Amniotic Fluid Disorders in Pregnant Women With COVID-19 in Ardabil (Iran): A Descriptive Cross-Sectional Study (2020-2022)

Background and aims: Pregnant women faced heightened vulnerability during the coronavirus disease 2019 (COVID-19) pandemic, with evidence suggesting increased risks of adverse outcomes. However, the impact of COVID-19 on amniotic fluid disorders remains understudied. During the COVID-19 pandemic, oligohydramnios was more prevalent among pregnant women, and evidence indicates that COVID-19 increases the likelihood of adverse pregnancy outcomes. This study investigated the prevalence and characteristics of amniotic fluid disorders (oligohydramnios and polyhydramnios) among pregnant women with COVID-19 in Ardabil, Iran (2020–2022). Methods: A descriptive cross-sectional study was conducted on 207 COVID-19-positive pregnant women admitted to Alavi Hospital. Data included demographics, clinical symptoms, disease severity (mild/moderate/severe), lung involvement, hospitalization, intensive care requirements, amniotic fluid disorders, and pregnancy outcomes (miscarriage, preterm delivery, cesarean section). Statistical analysis was performed using SPSS version 21, with P<0.05 considered statistically significant. Results: The mean maternal age was 28.3±6.5 years, with COVID-19 infections occurring during the first (3.9%), second (47.3%), and third trimesters (48.8%). Disease severity was mild (48.3%), moderate (40.6%), or severe (11.1%), with 3.4% of patients requiring intensive care unit (ICU) admission. Oligohydramnios was observed in 9.2% of cases, and it was significantly associated with third-trimester infection (P=0.007), shortness of breath (P=0.004), lung involvement (P=0.027), severe disease (P<0.001), ICU admission (P<0.001), cesarean section (P=0.021), and preterm birth (P<0.001). No significant correlations were found with maternal age, Body Mass Index (BMI), or underlying conditions (P>0.05). Conclusion: This study observed that COVID-19-associated oligohydramnios affected nearly one in 10 pregnancies, with a higher prevalence in severe cases, third-trimester infections, and women exhibiting respiratory complications. Cesarean delivery and preterm birth rates were significantly elevated in these patients, underscoring the need for targeted monitoring in high-risk pregnancies.