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There is limited information on the association between SARS\u2010CoV\u20102 infection in early pregnancy and outcomes thereof.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We aimed to systematically review the maternal, fetal and neonatal outcomes following SARS\u2010CoV\u20102 infection in early pregnancy, defined as &lt;20\u2009weeks of gestation (PROSPERO Registration 2020 CRD42020177673). Searches were carried out in PubMed, Medline, EMBASE, and Scopus databases from January 2020 until April 2023 and the WHO database of publications on coronavirus disease 2019 (COVID\u201019) from December 2019 to April 2023. Cohort and case\u2013control studies on COVID\u201019 occurring in early pregnancy that reported data on maternal, fetal, and neonatal outcomes were included. Case reports and studies reporting only exposure to SARS\u2010CoV\u20102 or not stratifying outcomes based on gestational age were excluded. Data were extracted in duplicate. Meta\u2010analyses were conducted when appropriate, using R meta (R version 4.0.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 18 studies, 12 retrospective and six prospective, were included in this review, reporting on 10\u2009147 SARS\u2010CoV\u20102\u2010positive women infected in early pregnancy, 9533 neonates, and 180\u2009882 SARS\u2010CoV\u20102 negative women. The studies had low to moderate risk of bias according to the Newcastle\u2013Ottawa quality assessment Scale. The studies showed significant clinical and methodological heterogeneity. A meta\u2010analysis could be performed only on the outcome miscarriage rate, with a pooled random effect odds ratio of 1.44 (95% confidence interval 0.96\u20132.18), showing no statistical difference in miscarriage in SARS\u2010CoV\u20102\u2010infected women. Individual studies reported increased incidences of stillbirth, low birthweight and preterm birth among neonates born to mothers affected by COVID\u201019 in early pregnancy; however, these results were not consistent among all studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this comprehensive systematic review of available evidence, we identified no statistically significant adverse association between SARS\u2010CoV\u20102 infection in early pregnancy (before 20\u2009weeks of gestation) and fetal, neonatal, or maternal outcomes. However, a 44% increase in miscarriage rate is concerning and further studies of larger sample size are needed to confirm or refute our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14764","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T05:28:40Z","timestamp":1704950920000},"page":"786-798","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Outcomes of SARS\u2010CoV\u20102 infection in early pregnancy\u2014A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-6181","authenticated-orcid":false,"given":"Kenny A.","family":"Rodriguez\u2010Wallberg","sequence":"first","affiliation":[{"name":"Department of Oncology\u2010Pathology, Laboratory of Translational Fertility Preservation Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Reproductive Medicine, Division of Gynecology and Reproduction Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8218-3835","authenticated-orcid":false,"given":"Hanna P.","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology, Laboratory of Translational Fertility Preservation Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelie Bergman","family":"R\u00f8the","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology, Laboratory of Translational Fertility Preservation Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-0923","authenticated-orcid":false,"given":"Allan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm 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