Smith, Emily REmily RSmithOakley, ErinErinOakleyGrandner, Gargi WableGargi WableGrandnerFerguson, KaceyKaceyFergusonFarooq, FouziaFouziaFarooqAfshar, YaldaYaldaAfsharAhlberg, MiaMiaAhlbergAhmadzia, HomaHomaAhmadziaAkelo, VictorVictorAkeloAldrovandi, GraceGraceAldrovandiTippett Barr, Beth ABeth ATippett BarrBevilacqua, ElisaElisaBevilacquaBrandt, Justin SJustin SBrandtBroutet, NathalieNathalieBroutetFernández Buhigas, IreneIreneFernández BuhigasCarrillo, JorgeJorgeCarrilloClifton, RebeccaRebeccaCliftonConry, JeanneJeanneConryCosmi, ErichErichCosmiCrispi, FatimaFatimaCrispiCrovetto, FrancescaFrancescaCrovettoDelgado-López, CamilleCamilleDelgado-LópezDivakar, HemaHemaDivakarDriscoll, Amanda JAmanda JDriscollFavre, GuillaumeGuillaumeFavreFlaherman, Valerie JValerie JFlahermanGale, ChrisChrisGaleGil, Maria MMaria MGilGottlieb, Sami LSami LGottliebGratacós, EduardEduardGratacósHernandez, OliviaOliviaHernandezJones, StephanieStephanieJonesKalafat, ErkanErkanKalafatKhagayi, SammySammyKhagayiKnight, MarianMarianKnightKotloff, KarenKarenKotloffLanzone, AntonioAntonioLanzoneLe Doare, KirstyKirstyLe DoareLees, ChristophChristophLeesLitman, EthanEthanLitmanLokken, Erica MErica MLokkenLaurita Longo, ValentinaValentinaLaurita LongoMadhi, Shabir AShabir AMadhiMagee, Laura ALaura AMageeMartinez-Portilla, Raigam JafetRaigam JafetMartinez-PortillaMcClure, Elizabeth MElizabeth MMcClureMetz, Tori DTori DMetzMiller, Emily SEmily SMillerMoney, DeborahDeborahMoneyMoungmaithong, SakitaSakitaMoungmaithongMullins, EdwardEdwardMullinsNachega, Jean BJean BNachegaNunes, Marta CMarta CNunesOnyango, DickensDickensOnyangoPanchaud Monnat, Alice Elke MartineAlice Elke MartinePanchaud MonnatPoon, Liona CLiona CPoonRaiten, DanielDanielRaitenRegan, LesleyLesleyReganRukundo, GordonGordonRukundoSahota, DaljitDaljitSahotaSakowicz, AllieAllieSakowiczSanin-Blair, JoseJoseSanin-BlairSöderling, JonasJonasSöderlingStephansson, OlofOlofStephanssonTemmerman, MarleenMarleenTemmermanThorson, AnnaAnnaThorsonTolosa, Jorge EJorge ETolosaTownson, JuliaJuliaTownsonValencia-Prado, MiguelMiguelValencia-PradoVisentin, SilviaSilviaVisentinvon Dadelszen, PeterPetervon DadelszenAdams Waldorf, KristinaKristinaAdams WaldorfWhitehead, ClareClareWhiteheadYassa, MuratMuratYassaTielsch, Jim MJim MTielsch2024-10-152024-10-152023-01https://boris-portal.unibe.ch/handle/20.500.12422/120613INTRODUCTION Despite 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. METHODS We 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. RESULTS We 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. CONCLUSIONS This 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.enCOVID-19 Epidemiology Maternal health600 - Technology::610 - Medicine & health300 - Social sciences, sociology & anthropology::360 - Social problems & social servicesarticle10.48350/1775083664647510.1136/bmjgh-2022-009495