{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:26:11Z","timestamp":1768443971151,"version":"3.49.0"},"reference-count":55,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014\u201cRicerca Corrente\u201d IRCCS"},{"name":"5X1000 founds"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The possible link between SARS-CoV-2 infection and adverse pregnancy outcomes has so far demonstrated heterogeneous results in terms of maternal, fetal, and neonatal complications. We aim to investigate the correlation between SARS-CoV-2 seroconversion and\/or neutralization titer and pregnancy outcomes. We analyzed a population of 528 pregnant women followed up from the first trimester of gestation until delivery. For each woman, we collected a first blood sample between 11 and 13 weeks of gestation and a second sample in the perinatal period (between peripartum and puerperium) to assess the presence of SARS-CoV-2 antibodies and\/or microneutralization titer (MN titer). Data on pregnancy outcomes (gestational age at delivery, preterm birth before 34 weeks, hypertensive disorders, gestational diabetes, and abnormal fetal growth) were collected. We observed that serologic status per se is not associated with major pregnancy complications. On the contrary, the MN titer was associated with increased odds of gestational diabetes. Although we mainly reported asymptomatic SARS-CoV-2 infections and the absence of severe maternal and neonatal adverse outcomes, SARS-CoV-2 infection might challenge the maternal immune system and explain the moderate increase in adverse outcome odds.<\/jats:p>","DOI":"10.3390\/ijerph192416720","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T04:00:11Z","timestamp":1670904011000},"page":"16720","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["SARS-CoV-2 Seroconversion and Pregnancy Outcomes in a Population of Pregnant Women Recruited in Milan, Italy, between April 2020 and October 2020"],"prefix":"10.3390","volume":"19","author":[{"given":"Veronica","family":"Accurti","sequence":"first","affiliation":[{"name":"Fetal Medicine and Surgery Service, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Gambitta","sequence":"additional","affiliation":[{"name":"Fetal Medicine and Surgery Service, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5594-8761","authenticated-orcid":false,"given":"Simona","family":"Iodice","sequence":"additional","affiliation":[{"name":"EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Manenti","sequence":"additional","affiliation":[{"name":"VisMederi Srl, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Boito","sequence":"additional","affiliation":[{"name":"Fetal Medicine and Surgery Service, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7897-4452","authenticated-orcid":false,"given":"Francesca","family":"Dapporto","sequence":"additional","affiliation":[{"name":"VisMederi Srl, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Leonardi","sequence":"additional","affiliation":[{"name":"VisMederi Srl, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Molesti","sequence":"additional","affiliation":[{"name":"VisMederi Srl, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Fabietti","sequence":"additional","affiliation":[{"name":"Fetal Medicine and Surgery Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Montomoli","sequence":"additional","affiliation":[{"name":"VisMederi Srl, 53100 Siena, Italy"},{"name":"Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0370-9598","authenticated-orcid":false,"given":"Valentina","family":"Bollati","sequence":"additional","affiliation":[{"name":"EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"},{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Persico","sequence":"additional","affiliation":[{"name":"Fetal Medicine and Surgery Service, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0140-6736(20)30251-8","article-title":"Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding","volume":"395","author":"Lu","year":"2020","journal-title":"Lancet"},{"key":"ref_3","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_4","doi-asserted-by":"crossref","first-page":"m3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis","volume":"370","author":"Allotey","year":"2020","journal-title":"BMJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"05018","DOI":"10.7189\/jogh.11.05018","article-title":"A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity","volume":"11","author":"Lassi","year":"2021","journal-title":"J. Glob. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.ajog.2021.08.020","article-title":"SARS-CoV-2 and the subsequent development of preeclampsia and preterm birth: Evidence of a dose-response relationship supporting causality","volume":"225","author":"Lai","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_7","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_8","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1111\/aogs.13867","article-title":"Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies","volume":"99","author":"Zaigham","year":"2020","journal-title":"Acta Obstet. et Gynecol. Scand."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.bpobgyn.2021.03.004","article-title":"Effects of the COVID pandemic on pregnancy outcomes","volume":"73","author":"Elsaddig","year":"2021","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.preghy.2014.02.001","article-title":"The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP","volume":"4","author":"Tranquilli","year":"2014","journal-title":"Pregnancy Hypertens."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"(2009). Diagnosis and classification of diabetes mellitus. Diabetes Care, 32, S62\u2013S67.","DOI":"10.2337\/dc09-S062"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/uog.19073","article-title":"Fetal Medicine Foundation fetal and neonatal population weight charts","volume":"52","author":"Nicolaides","year":"2018","journal-title":"Ultrasound Obstet. Gynecol. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"112937","DOI":"10.1016\/j.jim.2020.112937","article-title":"Comparative analyses of SARS-CoV-2 binding (IgG, IgM, IgA) and neutralizing antibodies from human serum samples","volume":"489","author":"Mazzini","year":"2021","journal-title":"J. Immunol. Methods"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1002\/jmv.25986","article-title":"Evaluation of SARS-CoV-2 neutralizing antibodies using a CPE-based colorimetric live virus micro-neutralization assay in human serum samples","volume":"92","author":"Manenti","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4423","DOI":"10.1016\/j.vaccine.2021.05.063","article-title":"Evidence for antibody as a protective correlate for COVID-19 vaccines","volume":"39","author":"Earle","year":"2021","journal-title":"Vaccine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.cell.2020.12.015","article-title":"COVID-19-neutralizing antibodies predict disease severity and survival","volume":"184","author":"Lam","year":"2021","journal-title":"Cell"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/S0140-6736(20)31714-1","article-title":"Seroprevalence and presentation of SARS-CoV-2 in pregnancy","volume":"396","author":"Crovetto","year":"2020","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Mattern, J., Vauloup-Fellous, C., Zakaria, H., Benachi, A., Carrara, J., Letourneau, A., Bourgeois-Nicolaos, N., De Luca, D., Doucet-Populaire, F., and Vivanti, A.J. (2020). Post lockdown COVID-19 seroprevalence and circulation at the time of delivery, France. PLoS ONE, 15.","DOI":"10.1101\/2020.07.14.20153304"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102041","DOI":"10.1016\/j.jogoh.2020.102041","article-title":"SARS-COV-2 IgG antibody response in pregnant women at delivery","volume":"50","author":"Tsatsaris","year":"2021","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5709","DOI":"10.1126\/sciimmunol.abd5709","article-title":"SARS-CoV-2 seroprevalence among parturient women in Philadelphia","volume":"5","author":"Flannery","year":"2020","journal-title":"Sci. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Villalain, C., Herraiz, I., Luczkowiak, J., Perez-Rivilla, A., Folgueira, M.D., Mejia, I., Batllori, E., Felipe, E., Risco, B., and Galindo, A. (2020). Seroprevalence analysis of SARS-CoV-2 in pregnant women along the first pandemic outbreak and perinatal outcome. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243029"},{"key":"ref_22","first-page":"2001721","article-title":"SARS-CoV-2 antibody prevalence, titres and neutralising activity in an antenatal cohort, United Kingdom, 14 April to 15 June 2020","volume":"25","author":"Lumley","year":"2020","journal-title":"Euro Surveill. Bull. Eur. Sur Les Mal. Transm. Eur. Commun. Dis. Bull."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ajog.2020.09.022","article-title":"Severe acute respiratory syndrome coronavirus 2 antibodies in pregnant women admitted to labor and delivery units","volume":"224","author":"Davidov","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1515\/jpm-2021-0001","article-title":"Peripartal anti-SARS-CoV-2-IgA\/IgG in asymptomatic pregnant women during regional SARS-CoV-2-outbreak","volume":"49","author":"Hausler","year":"2021","journal-title":"J. Perinat. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1515\/jpm-2021-0173","article-title":"SARS-CoV-2 in asymptomatic pregnant women in South Brazil: RT-PCR and serological detection","volume":"49","author":"Chiste","year":"2021","journal-title":"J. Perinat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.ajog.2021.09.037","article-title":"Persistence of infection-induced SARS-CoV-2 seropositivity throughout gestation","volume":"226","author":"Staszewski","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/AOG.0000000000004199","article-title":"Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies at Delivery in Women, Partners, and Newborns","volume":"137","author":"Egerup","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1093\/cid\/ciab104","article-title":"Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on Pregnancy Outcomes: A Population-based Study","volume":"73","author":"Crovetto","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1097\/AOG.0000000000004547","article-title":"Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy Outcomes in a U.S. Population","volume":"138","author":"Son","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2029256","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":"Adhikari","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1093\/jtm\/taaa158","article-title":"Maternal and neonatal outcomes in COVID-19 infected pregnancies: A prospective cohort study","volume":"27","author":"Pirjani","year":"2020","journal-title":"J. Travel Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ajog.2021.08.054","article-title":"An update on COVID-19 and pregnancy","volume":"226","author":"Jamieson","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1093\/cid\/ciab344","article-title":"Adverse Pregnancy Outcomes, Maternal Complications, and Severe Illness Among US Delivery Hospitalizations with and without a Coronavirus Disease 2019 (COVID-19) Diagnosis","volume":"73","author":"Ko","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ajog.2021.07.009","article-title":"SARS-CoV-2 infection during pregnancy and risk of preeclampsia: A systematic review and meta-analysis","volume":"226","author":"Romero","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e759","DOI":"10.1016\/S2214-109X(21)00079-6","article-title":"Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis","volume":"9","author":"Chmielewska","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100454","DOI":"10.1016\/j.ajogmf.2021.100454","article-title":"Obstetrical outcomes and follow-up for patients with asymptomatic COVID-19 at delivery: A multicenter prospective cohort study","volume":"3","author":"Hill","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Yang, R., Mei, H., Zheng, T., Fu, Q., Zhang, Y., Buka, S., Yao, X., Tang, Z., Zhang, X., and Qiu, L. (2020). Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: A population-based cohort study in Wuhan, China. BMC Med., 18.","DOI":"10.1186\/s12916-020-01798-1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"119200","DOI":"10.1016\/j.lfs.2021.119200","article-title":"Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing","volume":"271","author":"Villalba","year":"2021","journal-title":"Life Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1055\/s-0036-1582397","article-title":"Inflammation in Complicated Pregnancy and Its Outcome","volume":"33","author":"Kalagiri","year":"2016","journal-title":"Am. J. Perinatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1111\/1471-0528.16403","article-title":"Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: A prospective cohort study","volume":"127","author":"Prabhu","year":"2020","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Llorca, J., Lechosa-Mu\u00f1iz, C., de Zulueta, P.F., L\u00f3pez-G\u00f3mez, S., Orallo, V., Alonso-Molero, J., Arozamena-Llano, B., Jubete, Y., Paz-Zulueta, M., and Cabero, M. (2021). Results of Pregnancy Control before and during the COVID-19 Pandemic: A Comparison of Two Cohorts. Int. J. Environ. Res. Public Health, 18.","DOI":"10.20944\/preprints202106.0538.v1"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Cosma, S., Carosso, A.R., Cusato, J., Borella, F., Carosso, M., Gervasoni, F., Stura, I., Preti, M., Ghisetti, V., and Di Perri, G. (2021). Preterm birth is not associated with asymptomatic\/mild SARS-CoV-2 infection per se: Pre-pregnancy state is what matters. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254875"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"E1164","DOI":"10.1503\/cmaj.210081","article-title":"Preterm birth and stillbirth rates during the COVID-19 pandemic: A population-based cohort study","volume":"193","author":"Shah","year":"2021","journal-title":"Can. Med Assoc. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s00431-021-04265-y","article-title":"Preterm births in South-West England before and during the COVID-19 pandemic: An audit of retrospective data","volume":"181","author":"Maslin","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1093\/cid\/ciaa828","article-title":"Clinical Presentation and Outcomes of Pregnant Women with Coronavirus Disease 2019: A Systematic Review and Meta-analysis","volume":"72","author":"Matar","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1515\/jpm-2020-0431","article-title":"Clinical manifestation, outcomes in pregnant women with COVID-19 and the possibility of vertical transmission: A systematic review of the current data","volume":"48","author":"Han","year":"2020","journal-title":"J. P\u00e9rinat. Med."},{"key":"ref_47","first-page":"157","article-title":"Coronavirus Disease 2019 (COVID-19): A Systematic Review of Pregnancy and the Possibility of Vertical Transmission","volume":"21","author":"Ashraf","year":"2020","journal-title":"J. Reprod. Infertil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4592450","DOI":"10.1155\/2020\/4592450","article-title":"Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection: A Systematic Review","volume":"2020","author":"Chamseddine","year":"2020","journal-title":"J. Pregnancy"},{"key":"ref_49","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_50","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.15585\/mmwr.mm6944e2","article-title":"Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy\u2014SET-NET, 16 Jurisdictions, March 29\u2013October 14, 2020","volume":"69","author":"Woodworth","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_51","first-page":"100027","article-title":"The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California","volume":"2","author":"Karasek","year":"2021","journal-title":"Lancet Reg. Health\u2014Am."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100446","DOI":"10.1016\/j.eclinm.2020.100446","article-title":"SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes","volume":"25","author":"Khalil","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/1471-0528.16903","article-title":"SARS-CoV-2 infection in pregnancy during the first wave of COVID-19 in the Netherlands: A prospective nationwide population-based cohort study (NethOSS)","volume":"129","author":"Overtoom","year":"2022","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"(2021). Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection. Ultrasound Obstet. Gynecol. J. Int. Soc. Ultrasound Obstet. Gynecol., 57, 232\u2013241.","DOI":"10.1002\/uog.23107"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1093\/cid\/ciaa352","article-title":"Maternal and Neonatal Outcomes of Pregnant Women with Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case-Control Study","volume":"71","author":"Li","year":"2020","journal-title":"Clin. Infect. Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16720\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:40:20Z","timestamp":1760146820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,13]]},"references-count":55,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192416720"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192416720","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,13]]}}}