Examining the severity of illness in pregnant women infected with COVID-19 during three waves of the disease in Ahvaz, Iran.

BACKGROUND: This study investigates the severity of COVID-19 infection among pregnant women during three distinct waves of the pandemic in Ahvaz, Iran. Considering the serious impact of COVID-19 on maternal and neonatal health, this research aimed to compare the clinical characteristics and disease severity across these waves. METHODS: This was a retrospective observational cohort study conducted to identify the clinical features and outcomes of pregnant women with PCR-confirmed SARS-CoV-2 infection during three pandemic waves in Ahvaz. Data including demographic variables, disease severity (classified according to WHO clinical criteria), complications, and delivery outcomes were extracted from hospital medical records between February 2020 and December 2021. RESULTS: A total of 267 pregnant women with confirmed COVID-19 were analyzed across three pandemic waves. In the third wave, the mean maternal age was 30.58 years, mean gravida 2.61, and mean parity 1.23. The average gestational age at admission was 35.49 weeks, and mean BMI was 23.46 kg/m². The mean duration of hospitalization was 7.01 days, and average recovery time 20.09 days. Compared with earlier waves, the third wave showed a higher frequency of positive CT findings, fever, cough, and shortness of breath, indicating greater disease severity. CONCLUSION: The findings demonstrate changing patterns in the clinical presentation and severity of COVID-19 among pregnant women across successive pandemic waves. These differences may reflect evolving viral characteristics and public health responses. The study underscores the need for tailored maternal care strategies and ongoing surveillance to manage COVID-19 and its potential long-term effects in this vulnerable population.