{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:26:07Z","timestamp":1789057567566,"version":"build-2803163510"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Data regarding women infected with SARS-CoV-2 during early trimesters are scarce. We aimed to assess preterm birth (PTB) and small-for-gestational-age (SGA) rates in a large and unselected cohort by trimester at infection and overall.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>A retrospective cohort study including all women with a positive SARS-CoV-2 RT-PCR test during a non-ectopic singleton pregnancy between February 21<jats:sup>st<\/jats:sup> 2020 and July 2<jats:sup>nd<\/jats:sup> 2021 (N = 2753). Each infected woman was matched to a non-infected pregnant woman by age, last menstruation date, sector, and socioeconomic status.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Logistic regression was conducted to assess the risks of PTB and SGA including an interaction between group and trimester of infection. Multivariable models included underlying diseases, previous abortions and null parity. Subgroup analyses were conducted on symptomatic infected women and matched non-infected women.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 2753 \/2789 (98.7%) eligible women that were infected during pregnancy could be matched, among them, 17.4% and 48.4% were infected during the first and third trimesters, respectively. While first and second trimester infections were not associated with PTB (p&gt;0.8), third trimester infections and in particular after 34 weeks of gestation had a greater risk of PTB with adjusted ORs of 2.76 (95% CI 1.63\u20134.67) and 7.10 (95% CI 2.44\u201320.61), respectively. PTB risk was further heightened in symptomatic third trimester infections (OR = 4.28, 95% CI 1.94\u20139.25). SGA risk was comparable between study groups across all trimesters of infection. Pregnancy loss incidence was similar in both groups (adjusted OR = 1.16; 95% CI 0.90\u20131.50).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>SARS-CoV-2 infection was associated with increased risk of PTB only among women infected during late pregnancy, particularly among symptomatic women.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270893","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T17:24:13Z","timestamp":1658337853000},"page":"e0270893","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":55,"title":["Pregnancy outcomes after SARS-CoV-2 infection by trimester: A large, population-based cohort study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7483-9605","authenticated-orcid":true,"given":"Noga","family":"Fallach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaakov","family":"Segal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeny","family":"Agassy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galit","family":"Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asaf","family":"Peretz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Chodick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9875-3550","authenticated-orcid":true,"given":"Sivan","family":"Gazit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-1053","authenticated-orcid":true,"given":"Tal","family":"Patalon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Ben Tov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5317-2848","authenticated-orcid":true,"given":"Inbal","family":"Goldshtein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"pone.0270893.ref001","article-title":"Adverse pregnancy outcomes, maternal complications, and severe illness among US delivery hospitalizations with and without a COVID-19 diagnosis","author":"JY Ko","year":"2021","journal-title":"Clinical Infectious Diseases"},{"issue":"16","key":"pone.0270893.ref002","doi-asserted-by":"crossref","first-page":"E540","DOI":"10.1503\/cmaj.202604","article-title":"The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis","volume":"193","author":"SQ Wei","year":"2021","journal-title":"Cmaj"},{"key":"pone.0270893.ref003","doi-asserted-by":"crossref","first-page":"100027","DOI":"10.1016\/j.lana.2021.100027","article-title":"The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California","author":"D Karasek","year":"2021","journal-title":"The Lancet Regional Health-Americas"},{"issue":"11","key":"pone.0270893.ref004","doi-asserted-by":"crossref","first-page":"e2029256-e","DOI":"10.1001\/jamanetworkopen.2020.29256","article-title":"Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection","volume":"3","author":"EH Adhikari","year":"2020","journal-title":"JAMA Network Open"},{"key":"pone.0270893.ref005","article-title":"Impact of SARS-CoV-2 Infection on Pregnancy Outcomes: A Population-Based Study","author":"F Crovetto","year":"2021","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0270893.ref006","article-title":"Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the INTERCOVID multinational cohort study","author":"J Villar","year":"2021","journal-title":"JAMA pediatrics"},{"issue":"3","key":"pone.0270893.ref007","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/PSY.0b013e31820a62ce","article-title":"Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: a population study of 2.6 million pregnancies","volume":"73","author":"QA Class","year":"2011","journal-title":"Psychosomatic medicine"},{"issue":"3","key":"pone.0270893.ref008","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/padr.12232","article-title":"The effects of in utero exposure to influenza on birth and infant outcomes in the US","volume":"45","author":"A. 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