SynthesisBMJ global health2023
Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis.
Abstract readMeta-Analysis
In one paragraph
Synthesis in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 6 of them syntheses that pooled it.
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100citing papers in PubMed, 6 pooled it
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What it found
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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.
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Who cites it
100 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- How COVID-19 Treatment in Pregnancy Reflects Healthcare Utilization During a Pandemic: A Two-Stage Individual Participant Data Meta-Analysis Combining Case-Based Registries.Pharmacoepidemiology and drug safety · 2025Pooled it
- Safety and Effectiveness of COVID-19 Vaccines During Pregnancy: A Living Systematic Review and Meta-analysis.Drug safety · 2024Pooled it
- Antenatal and neonatal exposure to SARS-CoV-2 and children's development: a systematic review and meta-analysis.Pediatric research · 2024Pooled it
- Outcomes of SARS-CoV-2 infection in early pregnancy-A systematic review and meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2024Pooled it
- Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review.BMC medicine · 2024Pooled it
- Effect of COVID-19 on Pregnancy and Neonate's Vital Parameters: A Systematic Review.Journal of pregnancy · 2023Pooled it
- Pharmacokinetics and Safety of Remdesivir in Pregnant and Nonpregnant Women With COVID-19: Results From IMPAACT 2032.The Journal of infectious diseases · 2024Trial
- Trial
- Prenatal COVID-19 Exposure and Neurodevelopmental and Neurological Disorders in Children.JAMA network open · 2026Article
- Maternal deaths in the UK before and during the COVID-19 pandemic.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Maternal, perinatal, neonatal, and postpartum outcomes following Severe Acute Respiratory Syndrome - Coronavirus-2 infection in pregnancy: a World Health Organization multi-country prospective cohort study.BMC global and public health · 2026Article
- Preparedness for maternal and offspring health surveillance in pandemics: Lessons learned from studies on COVID-19 using Scandinavian registry data.Acta obstetricia et gynecologica Scandinavica · 2026Article
- COVID-19 and Global Perinatal Health: Lessons Learned on Maternal-Neonatal Outcomes, Infant Feeding Practices, and Health Care Economics across Income Settings.American journal of perinatology · 2026Article
- SARS-CoV-2 seroprevalence among pregnant women during the first three waves of the COVID-19 pandemic in southern Mozambique.BMC pregnancy and childbirth · 2026Observational
- Effect of SARS-CoV-2 infection on the antiphospholipid antibodies and perinatal outcomes of pregnant patients with antiphospholipid syndrome.Clinical rheumatology · 2026Article
- The Effect of Maternal Pertussis Vaccination on Neonatal Health Outcomes in the Dutch Pregnancy Drug Register.Birth defects research · 2026Article
- Infection with SARS-CoV-2 during pregnancy and perinatal death or neonatal intensive care admission: population-based cohort study.BMJ paediatrics open · 2026Article
- Review
- Changes in birth certificate-reported prevalence of congenital anomalies at live birth during the COVID-19 pandemic: a nationwide study of 26 million United States live births.Frontiers in cellular and infection microbiology · 2026Article
- Viral threats to pregnancy: Global health risks in the era of pandemics.Advances in virus research · 2026Review
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
77 authors.
Emily R SmithDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA emilysmith@gwu.edu.ORCID 0000-0001-5715-9459
Erin OakleyDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Gargi Wable GrandnerDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Kacey FergusonDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Fouzia FarooqDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Yalda AfsharDivision of Maternal Fetal Medicine, University of California Los Angeles, Los Angeles, California, USA.
Mia AhlbergDepartment of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden.
Homa AhmadziaDivision of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Victor AkeloOffice of the Director, US Centers for Disease Control and Prevention, Kisumu, Kenya.
Grace AldrovandiDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.
Beth A Tippett BarrOffice of the Director, US Centers for Disease Control and Prevention, Kisumu, Kenya.
Elisa BevilacquaDepartment of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma, Italy.
Justin S BrandtDivision of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Nathalie BroutetDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland.
Irene Fernández BuhigasDepartment of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Madrid, Spain.ORCID 0000-0003-4354-5273
Jorge CarrilloDepartamento de Obstetricia y Ginecologia, Universidad del Desarrollo Facultad de Medicina Clinica Alemana, Santiago, Chile.
Rebecca CliftonThe Biostatistics Center, The George Washington University Milken Institute School of Public Health, Rockville, Maryland, USA.
Jeanne ConryInternational Federation of Gynecology and Obstetrics, London, UK.
Erich CosmiDepartment of Women's and Children's Health, University of Padua, Padova, Italy.
Fatima CrispiDepartment of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Francesca CrovettoDepartment of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Camille Delgado-LópezSurveillance for Emerging Threats to Mothers and Babies, Puerto Rico Department of Health, San Juan, Puerto Rico.ORCID 0000-0003-3231-6942
Hema DivakarAsian Research and Training Institute for Skill Transfer (ARTIST), Bengaluru, India.
Amanda J DriscollCenter for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Guillaume FavreMaterno-Fetal and Obstetrics Research Unit, Department 'Femme-Mère-Enfant', Lausanne University Hospital, Lausanne, Switzerland.
Valerie J FlahermanDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Chris GaleNeonatal Medicine, School of Public Health, Imperial College London Faculty of Medicine, London, UK.ORCID 0000-0003-0707-876X
Maria M GilDepartment of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Madrid, Spain.
Sami L GottliebDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland.
Eduard GratacósDepartment of Maternal-Fetal Medicine, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Olivia HernandezGynecology and Obstetrics, Felix Bulnes Hospital and RedSalud Clinic, Santiago, Chile.
Stephanie JonesSouth African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa.
Erkan KalafatDepartment of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkey.
Sammy KhagayiCenter for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.ORCID 0000-0002-2470-1851
Marian KnightNuffield Department of Population Health, University of Oxford, Oxford, UK.
Karen KotloffDepartment of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Antonio LanzoneDepartment of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma, Italy.
Kirsty Le DoareUganda Virus Institute and the London School of Hygiene & Tropical Medicine, Entebbe, Uganda.
Christoph LeesDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Ethan LitmanDivision of Maternal-Fetal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Erica M LokkenDepartment of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA.
Valentina Laurita LongoInstitute of Obstetrics and Gynecology Clinic, Catholic University of Sacred Heart, Rome, Italy.
Shabir A MadhiSouth African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa.
Laura A MageeDepartment of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
Raigam Jafet Martinez-PortillaClinical Research Division, National Institute of Perinatology, Mexico City, Mexico.ORCID 0000-0003-4711-3857
Elizabeth M McClureRTI International, Research Triangle Park, North Carolina, USA.
Tori D MetzDepartments of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake, Utah, USA.
Emily S MillerDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Deborah MoneyDepartment of Obstetrics and Gynecology, The University of British Columbia, Vancouver, British Columbia, Canada.
Sakita MoungmaithongDepartment of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Edward MullinsDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Jean B NachegaDepartment of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
Marta C NunesSouth African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa.
Dickens OnyangoKisumu County Department of Health, Kisumu, Kenya.
Alice PanchaudInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Liona C PoonDepartment of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Daniel RaitenPediatric Growth and Nutrition Branch, National Institute of Health, Bethesda, Maryland, USA.
Lesley ReganInternational Federation of Gynecology and Obstetrics, London, UK.
Gordon RukundoUganda Virus Institute and the London School of Hygiene & Tropical Medicine, Entebbe, Uganda.
Daljit SahotaDepartment of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Allie SakowiczDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Jose Sanin-BlairUniversidad Pontificia Bolivariana, Medellin, Antioquia, Colombia.
Jonas SöderlingDepartment of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden.
Olof StephanssonDepartment of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden.
Marleen TemmermanCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Anna ThorsonDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland.
Jorge E TolosaDepartment of Obstetrics and Gynecology, St Luke's University Health Network, Bethlehem, Pennsylvania, USA.
Julia TownsonCentre for Trials Research, Cardiff University, Cardiff, UK.
Miguel Valencia-PradoChildren with Special Medical Needs Division, Puerto Rico Department of Health, San Juan, Puerto Rico.
Silvia VisentinDepartment of Women's and Children's Health, University of Padua, Padova, Italy.
Peter von DadelszenDepartment of Women and Children's Health, King's College London Faculty of Life Sciences and Medicine, London, UK.ORCID 0000-0003-4136-3070
Kristina Adams WaldorfDepartment of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA.
Clare WhiteheadDepartment of Maternal-Fetal Medicine, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia.
Murat YassaDepartment of Obstetrics and Gynecology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Jim M TielschDepartment of Global Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Perinatal COVID PMA Study Collaborators
Perinatal COVID PMA Study Collaborators
Funding
Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research NetU10HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI CLIFTON, REBECCA GERSNOVIEZ · 2009 to 2021
$174.2MSARS-CoV-2 Vaccine Pregnancy RegistryU24HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI Rebecca Gersnoviez Clifton · 2021 to 2026
$39.2MMATERNAL FETAL RESEARCH NETWORK: DATA COORDINATING CTRU01HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI THOM, ELIZABETH ANN · 1998 to 2008
$27.0MFELLOWSHIP TRAINING PROGRAM IN VACCINOLOGYT32AI007524 · NIAID · UNIVERSITY OF MARYLAND BALTIMORE · PI Marcelo B. Sztein · 1997 to 2026
$6.4MNIAID NIH HHS T32 AI007524NICHD NIH HHS U01 HD036801NICHD NIH HHS U10 HD036801NICHD NIH HHS U24 HD036801World Health Organization 001
Abstract
introductionDespite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.
methodsWe screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.
resultsWe screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection-as compared with uninfected pregnant women-were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias.
conclusionsThis analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
Indexed as
COVID-19Pregnant PeopleFemaleHumansInfant, NewbornPregnancyProspective StudiesSARS-CoV-2COVID-19EpidemiologyMaternal health
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