Document Type : Case Report


1 Student Research Committee, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran

2 29 Bahman Hospital, Iranian social security organization, Tabriz, Iran

3 Department of Midwifery, Women’s Reproductive and Mental Health Research Center, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran


Introduction: There is scarce information about the effects of SARS‐CoV‐2 infection in pregnant women. The present study aimed to evaluate pregnancy’s clinical characteristics and outcomes in women with COVID-19 and their babies.
Case Presentation: We conducted a case series study, from April 15 to May 30, 2021, including 24 cases with COVID-19 infection and their babies with a 30-day follow-up after delivery. The patients’ mean (SD) age of was 31.50 (5.69) years, and all the deliveries were in the third trimester. Fever and myalgia were the most prevalent clinical symptoms in women. Positive RTPCR test results [in 20 pateints (83.33%)], and CT scan findings [in four patients (16.67%)] confirmed the diagnosis. Moreover, 66.66% of pregnant women with COVID-19 underwent Cesarean section. Performing a Cesarean section was mostly due to obstetric indications or the mother’s request. None of the babies were positive PCR. Out of eight preterm infants, seven were admitted to the intensive care unit (NICU) for reasons other than COVID-19.
Conclusion: The most common obstetric outcomes were high rates of premature delivery and Cesarean section. Additionally, the most prevalent neonatal consequences were prematurity and low birth weight. There was; however, no evidence of intrauterine vertical transmission.


How to Cite: Aghaei S, Mohammadirad R, Fathnezhad-Kazemi A. Pregnancy and COVID-19 Infection: A Study of 24 Cases. Women. Health. Bull. 2023;10(1):67-76. doi: 10.30476/WHB.2023.97655.1215.


Cheng MP, Papenburg J, Desjardins M, Kanjilal S, Quach C, Libman M, et al. Diagnostic testing for severe acute respiratory syndrome–related coronavirus 2: a narrative review. Ann Intern Med. 2020;172(11):726-734. doi: 10.7326/M20-1301. PubMed PMID: 32282894; PubMed Central PMCID: PMC7170415. ## 2. Gorbalenya AE, Baker SC, Baric R, Groot RJd, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses–a statement of the Coronavirus Study Group. 2020. doi: 10.1101/2020.02.07.937862. ## 3. Masjoudi M, Aslani A, Seifi M, Khazaeian S, Fathnezhad-Kazemi A. Association between perceived stress, fear and anxiety of COVID 19 with self-care in pregnant women: a cross-sectional study. Psychol Health Med. 2022;27(2):289-300. doi: 10.1080/13548506.2021.1894344. PubMed PMID: 33632035. ## 4. Naccasha N, Gervasi M-T, Chaiworapongsa T, Berman S, Yoon BH, Maymon E, et al. Phenotypic and metabolic characteristics of monocytes and granulocytes in normal pregnancy and maternal infection. Am J Obstet Gynecol. 2001;185(5):1118-23. doi: 10.1067/mob.2001.117682. PubMed PMID: 11717644. ## 5. Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12(2):194. doi: 10.3390/v12020194. PubMed PMID: 32050635; PubMed Central PMCID: PMC7077337. ## 6. Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, et al. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1953-66. doi: 10.1056/NEJMoa030781. PubMed PMID: 12690092. ## 7. Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol. 2012;207(3 Suppl):S3-8. doi: 10.1016/j.ajog.2012.06.068. PubMed PMID: 22920056. ## 8. 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):1061-1069. doi: 10.1001/jama.2020.1585. PubMed PMID: 32031570; PubMed Central PMCID: PMC7042881. ## 9. 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. PubMed PMID: 31986264; PubMed Central PMCID: PMC7159299. ## 10. Nikpour M, Behmanesh F, Darzipoor M, Zavareh MSH. Pregnancy outcomes and clinical manifestations of Covid-19 in pregnant women: a narrative review. J Mil Med. 2020;22(2):177-183. doi:‎ 10.30491/JMM.22.2.177. Persian. ## 11. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020;37(8):861-865. doi: 10.1055/s-0040-1710050. PubMed PMID: 32305046; PubMed Central PMCID: PMC7356080. ## 12. Schnettler WT, Al Ahwel Y, Suhag A. Severe acute respiratory distress syndrome in coronavirus disease 2019–infected pregnancy: obstetric and intensive care considerations. Am J Obstet Gynecol MFM. 2020;2(3):100120. doi: 10.1016/j.ajogmf.2020.100120. PubMed PMID: 32363337; PubMed Central PMCID: PMC7194528. ## 13. Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273. doi: 10.1038/s41586-020-2012-7. PubMed PMID: 32015507; PubMed Central PMCID: PMC7095418. ## 14. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-280. doi: 10.1016/j.cell.2020.02.052. PubMed PMID: 32142651; PubMed Central PMCID: PMC7102627. ## 15. Dang D, Wang L, Zhang C, Li Z, Wu H. Potential effects of SARS‐CoV‐2 infection during pregnancy on fetuses and newborns are worthy of attention. J Obstet Gynaecol Res. 2020;46(10):1951-1957. doi: 10.1111/jog.14406. PubMed PMID: 32779309; PubMed Central PMCID: PMC7436741. ## 16. Chen S, Huang B, Luo D, Li X, Yang F, Zhao Y, et al. Pregnancy with new coronavirus infection: clinical characteristics and placental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi. 2020;49(5):418-423. doi: 10.3760/cma.j.cn112151-20200225-00138. PubMed PMID: 32114744. Chinese. ## 17. 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. Lancet. 2020;395(10226):809-815. doi: 10.1016/S0140-6736(20)30360-3. PubMed PMID: 32151335; PubMed Central PMCID: PMC7159281. ## 18. Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z. Clinical characteristics of 19 neonates born to mothers with COVID-19. Front Med. 2020;14(2):193-198. doi: 10.1007/s11684-020-0772-y. PubMed PMID: 32285380; PubMed Central PMCID: PMC7152620. ## 19. Zhang L, Jiang Y, Wei M, Cheng B, Zhou X, Li J, et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi. 2020;55(3):166-171. doi: 10.3760/cma.j.cn112141-20200218-00111. PubMed PMID: 32145714. ## 20. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60. doi: 10.21037/tp.2020.02.06. PubMed PMID: 32154135; PubMed Central PMCID: PMC7036645. ## 21. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111. doi: 10.1016/j.ajog.2020.04.014. PubMed PMID: 32335053; PubMed Central PMCID: PMC7177142. ## 22. Abedzadeh-Kalahroudi M, Sehat M, Vahedpour Z, Talebian P, Haghighi A. Clinical and obstetric characteristics of pregnant women with Covid-19: A case series study on 26 patients. Taiwan J Obstet Gynecol. 2021;60(3):458-462. doi: 10.1016/j.tjog.2021.03.012. PubMed PMID: 33966728; PubMed Central PMCID: PMC7985931. ## 23. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID‐19. Diabetes Metab Res Rev. 2020;36(7):e3319. doi: 10.1002/dmrr.3319. PubMed PMID: 32233013; PubMed Central PMCID: PMC7228407. ## 24. Nasrollahzadeh Sabet M, Khanalipour M, Gholami M, Sarli A, Rahimi Khorrami A, Esmaeilzadeh E. Prevalence, Clinical Manifestation and Mortality Rate in COVID-19 Patients With Underlying Diseases. J Arak Uni Med Sci. 2020;23(5):740-749. doi: 10.32598/jams.23.COV.5797.1. ## 25. Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. Am J Hypertens. 2020;33(5):373-374. doi: 10.1093/ajh/hpaa057. PubMed PMID: 32251498; PubMed Central PMCID: PMC7184512. ## 26. Askary E, Poordast T, Shiravani Z, Ashraf MA, Hashemi A, Naseri R, et al. Coronavirus disease 2019 (COVID-19) manifestations during pregnancy in all three trimesters: A case series. Int J Reprod Biomed. 2021;19(2):191-204. doi: 10.18502/ijrm.v19i2.8477. PubMed PMID: 33718763; PubMed Central PMCID: PMC7922300. ## 27. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-564. doi: 10.1016/S1473-3099(20)30176-6. PubMed PMID: 32220284; PubMed Central PMCID: PMC7158904. ## 28. 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):727-733. doi: 10.1056/NEJMoa2001017. PubMed PMID: 31978945; PubMed Central PMCID: PMC7092803. ##