{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:56:20Z","timestamp":1760057780981,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The first trimester of pregnancy is known for its proinflammatory state, so it is considered a challenging period due to increased maternal vulnerability to viral infections. The main purpose of the current study was to evaluate the incidence trend of early miscarriages and whether there was any possible influence of the COVID-19 pandemic on pregnancy outcomes. Materials and Methods: We conducted a retrospective cohort study in which we included all pregnant women who had been admitted to our hospital between January 2018 and December 2022. Our aim was to compare the percentage of early miscarriages occurring in the pre-pandemic period (January 2018\u2013February 2020) and during the pandemic (March 2020\u2013December 2022). We decided to measure the total number and percentage of early pregnancy outcomes, including all viable pregnancies, ectopic pregnancies, and both medical and spontaneous abortions. Results: The annual incidence of registry-identified early miscarriages declined from 5.4% of 12\u201346-year-old women in 2018 to 3.6% in 2022 (p = 0.008). An overall incidence rate of 3.66% [95% C.I. 3.26\u20134.05] was calculated, with 4.25% [95% C.I. 3.35\u20134.41] in the pre-pandemic period and 3.24% [95% C.I. 2.82\u20133.57] during the pandemic. The highest incidence rate (p &lt; 0.0001) was identified among nulliparous women (36.9%). Conclusions: To conclude, this study proved that the increase in the early miscarriage incidence rate could be assigned to an advanced maternal age, irrespective of one\u2019s reproductive history. This study proved that no significant increase in the incidence rate of early miscarriage during the COVID-19 pandemic was noted, suggesting that this viral infection does not alter the risk of miscarriages. We hope that these findings help women deal with emotional stress and offer them reassurance about bearing children during pandemic periods.<\/jats:p>","DOI":"10.3390\/jcm14051418","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T11:03:37Z","timestamp":1740049417000},"page":"1418","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of Spontaneous Abortions During the COVID-19 Pandemic in a Regional County Hospital in Romania: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Diana","family":"Burlacu","sequence":"first","affiliation":[{"name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Pathology, County Emergency Clinical Hospital of Targu Mures, 54000 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Burlacu","sequence":"additional","affiliation":[{"name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Ladanyi","sequence":"additional","affiliation":[{"name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Obstetrics and Gynecology, County Emergency Clinical Hospital of Targu Mures, 54000 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bela","family":"Szabo","sequence":"additional","affiliation":[{"name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Obstetrics and Gynecology, County Emergency Clinical Hospital of Targu Mures, 54000 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5150-7993","authenticated-orcid":false,"given":"Tibor","family":"Mezei","sequence":"additional","affiliation":[{"name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Pathology, County Emergency Clinical Hospital of Targu Mures, 54000 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"The Lancet (2021). The Lancet Miscarriage: Worldwide Reform of Care Is Needed. Lancet, 397, 1597.","DOI":"10.1016\/S0140-6736(21)00954-5"},{"key":"ref_2","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_3","first-page":"40","article-title":"SARS-CoV-2 in First Trimester Pregnancy: A Cohort Study","volume":"36","author":"Egerup","year":"2021","journal-title":"Hum. Reprod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"242","DOI":"10.15585\/mmwr.mm6509e2","article-title":"Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission during the First Trimester of Pregnancy\u2014Brazil, 2015","volume":"65","author":"Henriques","year":"2016","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1055\/s-0038-1668531","article-title":"Abortion and Zika Virus Congenital Infection","volume":"40","author":"Sookaromdee","year":"2018","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ogc.2017.02.004","article-title":"Prenatal Diagnosis: Screening and Diagnostic Tools","volume":"44","author":"Carlson","year":"2017","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s40556-020-00259-2","article-title":"Diagnosis of Infections in Fetus: Ultrasound and Invasive Techniques","volume":"07","author":"Rana","year":"2020","journal-title":"J. Fetal Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Auriti, C., De Rose, D.U., Santisi, A., Martini, L., Piersigilli, F., Bersani, I., Ronchetti, M.P., and Caforio, L. (2021). Pregnancy and Viral Infections: Mechanisms of Fetal Damage, Diagnosis and Prevention of Neonatal Adverse Outcomes from Cytomegalovirus to SARS-CoV-2 and Zika Virus. Biochim. Biophys. Acta Mol. Basis Dis., 1867.","DOI":"10.1016\/j.bbadis.2021.166198"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00404-020-05848-0","article-title":"COVID-19 Pandemic Effect on Early Pregnancy: Are Miscarriage Rates Altered, in Asymptomatic Women?","volume":"303","author":"Steiner","year":"2021","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ijid.2020.01.009","article-title":"The Continuing 2019-nCoV Epidemic Threat of Novel Coronaviruses to Global Health\u2014The Latest 2019 Novel Coronavirus Outbreak in Wuhan, China","volume":"91","author":"Hui","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1097\/AOG.0000000000002318","article-title":"Interpregnancy Interval After Pregnancy Loss and Risk of Repeat Miscarriage","volume":"130","author":"Sundermann","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_12","first-page":"1","article-title":"Estimated Pregnancy Rates and Rates of Pregnancy Outcomes for the United States, 1990\u20132008","volume":"60","author":"Ventura","year":"2012","journal-title":"Natl. Vital Stat. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1136\/bmj.320.7251.1708","article-title":"Maternal Age and Fetal Loss: Population Based Register Linkage Study","volume":"320","author":"Wohlfahrt","year":"2000","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1111\/1471-0528.12694","article-title":"Risk Factors for Miscarriage from a Prevention Perspective: A Nationwide Follow-up Study","volume":"121","author":"Andersen","year":"2014","journal-title":"BJOG"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"l869","DOI":"10.1136\/bmj.l869","article-title":"Role of Maternal Age and Pregnancy History in Risk of Miscarriage: Prospective Register Based Study","volume":"364","author":"Magnus","year":"2019","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1056\/NEJM197611252952201","article-title":"Maternal-Fetal Relation. Absence of an Immunologic Blocking Factor from the Serum of Women with Chronic Abortions","volume":"295","author":"Rocklin","year":"1976","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1471-0528.1979.tb10682.x","article-title":"Studies on the Maternal Immune Response to Placental Antigens: Absence of a Blocking Factor from the Blood of Abortion-Prone Women","volume":"86","author":"Stimson","year":"1979","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1136\/bmj.299.6698.541","article-title":"Influence of Past Reproductive Performance on Risk of Spontaneous Abortion","volume":"299","author":"Regan","year":"1989","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S0140-6736(83)92246-8","article-title":"The Fetus as an Allograft: Evidence for Protective Antibodies to HLA-Linked Paternal Antigens","volume":"2","author":"Power","year":"1983","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/S0015-0282(16)47119-0","article-title":"Histocompatibility in Couples with Recurrent Spontaneous Abortion and Normal Fertility","volume":"39","author":"Caudle","year":"1983","journal-title":"Fertil. Steril."},{"key":"ref_21","first-page":"116","article-title":"Feto-Maternal HLA Compatibility Does Not Have a Major Influence on Human Pregnancy except for Lymphocytotoxin Production","volume":"69","author":"Jazwinska","year":"1987","journal-title":"Clin. Exp. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1136\/bmj.4.5999.743","article-title":"Spina Bifida and Anencephaly: Miscarriage as Possible Cause","volume":"4","author":"Clarke","year":"1975","journal-title":"Br. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1136\/postgradmedj-2014-132672","article-title":"Recurrent Miscarriage: Causes, Evaluation and Management","volume":"91","year":"2015","journal-title":"Postgrad. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1056\/NEJM198807283190401","article-title":"Incidence of Early Loss of Pregnancy","volume":"319","author":"Wilcox","year":"1988","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1097\/EDE.0000000000000484","article-title":"Risk of Miscarriage in Women Receiving Antidepressants in Early Pregnancy, Correcting for Induced Abortions","volume":"27","author":"Almeida","year":"2016","journal-title":"Epidemiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1053\/beog.2000.0124","article-title":"Genetic Aspects of Miscarriage","volume":"14","author":"Goddijn","year":"2000","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_27","first-page":"1243","article-title":"Management of Spontaneous Abortion","volume":"72","author":"Griebel","year":"2005","journal-title":"Am. Fam. Physician"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.2105\/AJPH.82.10.1332","article-title":"Determinants of Depressive Symptoms in the Early Weeks after Miscarriage","volume":"82","author":"Neugebauer","year":"1992","journal-title":"Am. J. Public Health"},{"key":"ref_29","first-page":"94","article-title":"Psychological Sequelae of Miscarriage: A Controlled Study Using the General Health Questionnaire and the Hospital Anxiety and Depression Scale","volume":"42","author":"Thapar","year":"1992","journal-title":"Br. J. Gen. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1097\/AOG.0000000000000859","article-title":"A National Survey on Public Perceptions of Miscarriage","volume":"125","author":"Bardos","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_31","first-page":"S34","article-title":"Effect of the Interpregnancy Interval after an Abortion on Maternal and Perinatal Health in Latin America","volume":"89","author":"Breman","year":"2005","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"#cr-split#-ref_32.1","unstructured":"Marston, C., Conde-Agudelo, A., and World Health Organization (2007). Department of Making Pregnancy Safer"},{"key":"#cr-split#-ref_32.2","unstructured":"World Health Organization. Reproductive Health and Research. Report of a WHO Technical Consultation on Birth Spacing, Geneva, Switzerland, 13-15 June 2005, WHO."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e000377","DOI":"10.1136\/bmjgh-2017-000377","article-title":"Adverse Effects of Exposure to Armed Conflict on Pregnancy: A Systematic Review","volume":"2","author":"Keasley","year":"2017","journal-title":"BMJ Glob. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/PSY.0b013e318280f5f3","article-title":"Prenatal Stress and Risk of Spontaneous Abortion","volume":"75","author":"Wainstock","year":"2013","journal-title":"Psychosom. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.ajog.2003.11.019","article-title":"Pregnancy and Perinatal Outcomes of Women with Severe Acute Respiratory Syndrome","volume":"191","author":"Wong","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1007\/s42399-020-00443-5","article-title":"Miscarriage Risk in COVID-19 Infection","volume":"2","author":"Wong","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.jinf.2020.09.002","article-title":"First Trimester Miscarriage in a Pregnant Woman Infected with COVID-19 in Pakistan","volume":"82","author":"Rana","year":"2021","journal-title":"J. Infect."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Kazemi, S.N., Hajikhani, B., Didar, H., Hosseini, S.S., Haddadi, S., Khalili, F., Mirsaeidi, M., and Nasiri, M.J. (2021). COVID-19 and Cause of Pregnancy Loss during the Pandemic: A Systematic Review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0255994"},{"key":"ref_39","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_40","doi-asserted-by":"crossref","first-page":"4431","DOI":"10.1080\/14767058.2020.1850683","article-title":"Clinical Course of Novel COVID-19 Infection in Pregnant Women","volume":"35","author":"Shmakov","year":"2022","journal-title":"J. Matern. Fetal. Neonatal Med."},{"key":"ref_41","first-page":"e49","article-title":"Analysis of Maternal Coronavirus Infections and Neonates Born to Mothers with 2019-nCoV; a Systematic Review","volume":"8","author":"Muhidin","year":"2020","journal-title":"Arch. Acad. Emerg. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"391.e1","DOI":"10.1016\/j.ajog.2020.10.005","article-title":"Coronavirus Disease 2019 and First-Trimester Spontaneous Abortion: A Case-Control Study of 225 Pregnant Patients","volume":"224","author":"Cosma","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1111\/jog.14321","article-title":"Clinical Update on COVID-19 in Pregnancy: A Review Article","volume":"46","author":"Ryan","year":"2020","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"111.e1","DOI":"10.1016\/j.ajog.2020.04.014","article-title":"Coronavirus Disease 2019 in Pregnant Women: A Report Based on 116 Cases","volume":"223","author":"Yan","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.ijid.2020.04.047","article-title":"Clinical Analysis of Ten Pregnant Women with COVID-19 in Wuhan, China: A Retrospective Study","volume":"95","author":"Cao","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/1471-0528.16278","article-title":"Vaginal Delivery in SARS-CoV-2-Infected Pregnant Women in Northern Italy: A Retrospective Analysis","volume":"127","author":"Ferrazzi","year":"2020","journal-title":"BJOG"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/NMC.0000000000000742","article-title":"Narrative Analysis of Childbearing Experiences during the COVID-19 Pandemic","volume":"46","author":"Ajayi","year":"2021","journal-title":"MCN Am. J. Matern.\/Child Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/rfc2.57","article-title":"Multiple Case Study Exploring the Impact of Visitor Restrictions in Hospitals on Childbirth Support during the COVID-19 Pandemic","volume":"2","author":"Hicks","year":"2023","journal-title":"Reprod. Female Child Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4138","DOI":"10.1111\/jonm.13890","article-title":"Becoming a Mother during the COVID-19 Pandemic: The Lived Experience as Told by Birthing Mothers: A Qualitative Study","volume":"30","author":"Bolgeo","year":"2022","journal-title":"J. Nurs. Manag."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1418\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:38:50Z","timestamp":1760027930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":50,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14051418"],"URL":"https:\/\/doi.org\/10.3390\/jcm14051418","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}