COVID-19 Infection Linked to Higher Miscarriage Risk in Early Pregnancy: Study

A new study published in the journal of BMC Medicine showed women infected with COVID-19 before or during pregnancy faced a two to three times higher risk of miscarriage before 20 weeks of gestation.

It is yet unclear how SARS-CoV-2 infection prior to or during pregnancy affects the course of the pregnancy. COVID-19 in late pregnancy or the peripartum period was associated with higher incidence of problems, including hypertensive disorders of pregnancy, preterm delivery, and maternal death, during the early waves of the pandemic (pre-Delta).

There is probably a complicated physiological link between maternal and newborn outcomes and SARS-CoV-2 infection at various periods of pregnancy or even before conception. Micaela Sandoval and colleagues therefore developed a tailored electronic health record (EHR)-based cohort of COVID-19 patients who experienced at least one pregnancy episode between 2019 and 2023 in order to investigate the association between COVID-19 and miscarriage.

Using a large, retrospective, electronic health record (EHR)-based cohort, this study investigated the association between COVID-19 and unfavorable pregnancy outcomes, like spontaneous abortion, ectopic pregnancy, and premature birth, between 2019 and 2023. Using generalized estimating equation modeling, risk variables for unfavorable pregnancy outcomes were determined. The following exposures were included in the study: age, race/ethnicity, comorbidity load, neighborhood-level social vulnerability, COVID-19 before pregnancy, and COVID-19 during pregnancy.

The risk of miscarriage was 6.3% among pregnancy episodes with a miscarriage, livebirth, or delivery result in the Southeast Texas Pregnancy and COVID Cohort (26,783 pregnancy episodes) (1514/ 24,119). A history of mild or moderate to severe COVID-19 before to pregnancy was linked to miscarriage in multivariable modeling (adjusted odds ratio (aOR) 2.48, CI 2.21–2.78 and aOR 2.81, CI 1.8–4.38, respectively).

Furthermore, miscarriage was linked to both mild and moderate to severe COVID-19 in the first trimester in the same model. Overall, COVID-19 was found to be a risk factor for spontaneous abortion both before and during pregnancy. These results emphasize how crucial COVID prevention is for expectant mothers and those preparing to become pregnant.

Source:

Sandoval, M. N., Klawans, M. R., Bach, M. A., Mikhail, J., Graviss, E. A., Cao, T., Parchem, J. G., Husain, J., & Boerwinkle, E. (2025). 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. BMC Medicine, 23(1), 274. https://doi.org/10.1186/s12916-025-04094-y