 2021;18(1):1-9. [DOI:10.1186/s12985-021-01593-1] [PMID] [PMCID]
20. Guan WJ, Ni Z, Hu Y, et al.. Clinical characteristics of coronavirus disease 2019 in China. 2020; N Engl J Med. 80: 656-65.
21. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020 1;5(5):428-30. [DOI:10.1016/S2468-1253(20)30057-1] [PMID]
22. Jafari M, Pormohammad A, Sheikh Neshin SA, et al. Clinical characteristics and outcomes of pregnant women with COVID‐19 and comparison with control patients: A systematic review and meta‐analysis. Rev Med Virol. 2021:e2208. [DOI:10.1002/rmv.2208] [PMID] [PMCID]
23. Can E, Oğlak SC, Ölmez F. Abnormal liver function tests in pregnant patients with COVID-19-a retrospective cohort study in a tertiary center. Ginekologia Polska. 2022;93(2):151-7. [DOI:10.5603/GP.a2021.0182] [PMID]
24. Jering KS, Claggett BL, Cunningham JW, et al. Clinical characteristics and outcomes of hospitalized women giving birth with and without COVID-19. JAMA Int Med. 2021;181(5):714-7. [DOI:10.1001/jamainternmed.2020.9241] [PMID] [PMCID]
25. Chinn J, Sedighim S, Kirby KA, et al. Characteristics and outcomes of women with COVID-19 giving birth at US academic centers during the COVID-19 pandemic. JAMA Network Open. 2021;4(8):e2120456-e. [DOI:10.1001/jamanetworkopen.2021.20456] [PMID] [PMCID]
26. Martinez‐Portilla R, Sotiriadis A, Chatzakis C, et al. Pregnant women with SARS‐CoV‐2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound Obstet Gynecol. 2021;57(2):224-31. [DOI:10.1002/uog.23575] [PMID]
27. Tunç Ş, Göklü MR, Oğlak SC. COVID-19 in pregnant women. Saudi Med J. 2022;43(4):378-85. [DOI:10.15537/smj.2022.43.4.20210904] [PMID]
28. Vale AJM, Fernandes ACL, Guzen FP, Pinheiro FI, de Azevedo EP, Cobucci RN. Susceptibility to COVID-19 in pregnancy, labor, and postpartum period: immune system, vertical transmission, and breastfeeding. Front Glob Women's Health. 2021;2:602572. [DOI:10.3389/fgwh.2021.602572] [PMID] [PMCID]

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 | Journal of Advances in Medical and Biomedical Research

Designed & Developed by : Yektaweb