Evidence map›Paper›PMID 38200686›Full record

SynthesisActa obstetricia et gynecologica Scandinavica2024

Outcomes of SARS-CoV-2 infection in early pregnancy-A systematic review and meta-analysis.

Kenny A Rodriguez-Wallberg, Hanna P Nilsson, Emelie Bergman Røthe, Allan Zhao, Prakesh S Shah, Ganesh Acharya

Open access · diamondAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Acta obstetricia et gynecologica Scandinavica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
5.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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  5. Article
  6. Article
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  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Kenny A Rodriguez-WallbergDepartment of Oncology-Pathology, Laboratory of Translational Fertility Preservation, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-4378-6181
Hanna P NilssonDepartment of Oncology-Pathology, Laboratory of Translational Fertility Preservation, Karolinska Institutet, Stockholm, Sweden.ORCID 0009-0009-8218-3835
Emelie Bergman RøtheDepartment of Oncology-Pathology, Laboratory of Translational Fertility Preservation, Karolinska Institutet, Stockholm, Sweden.
Allan ZhaoDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-2492-0923
Prakesh S ShahDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-9920-0488
Ganesh AcharyaDepartment of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.ORCID 0000-0002-1997-3107
Karolinska Institutet · SEKarolinska University Hospital · SEMount Sinai Hospital · CA

Funding

Cancerfonden 20 0170FRadiumhemmets Forskningsfonder 201313Vetenskapsrådet 2019-00446
6 · The paper itself

Abstract

introductionAvailable data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and pregnancy outcomes mostly refer to women contracting the infection during advanced pregnancy or close to delivery. There is limited information on the association between SARS-CoV-2 infection in early pregnancy and outcomes thereof. MATERIAL AND

methodsWe aimed to systematically review the maternal, fetal and neonatal outcomes following SARS-CoV-2 infection in early pregnancy, defined as <20 weeks of gestation (PROSPERO Registration 2020 CRD42020177673). Searches were carried out in PubMed, Medline, EMBASE, and Scopus databases from January 2020 until April 2023 and the WHO database of publications on coronavirus disease 2019 (COVID-19) from December 2019 to April 2023. Cohort and case-control studies on COVID-19 occurring in early pregnancy that reported data on maternal, fetal, and neonatal outcomes were included. Case reports and studies reporting only exposure to SARS-CoV-2 or not stratifying outcomes based on gestational age were excluded. Data were extracted in duplicate. Meta-analyses were conducted when appropriate, using R meta (R version 4.0.5).

resultsA total of 18 studies, 12 retrospective and six prospective, were included in this review, reporting on 10 147 SARS-CoV-2-positive women infected in early pregnancy, 9533 neonates, and 180 882 SARS-CoV-2 negative women. The studies had low to moderate risk of bias according to the Newcastle-Ottawa quality assessment Scale. The studies showed significant clinical and methodological heterogeneity. A meta-analysis could be performed only on the outcome miscarriage rate, with a pooled random effect odds ratio of 1.44 (95% confidence interval 0.96-2.18), showing no statistical difference in miscarriage in SARS-CoV-2-infected women. Individual studies reported increased incidences of stillbirth, low birthweight and preterm birth among neonates born to mothers affected by COVID-19 in early pregnancy; however, these results were not consistent among all studies.

conclusionsIn this comprehensive systematic review of available evidence, we identified no statistically significant adverse association between SARS-CoV-2 infection in early pregnancy (before 20 weeks of gestation) and fetal, neonatal, or maternal outcomes. However, a 44% increase in miscarriage rate is concerning and further studies of larger sample size are needed to confirm or refute our findings.

Indexed as

COVID-19Pregnancy Complications, InfectiousPregnancy OutcomeSARS-CoV-2FemaleHumansInfant, NewbornPandemicsPregnancyPremature BirthCOVID‐19early complicationsmiscarriagepregnancystillbirth

Identifiers

PMID38200686
PMCPMC11019531
OpenAlexW4390743394

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.