TY - JOUR T1 - Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-009495 VL - 8 IS - 1 SP - e009495 AU - Emily R Smith AU - Erin Oakley AU - Gargi Wable Grandner AU - Kacey Ferguson AU - Fouzia Farooq AU - Yalda Afshar AU - Mia Ahlberg AU - Homa Ahmadzia AU - Victor Akelo AU - Grace Aldrovandi AU - Beth A Tippett Barr AU - Elisa Bevilacqua AU - Justin S Brandt AU - Nathalie Broutet AU - Irene Fernández Buhigas AU - Jorge Carrillo AU - Rebecca Clifton AU - Jeanne Conry AU - Erich Cosmi AU - Fatima Crispi AU - Francesca Crovetto AU - Camille Delgado-López AU - Hema Divakar AU - Amanda J Driscoll AU - Guillaume Favre AU - Valerie J Flaherman AU - Chris Gale AU - Maria M Gil AU - Sami L Gottlieb AU - Eduard Gratacós AU - Olivia Hernandez AU - Stephanie Jones AU - Erkan Kalafat AU - Sammy Khagayi AU - Marian Knight AU - Karen Kotloff AU - Antonio Lanzone AU - Kirsty Le Doare AU - Christoph Lees AU - Ethan Litman AU - Erica M Lokken AU - Valentina Laurita Longo AU - Shabir A Madhi AU - Laura A Magee AU - Raigam Jafet Martinez-Portilla AU - Elizabeth M McClure AU - Tori D Metz AU - Emily S Miller AU - Deborah Money AU - Sakita Moungmaithong AU - Edward Mullins AU - Jean B Nachega AU - Marta C Nunes AU - Dickens Onyango AU - Alice Panchaud AU - Liona C Poon AU - Daniel Raiten AU - Lesley Regan AU - Gordon Rukundo AU - Daljit Sahota AU - Allie Sakowicz AU - Jose Sanin-Blair AU - Jonas Söderling AU - Olof Stephansson AU - Marleen Temmerman AU - Anna Thorson AU - Jorge E Tolosa AU - Julia Townson AU - Miguel Valencia-Prado AU - Silvia Visentin AU - Peter von Dadelszen AU - Kristina Adams Waldorf AU - Clare Whitehead AU - Murat Yassa AU - Jim M Tielsch A2 - , Y1 - 2023/01/01 UR - http://gh.bmj.com/content/8/1/e009495.abstract N2 - Introduction 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.No data are available. Individual patient data should be requested from the original or parent study investigators. ER -