{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:05:53Z","timestamp":1792433153497,"version":"4.5.0"},"reference-count":64,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The new coronavirus, SARS-CoV-2, is devastating for specific groups of patients, but currently there is not enough information concerning its effects on pregnant women. The purpose of this study is to identify the impact of SARS-CoV-2 infection on pregnancy and the consequences that it could cause. We studied a cohort of pregnant ladies who were tested for SARS-CoV-2 infection by RT-PCR and classified as infected or not infected. The recruitment was carried out in the HUMV hospital, a third-level hospital located in Santander, northern Spain. It started on 23 March 2020 and ended on 14 October 2020. Data from our cohort were compared to another cohort recruited in 2018 at the same hospital. We found that gestational hypertension, placental abruptio, and home exposure to an infected person, among other variables, could be associated with SARS-CoV-2 infection. In conclusion, we consider pregnant women a high-risk group of patients towards a possible SARS-CoV-2 infection, especially those who present with conditions such as gestational hypertension or obesity; moreover, we think that SARS-CoV-2 infection could increase the possibilities of having an abruptio placentae, although this result was found in only a few women, so it requires further confirmation.<\/jats:p>","DOI":"10.3390\/ijerph182010931","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T22:52:47Z","timestamp":1634683967000},"page":"10931","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pregnancy and Birth Outcomes during the Early Months of the COVID-19 Pandemic: The MOACC-19 Cohort"],"prefix":"10.3390","volume":"18","author":[{"given":"Marta","family":"Rodr\u00edguez-D\u00edaz","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1939-8798","authenticated-orcid":false,"given":"J\u00e9ssica","family":"Alonso-Molero","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"},{"name":"IDIVAL Instituto de Investigaci\u00f3n Sanitaria Valdecilla, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda J.","family":"Cabero-Perez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"},{"name":"IDIVAL Instituto de Investigaci\u00f3n Sanitaria Valdecilla, 39011 Santander, Spain"},{"name":"Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Llorca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinidad","family":"Dierssen-Sotos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"},{"name":"IDIVAL Instituto de Investigaci\u00f3n Sanitaria Valdecilla, 39011 Santander, Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8793-8314","authenticated-orcid":false,"given":"In\u00e9s","family":"G\u00f3mez-Acebo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain"},{"name":"IDIVAL Instituto de Investigaci\u00f3n Sanitaria Valdecilla, 39011 Santander, Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The MOACC-19 Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/JCMA.0000000000000270","article-title":"The outbreak of COVID-19: An overview","volume":"83","author":"Wu","year":"2020","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100107","DOI":"10.1016\/j.ajogmf.2020.100107","article-title":"Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: A systematic review and meta-analysis","volume":"2","author":"Khalil","year":"2020","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_4","first-page":"2019","article-title":"Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: National population based cohort study","volume":"369","author":"Knight","year":"2020","journal-title":"BMJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1016\/j.jinf.2020.04.021","article-title":"Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis","volume":"81","author":"Zheng","year":"2020","journal-title":"J. Infect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1016\/j.jinf.2020.03.059","article-title":"Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis","volume":"81","author":"Zuin","year":"2020","journal-title":"J. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kucirka, L.M., Norton, A., and Sheffield, J.S. (2020). Severity of COVID-19 in pregnancy: A review of current evidence. Am. J. Reprod. Immunol., 84.","DOI":"10.1111\/aji.13332"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.15585\/mmwr.mm6944e3","article-title":"Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status\u2014United States, January 22\u2013October 3, 2020","volume":"69","author":"Zambrano","year":"2020","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.ejogrb.2020.07.008","article-title":"Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study","volume":"252","author":"Antoun","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chen, L., Jiang, H., and Zhao, Y. (2020). Pregnancy with COVID-19: Management considerations for care of severe and critically ill cases. Am. J. Reprod. Immunol.","DOI":"10.1111\/aji.13299"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"103122","DOI":"10.1016\/j.jri.2020.103122","article-title":"Why are pregnant women susceptible to COVID-19? An immunological viewpoint","volume":"139","author":"Liu","year":"2020","journal-title":"J. Reprod. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.ejogrb.2020.06.058","article-title":"Is pregnancy a risk factor of COVID-19?","volume":"252","author":"Phoswa","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"77.e1","DOI":"10.1016\/j.ajog.2020.12.1221","article-title":"Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infection in Washington State","volume":"225","author":"Lokken","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kreis, N.-N., Ritter, A., Louwen, F., and Yuan, J. (2020). A Message from the Human Placenta: Structural and Immunomodulatory Defense against SARS-CoV-2. Cells, 9.","DOI":"10.3390\/cells9081777"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4947","DOI":"10.1172\/JCI139569","article-title":"SARS-CoV-2 infection of the placenta","volume":"130","author":"Hosier","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100246","DOI":"10.1016\/j.ajogmf.2020.100246","article-title":"Coronavirus disease 2019 pregnancy outcomes in a racially and ethnically diverse population","volume":"2","author":"Grechukhina","year":"2020","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"799","DOI":"10.5858\/arpa.2020-0901-SA","article-title":"An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: Maternal coronavirus infections and pregnancy outcomes","volume":"144","author":"Schwartz","year":"2020","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1055\/s-0040-1710538","article-title":"A Proposed Plan for Prenatal Care to Minimize Risks of COVID-19 to Patients and Providers: Focus on Hypertensive Disorders of Pregnancy","volume":"37","author":"Barton","year":"2020","journal-title":"Am. J. Perinatol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Jin, Y., Xu, H., Wu, M., Yi, B., Zhu, M., Zhou, Y., and Wang, J. (2019). Correlation of gestational hypertension with abnormal lipid metabolism, insulin resistance and d-dimer and their clinical significance. Exp. Ther. Med., 17.","DOI":"10.3892\/etm.2018.7070"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bulavenko, O., and Vaskiv, O. (2017). Risk factors of gestational hypertension development. Curr. Issues Pharm. Med. Sci., 30.","DOI":"10.1515\/cipms-2017-0013"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area","volume":"323","author":"Richardson","year":"2020","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1056\/NEJMc2010419","article-title":"Clinical Characteristics of Covid-19 in New York City","volume":"382","author":"Goyal","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"911.e1","DOI":"10.1016\/j.ajog.2020.05.031","article-title":"Clinical characteristics of 46 pregnant women with a severe acute respiratory syndrome coronavirus 2 infection in Washington State","volume":"223","author":"Lokken","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Akoumianakis, I., and Filippatos, T. (2020). The renin\u2013angiotensin\u2013aldosterone system as a link between obesity and coronavirus disease 2019 severity. Obes. Rev., 21.","DOI":"10.1111\/obr.13077"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Li, N., Han, L., Peng, M., Lv, Y., Ouyang, Y., Liu, K., Yue, L., Li, Q., Sun, G., and Chen, L. (2020). Maternal and Neonatal Outcomes of Pregnant Women With Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case-Control Study. Clin. Infect. Dis., 71.","DOI":"10.1093\/cid\/ciaa352"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wu, Y., Kataria, Y., Wang, Z., Ming, W.-K., and Ellervik, C. (2019). Factors associated with successful vaginal birth after a cesarean section: A systematic review and meta-analysis. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2517-y"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102433","DOI":"10.1016\/j.jaut.2020.102433","article-title":"The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak","volume":"109","author":"Rothan","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1007\/s00405-020-05965-1","article-title":"Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): A multicenter European study","volume":"277","author":"Lechien","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1002\/lary.28692","article-title":"Anosmia and Ageusia: Common Findings in COVID-19 Patients","volume":"130","author":"Vaira","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Allotey, J., Stallings, E., Bonet, M., Yap, M., Chatterjee, S., Kew, T., Debenham, L., Llavall, A.C., Dixit, A., and Zhou, D. (2020). Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ, m3320.","DOI":"10.1097\/01.aoa.0000744128.44930.48"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.it.2020.10.004","article-title":"Mechanisms of SARS-CoV-2 Transmission and Pathogenesis","volume":"41","author":"Harrison","year":"2020","journal-title":"Trends Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Arora, M., and Lakshmi, R. (2021). Maternal vaccines\u2014Safety in pregnancy. Best Pract. Res. Clin. Obstet. Gynaecol.","DOI":"10.1016\/j.bpobgyn.2021.02.002"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ni, Y., Guo, J., Turner, D., and Tizard, I. (2018). An Improved Inactivated Influenza Vaccine with Enhanced Cross Protection. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.01815"},{"key":"ref_35","first-page":"1","article-title":"Cohort profile: The MCC-Spain follow-up on colorectal, breast and prostate cancers: Study design and initial results","volume":"9","author":"Molina","year":"2019","journal-title":"BMJ Open"},{"key":"ref_36","unstructured":"Carrillo, J., Rodriguez, M.L., and \u00c1vila, C. (2021, October 13). Detection of SARS-CoV-2 antibodies by ELISA. Available online: https:\/\/www.irsicaixa.es\/sites\/default\/files\/detection_of_sars-cov-2_antibodies_by_elisa_-_protocol_by_irsicaixa_protected.pdf."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Syeda, S., Baptiste, C., Breslin, N., Gyamfi-Bannerman, C., and Miller, R. (2020). The clinical course of COVID in pregnancy. Semin. Perinatol., 151284.","DOI":"10.1016\/j.semperi.2020.151284"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/8868952","article-title":"Hypertensive Crisis in Pregnancy with COVID19: Confirmed with rt-PCR for Nasopharyngeal Swab","volume":"2020","author":"Bandara","year":"2020","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"101826","DOI":"10.1016\/j.jogoh.2020.101826","article-title":"A snapshot of the Covid-19 pandemic among pregnant women in France","volume":"49","author":"Kayem","year":"2020","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"McDonnell, S., McNamee, E., Lindow, S.W., and O\u2019Connell, M.P. (2020). The impact of the Covid-19 pandemic on maternity services: A review of maternal and neonatal outcomes before, during and after the pandemic. Eur. J. Obstet. Gynecol. Reprod. Biol.","DOI":"10.1016\/j.ejogrb.2020.10.023"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S685","DOI":"10.1016\/j.ajog.2020.12.1135","article-title":"1111 Increased rates of hypertensive disorders of pregnancy during the COVID-19 pandemic","volume":"224","author":"Sinnott","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/path.5471","article-title":"Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19)","volume":"251","author":"Bourgonje","year":"2020","journal-title":"J. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Li, M., Chen, L., Zhang, J., Xiong, C., and Li, X. (2020). The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study. PLoS ONE, 15.","DOI":"10.1101\/2020.02.27.967760"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Jin, X. (2018). Role of Renin-Angiotensin System Components in Hypertension During Pregnancy. Res. Pediatr. Neonatol., 2.","DOI":"10.31031\/RPN.2018.02.000537"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.ajog.2020.02.017","article-title":"Coronavirus Disease 2019 (COVID-19) and pregnancy: What obstetricians need to know","volume":"222","author":"Rasmussen","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_46","first-page":"46","article-title":"COVID-19 and pregnancy: A review of current knowledge","volume":"28","author":"Kolahdooz","year":"2020","journal-title":"Le Infez. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1002\/ijgo.13182","article-title":"A systematic scoping review of COVID-19 during pregnancy and childbirth","volume":"150","author":"Elshafeey","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"103180","DOI":"10.1016\/j.jri.2020.103180","article-title":"What immunological and hormonal protective factors lower the risk of COVID-19 related deaths in pregnant women?","volume":"142","author":"Berhan","year":"2020","journal-title":"J. Reprod. Immunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s10096-020-04033-0","article-title":"The metabolic and immunological characteristics of pregnant women with COVID-19 and their neonates","volume":"40","author":"Zhou","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/ijgo.13329","article-title":"Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review","volume":"151","author":"Turan","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"He, M., Skaria, P., Kreutz, K., Chen, L., Hagemann, I.S., Carter, E.B., Mysorekar, I.U., Nelson, D.M., Pfeifer, J., and Dehner, L.P. (2020). Histopathology of Third Trimester Placenta from SARS-CoV-2-Positive Women. Fetal Pediatr. Pathol., 1\u201310.","DOI":"10.1101\/2020.08.11.20173005"},{"key":"ref_52","unstructured":"(2021, May 14). N\u00famero de Ces\u00e1reas Practicadas En Espa\u00f1a y Datos y Estad\u00edsticas Sobre Partos. Available online: https:\/\/www.epdata.es\/datos\/partos-madrid-barcelona-valencia-sevillas-otras-ciudades-datos-estadisticas\/490."},{"key":"ref_53","first-page":"166","article-title":"[Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]","volume":"55","author":"Zhang","year":"2020","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00404-020-05889-5","article-title":"Clinical characteristics and outcomes of pregnant women with COVID-19 and the risk of vertical transmission: A systematic review","volume":"303","author":"Chi","year":"2021","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1001\/jama.2020.10125","article-title":"Association between Mode of Delivery among Pregnant Women with COVID-19 and Maternal and Neonatal Outcomes in Spain","volume":"324","author":"Vouga","year":"2020","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.ejogrb.2020.07.034","article-title":"Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis","volume":"252","author":"Dubey","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ajog.2020.04.013","article-title":"Coronavirus disease 2019 during pregnancy: A systematic review of reported cases","volume":"223","author":"Rizzo","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Gao, Y., Ye, L., Zhang, J., Yin, Y., Liu, M., Yu, H., and Zhou, R. (2020). Clinical features and outcomes of pregnant women with COVID-19: A systematic review and meta-analysis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05274-2"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Cosma, S., Carosso, A.R., Cusato, J., Borella, F., Carosso, M., Bovetti, M., Filippini, C., D\u2019Avolio, A., Ghisetti, V., and Di Perri, G. (2020). COVID-19 and first trimester spontaneous abortion: A case-control study of 225 pregnant patients. Am. J. Obstet. Gynecol.","DOI":"10.1101\/2020.06.19.20135749"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"51","DOI":"10.21037\/tp.2020.02.06","article-title":"Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia","volume":"9","author":"Zhu","year":"2020","journal-title":"Transl. Pediatr."},{"key":"ref_61","first-page":"7804","article-title":"Clinical outcomes of 201 neonates born to mothers with COVID-19: A systematic review","volume":"24","author":"Yoon","year":"2020","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"142810","DOI":"10.1016\/j.scitotenv.2020.142810","article-title":"Identifying novel factors associated with COVID-19 transmission and fatality using the machine learning approach","volume":"764","author":"Li","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1056\/NEJMoa0708630","article-title":"Effectiveness of Maternal Influenza Immunization in Mothers and Infants","volume":"359","author":"Zaman","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/S0140-6736(14)60686-3","article-title":"Effectiveness of maternal pertussis vaccination in England: An observational study","volume":"384","author":"Amirthalingam","year":"2014","journal-title":"Lancet"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/20\/10931\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:16:59Z","timestamp":1760167019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/20\/10931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":64,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["ijerph182010931"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182010931","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,18]]}}}