RT Journal Article SR Electronic 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 FD BMJ Publishing Group Ltd SP e009495 DO 10.1136/bmjgh-2022-009495 VO 8 IS 1 A1 Emily R Smith A1 Erin Oakley A1 Gargi Wable Grandner A1 Kacey Ferguson A1 Fouzia Farooq A1 Yalda Afshar A1 Mia Ahlberg A1 Homa Ahmadzia A1 Victor Akelo A1 Grace Aldrovandi A1 Beth A Tippett Barr A1 Elisa Bevilacqua A1 Justin S Brandt A1 Nathalie Broutet A1 Irene Fernández Buhigas A1 Jorge Carrillo A1 Rebecca Clifton A1 Jeanne Conry A1 Erich Cosmi A1 Fatima Crispi A1 Francesca Crovetto A1 Camille Delgado-López A1 Hema Divakar A1 Amanda J Driscoll A1 Guillaume Favre A1 Valerie J Flaherman A1 Chris Gale A1 Maria M Gil A1 Sami L Gottlieb A1 Eduard Gratacós A1 Olivia Hernandez A1 Stephanie Jones A1 Erkan Kalafat A1 Sammy Khagayi A1 Marian Knight A1 Karen Kotloff A1 Antonio Lanzone A1 Kirsty Le Doare A1 Christoph Lees A1 Ethan Litman A1 Erica M Lokken A1 Valentina Laurita Longo A1 Shabir A Madhi A1 Laura A Magee A1 Raigam Jafet Martinez-Portilla A1 Elizabeth M McClure A1 Tori D Metz A1 Emily S Miller A1 Deborah Money A1 Sakita Moungmaithong A1 Edward Mullins A1 Jean B Nachega A1 Marta C Nunes A1 Dickens Onyango A1 Alice Panchaud A1 Liona C Poon A1 Daniel Raiten A1 Lesley Regan A1 Gordon Rukundo A1 Daljit Sahota A1 Allie Sakowicz A1 Jose Sanin-Blair A1 Jonas Söderling A1 Olof Stephansson A1 Marleen Temmerman A1 Anna Thorson A1 Jorge E Tolosa A1 Julia Townson A1 Miguel Valencia-Prado A1 Silvia Visentin A1 Peter von Dadelszen A1 Kristina Adams Waldorf A1 Clare Whitehead A1 Murat Yassa A1 Jim M Tielsch A1 , YR 2023 UL http://gh.bmj.com/content/8/1/e009495.abstract AB 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.