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Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America

Odette de Bruin Orcid Logo, Emeline Maisonneuve, Eimir Hurley, Hedvig M. E. Nordeng, Anick Bérard, Odile Sheehy, Padma Kaul, Mayura U. Shinde, Austin Cosgrove, Jennifer G. Lyons, Elizabeth Messenger‐Jones, Maria E. Kempner, Sengwee Toh, Wei Hua, José J. Hernández‐Muñoz, Leyla Sahin, Carolyn E. Cesta, David Hägg, Rosa Gini, Olga Paoletti, Beatriz Poblador‐Plou, Sue Jordan, Clara L. Rodríguez‐Bernal, Francisco Sánchez‐Sáez, Régis Lassalle, Marie‐Agnès Bernard, Fariba Ahmadizar, Guillaume Favre, Alice Panchaud, Kitty W. M. Bloemenkamp, Kelly Plueschke, Corinne de Vries, Satu J. Siiskonen, Miriam C. J. M. Sturkenboom, (the CONSIGN Collaboration Group)

International Journal of Gynecology & Obstetrics

Swansea University Author: Sue Jordan

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DOI (Published version): 10.1002/ijgo.70694

Abstract

BackgroundUnderstanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.ObjectiveTo evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requi...

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Published in: International Journal of Gynecology & Obstetrics
ISSN: 0020-7292 1879-3479
Published: Wiley 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa71343
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2026-02-02T14:47:16.0308344</datestamp><bib-version>v2</bib-version><id>71343</id><entry>2026-01-29</entry><title>Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America</title><swanseaauthors><author><sid>24ce9db29b4bde1af4e83b388aae0ea1</sid><firstname>Sue</firstname><surname>Jordan</surname><name>Sue Jordan</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2026-01-29</date><abstract>BackgroundUnderstanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.ObjectiveTo evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.Search StrategyRegulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.Selection CriteriaData sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.Data Collection and AnalysisPRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.Main ResultsData from 10 sources across seven countries contributed to the meta-analysis, including 86&#x2009;210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22&#x2013;15.71, I2&#x2009;=&#x2009;0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93&#x2013;4.64, I2&#x2009;=&#x2009;65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48&#x2013;6.66, I2&#x2009;=&#x2009;71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55&#x2013;3.06, I2&#x2009;=&#x2009;0%).Conclusions and RelevanceCOVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises.</abstract><type>Journal Article</type><journal>International Journal of Gynecology &amp;amp; Obstetrics</journal><volume>0</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0020-7292</issnPrint><issnElectronic>1879-3479</issnElectronic><keywords>adverse outcomes; COVID-19; hospitalization; international collaboration; meta-analysis; pregnancy</keywords><publishedDay>15</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-12-15</publishedDate><doi>10.1002/ijgo.70694</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>European Medicines Agency; Canadian Institutes of Health Research; Canada Foundation for Innovation; Food and Drug Administration</funders><projectreference/><lastEdited>2026-02-02T14:47:16.0308344</lastEdited><Created>2026-01-29T15:07:39.9211274</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Odette de</firstname><surname>Bruin</surname><orcid>0000-0001-6295-3411</orcid><order>1</order></author><author><firstname>Emeline</firstname><surname>Maisonneuve</surname><order>2</order></author><author><firstname>Eimir</firstname><surname>Hurley</surname><order>3</order></author><author><firstname>Hedvig M. E.</firstname><surname>Nordeng</surname><order>4</order></author><author><firstname>Anick</firstname><surname>B&#xE9;rard</surname><order>5</order></author><author><firstname>Odile</firstname><surname>Sheehy</surname><order>6</order></author><author><firstname>Padma</firstname><surname>Kaul</surname><order>7</order></author><author><firstname>Mayura U.</firstname><surname>Shinde</surname><order>8</order></author><author><firstname>Austin</firstname><surname>Cosgrove</surname><order>9</order></author><author><firstname>Jennifer G.</firstname><surname>Lyons</surname><order>10</order></author><author><firstname>Elizabeth</firstname><surname>Messenger&#x2010;Jones</surname><order>11</order></author><author><firstname>Maria E.</firstname><surname>Kempner</surname><order>12</order></author><author><firstname>Sengwee</firstname><surname>Toh</surname><order>13</order></author><author><firstname>Wei</firstname><surname>Hua</surname><order>14</order></author><author><firstname>Jos&#xE9; J.</firstname><surname>Hern&#xE1;ndez&#x2010;Mu&#xF1;oz</surname><order>15</order></author><author><firstname>Leyla</firstname><surname>Sahin</surname><order>16</order></author><author><firstname>Carolyn E.</firstname><surname>Cesta</surname><order>17</order></author><author><firstname>David</firstname><surname>H&#xE4;gg</surname><order>18</order></author><author><firstname>Rosa</firstname><surname>Gini</surname><order>19</order></author><author><firstname>Olga</firstname><surname>Paoletti</surname><order>20</order></author><author><firstname>Beatriz</firstname><surname>Poblador&#x2010;Plou</surname><order>21</order></author><author><firstname>Sue</firstname><surname>Jordan</surname><order>22</order></author><author><firstname>Clara L.</firstname><surname>Rodr&#xED;guez&#x2010;Bernal</surname><order>23</order></author><author><firstname>Francisco</firstname><surname>S&#xE1;nchez&#x2010;S&#xE1;ez</surname><order>24</order></author><author><firstname>R&#xE9;gis</firstname><surname>Lassalle</surname><order>25</order></author><author><firstname>Marie&#x2010;Agn&#xE8;s</firstname><surname>Bernard</surname><order>26</order></author><author><firstname>Fariba</firstname><surname>Ahmadizar</surname><order>27</order></author><author><firstname>Guillaume</firstname><surname>Favre</surname><order>28</order></author><author><firstname>Alice</firstname><surname>Panchaud</surname><order>29</order></author><author><firstname>Kitty W. M.</firstname><surname>Bloemenkamp</surname><order>30</order></author><author><firstname>Kelly</firstname><surname>Plueschke</surname><order>31</order></author><author><firstname>Corinne de</firstname><surname>Vries</surname><order>32</order></author><author><firstname>Satu J.</firstname><surname>Siiskonen</surname><order>33</order></author><author><firstname>Miriam C. J. M.</firstname><surname>Sturkenboom</surname><order>34</order></author><author><firstname>(the CONSIGN Collaboration</firstname><surname>Group)</surname><order>35</order></author></authors><documents><document><filename>71343__36164__2c6c4b7f68b042d4869ed33c6a94540f.pdf</filename><originalFilename>71343.VoR.pdf</originalFilename><uploaded>2026-02-02T14:43:57.8918039</uploaded><type>Output</type><contentLength>1902619</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2025 The Author(s). 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spelling 2026-02-02T14:47:16.0308344 v2 71343 2026-01-29 Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America 24ce9db29b4bde1af4e83b388aae0ea1 Sue Jordan Sue Jordan true false 2026-01-29 BackgroundUnderstanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.ObjectiveTo evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.Search StrategyRegulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.Selection CriteriaData sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.Data Collection and AnalysisPRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.Main ResultsData from 10 sources across seven countries contributed to the meta-analysis, including 86 210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22–15.71, I2 = 0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93–4.64, I2 = 65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48–6.66, I2 = 71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55–3.06, I2 = 0%).Conclusions and RelevanceCOVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises. Journal Article International Journal of Gynecology &amp; Obstetrics 0 Wiley 0020-7292 1879-3479 adverse outcomes; COVID-19; hospitalization; international collaboration; meta-analysis; pregnancy 15 12 2025 2025-12-15 10.1002/ijgo.70694 COLLEGE NANME COLLEGE CODE Swansea University Another institution paid the OA fee European Medicines Agency; Canadian Institutes of Health Research; Canada Foundation for Innovation; Food and Drug Administration 2026-02-02T14:47:16.0308344 2026-01-29T15:07:39.9211274 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Odette de Bruin 0000-0001-6295-3411 1 Emeline Maisonneuve 2 Eimir Hurley 3 Hedvig M. E. Nordeng 4 Anick Bérard 5 Odile Sheehy 6 Padma Kaul 7 Mayura U. Shinde 8 Austin Cosgrove 9 Jennifer G. Lyons 10 Elizabeth Messenger‐Jones 11 Maria E. Kempner 12 Sengwee Toh 13 Wei Hua 14 José J. Hernández‐Muñoz 15 Leyla Sahin 16 Carolyn E. Cesta 17 David Hägg 18 Rosa Gini 19 Olga Paoletti 20 Beatriz Poblador‐Plou 21 Sue Jordan 22 Clara L. Rodríguez‐Bernal 23 Francisco Sánchez‐Sáez 24 Régis Lassalle 25 Marie‐Agnès Bernard 26 Fariba Ahmadizar 27 Guillaume Favre 28 Alice Panchaud 29 Kitty W. M. Bloemenkamp 30 Kelly Plueschke 31 Corinne de Vries 32 Satu J. Siiskonen 33 Miriam C. J. M. Sturkenboom 34 (the CONSIGN Collaboration Group) 35 71343__36164__2c6c4b7f68b042d4869ed33c6a94540f.pdf 71343.VoR.pdf 2026-02-02T14:43:57.8918039 Output 1902619 application/pdf Version of Record true © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
spellingShingle Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
Sue Jordan
title_short Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
title_full Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
title_fullStr Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
title_full_unstemmed Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
title_sort Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
author Sue Jordan
author2 Odette de Bruin
Emeline Maisonneuve
Eimir Hurley
Hedvig M. E. Nordeng
Anick Bérard
Odile Sheehy
Padma Kaul
Mayura U. Shinde
Austin Cosgrove
Jennifer G. Lyons
Elizabeth Messenger‐Jones
Maria E. Kempner
Sengwee Toh
Wei Hua
José J. Hernández‐Muñoz
Leyla Sahin
Carolyn E. Cesta
David Hägg
Rosa Gini
Olga Paoletti
Beatriz Poblador‐Plou
Sue Jordan
Clara L. Rodríguez‐Bernal
Francisco Sánchez‐Sáez
Régis Lassalle
Marie‐Agnès Bernard
Fariba Ahmadizar
Guillaume Favre
Alice Panchaud
Kitty W. M. Bloemenkamp
Kelly Plueschke
Corinne de Vries
Satu J. Siiskonen
Miriam C. J. M. Sturkenboom
(the CONSIGN Collaboration Group)
format Journal article
container_title International Journal of Gynecology &amp; Obstetrics
container_volume 0
publishDate 2025
institution Swansea University
issn 0020-7292
1879-3479
doi_str_mv 10.1002/ijgo.70694
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
active_str 0
description BackgroundUnderstanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.ObjectiveTo evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.Search StrategyRegulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.Selection CriteriaData sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.Data Collection and AnalysisPRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.Main ResultsData from 10 sources across seven countries contributed to the meta-analysis, including 86 210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22–15.71, I2 = 0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93–4.64, I2 = 65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48–6.66, I2 = 71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55–3.06, I2 = 0%).Conclusions and RelevanceCOVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises.
published_date 2025-12-15T05:35:05Z
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score 11.096275

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