Evidence map›Paper›PMID 40346585›Full record

ArticleBMC medicine2025

COVID-19 infection history as a risk factor for early pregnancy loss: results from the electronic health record-based Southeast Texas COVID and Pregnancy Cohort Study.

Micaela N Sandoval, Michelle R Klawans, MacKinsey A Bach, Jennifer Mikhail, Edward A Graviss, Tru Cao, Jacqueline G Parchem, Junaid Husain, Eric Boerwinkle

Abstract read
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

9 authors.

Micaela N SandovalDepartment of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77006, USA. Micaela.N.Sandoval@uth.tmc.edu.
Michelle R Klawans *Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77006, USA.
MacKinsey A Bach *Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77006, USA.
Jennifer MikhailHealthconnect Texas, Houston, TX, USA.
Edward A GravissHouston Methodist Research Institute, Houston, TX, USA.
Tru CaoDepartment of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
Jacqueline G ParchemDepartment of Obstetrics, Gynecology & Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Junaid HusainHealthconnect Texas, Houston, TX, USA.
Eric BoerwinkleDepartment of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77006, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of SARS-CoV-2 infection before or during pregnancy on pregnancy outcomes are still largely unknown. We hypothesized that COVID-19 in early pregnancy is a risk factor for adverse pregnancy outcomes, particularly miscarriage.

methodsWe examined the relationship between COVID-19 and adverse pregnancy outcomes, including spontaneous abortion, ectopic pregnancy, and preterm delivery in a large, retrospective, electronic health record (EHR)-based cohort, from 2019 to 2023. Generalized estimating equation modeling was performed to identify risk factors for adverse pregnancy outcomes. Study exposures included COVID-19 before pregnancy, COVID-19 during pregnancy, age, race/ethnicity, comorbidity burden, and neighborhood-level social vulnerability.

resultsIn the Southeast Texas Pregnancy and COVID Cohort (26,783 pregnancy episodes), the risk of miscarriage among pregnancy episodes with a miscarriage, livebirth, or delivery outcome was 6.3% (1514/ 24,119). In multivariable modeling, history of both mild and moderate to severe COVID-19 before pregnancy were associated with miscarriage (adjusted odds ratio (aOR) 2.48, confidence interval (CI) 2.21-2.78 and aOR 2.81, CI 1.8-4.38, respectively). Additionally, in the same model, both mild and moderate to severe COVID-19 in the first trimester were associated with miscarriage (aOR 2.31, CI 1.96-2.72 and aOR 2.45, CI 1.12-5.35, respectively).

conclusionsCOVID-19 both prior to and during pregnancy was identified as a risk factor for spontaneous abortion in this study sample. These findings highlight the importance of COVID-19 vaccination and post-COVID management for pregnant people and those planning a pregnancy.

Indexed as

Abortion, SpontaneousCOVID-19Pregnancy Complications, InfectiousAdultCohort StudiesElectronic Health RecordsFemaleHumansPregnancyPregnancy OutcomePremature BirthRetrospective StudiesRisk FactorsSARS-CoV-2TexasYoung AdultCOVID-19Electronic health recordsEpidemiologyInfectious diseaseMiscarriagePregnancy

Identifiers

PMID40346585
PMCPMC12065203

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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.