Severe COVID-19 and Its Related Factors in Pregnant Women: A Multi-Center Cross‐Sectional Study

Pregnant women are at a higher risk of contracting COVID-19 due to their weakened immune systems. There are various related factors for severe COVID-19 in pregnant women. This study aimed to assess the severe COVID-19 rate and its associated factors among Iranian pregnant women.

In this multi-center cross-sectional study from 21 March 2020-21 March 2021, all pregnant women (N=488) with COVID-19 who were admitted to healthcare centers in three counties (Mahabad, Miandoab, Bukan) in Iran were enrolled. Patients were categorized into two groups; hospitalized (severe COVID-19) and non-hospitalized. Data were collected through medical records using a researcher-made questionnaire. Statistical analysis was performed using multivariate logistic regression.

The mean age of pregnant women was 29.8±6.37 years and 19.9% were hospitalized(N=89). The COVID-19 hospitalization in pregnant women was significantly associated with fever (temperature ≥38 C) [aOR = 3.59, (95%CI; 2.08-6.17)], shortness of breath [aOR = 2.12, (95%CI; 1.24-3.61)], diagnosis of COVID-19 in the second trimester [aOR = 4.48, 95%CI; 1.48-13.58)], residence in the urban area [aOR = 0.45, (95%CI; 0.24-0.84)], and diploma and more education level [aOR = 0.58, (95%CI; 0.33-0.98)].

Urban residency and higher education level were protective factors. Fever, shortness of breath, and diagnosis of COVID-19 in the second trimester of pregnancy were related factors for hospitalization. Early diagnostic and therapeutic interventions for pregnant women with positive COVID-19 tests are essential in disease control. a longitudinal study with appropriate follow-up time to identify factors related to severe COVID-19 among pregnant women is needed.