Evidence map›Paper›PMID 40183658›Full record

ArticleInfection & chemotherapy2025

Unveiling the Outcomes of Mpox in Pregnancy: A Systematic Review and Single-Arm Meta-Analysis.

I Gde Sastra Winata, Leonardo Leonardo, Rosalia Sylfiasari, Angeline Ekafentie, Surya Sinaga Immanuel, Fenyta Christyani

Abstract read
In one paragraph

Article in Infection & chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Mpox and the one health approach.Dialogues in health · 2026
    Review
  3. Review
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.

I Gde Sastra WinataDepartment of Obstetrics and Gynecology, Prof. Dr. I.G.N.G. Ngoerah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Indonesia. sastra@unud.ac.id.ORCID https://orcid.org/0000-0001-6142-960X
Leonardo LeonardoDepartment of Obstetrics and Gynecology, Prof. Dr. I.G.N.G. Ngoerah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Indonesia.ORCID https://orcid.org/0000-0002-9327-9316
Rosalia SylfiasariSchool of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.ORCID https://orcid.org/0009-0000-3319-3492
Angeline EkafentieDepartment of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.ORCID https://orcid.org/0009-0001-2357-5857
Surya Sinaga ImmanuelSchool of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.ORCID https://orcid.org/0009-0005-3244-2350
Fenyta ChristyaniDepartment of Obstetrics and Gynecology, Prof. Dr. I.G.N.G. Ngoerah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Indonesia.ORCID https://orcid.org/0009-0008-4718-3373

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe global resurgence of mpox, formerly monkeypox, poses an emerging threat to pregnant women due to immunological changes and potential vertical transmission, yet its impact on pregnancy remains underexplored. This study aims to pioneer a comprehensive assessment of pregnancy outcomes and the risks of vertical transmission associated with mpox infection during pregnancy. MATERIALS AND

methodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched three databases up to September 2024 for studies on pregnant women with mpox confirmed by quantitative polymerase chain reaction. Primary outcomes were composite adverse pregnancy outcomes: miscarriage or fetal death, congenital anomalies, and chorioamnionitis; the secondary outcome was vertical transmission. Study quality was assessed using Joanna Briggs Institute tools. Statistical analysis employed R software using a one-proportion model with Freeman-Tukey transformation and random-effects meta-analysis (restricted maximum-likelihood estimator, Knapp-Hartung adjustment), presenting estimated proportions with 95% confidence intervals (CIs).

resultsSix studies (three case series, three case reports) comprising 11 singleton pregnancies were included. Diagnoses occurred in the first (27.3%), second (45.4%), and third trimesters (27.3%). Among the five genotypically identified Mpox cases, 20.0% were classified Clade I and 80.0% as Clade II. Meta-analysis indicated that an estimated 63% (95% CI, 43-83%) of pregnancies experienced composite adverse pregnancy outcomes. Specifically, miscarriage or fetal death occurred in 62% (95% CI, 21-102%), congenital anomalies in 50% (95% CI, 21-80%), and chorioamnionitis in 78% (95% CI, 44-96%). Vertical transmission was observed in 79% (95% CI, 6-151%). Despite small sample sizes leading to wide confidence intervals, high estimated proportions suggest that mpox severely impacts pregnancy outcomes, likely linked to maternal inflammation, placental invasion, and significant fetal risks from vertical transmission.

conclusionMpox infection during pregnancy appears to be associated with high rates of adverse pregnancy outcomes and vertical transmission. Further large-scale studies are warranted to confirm these findings and develop preventive and management strategies mitigating this emerging threat.

Indexed as

Monkeypox virusMpoxPregnancyVertical transmission

Identifiers

PMID40183658
PMCPMC11972915

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Registered trials

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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 OpenQuestion graph.