{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:20:20Z","timestamp":1769732420977,"version":"3.49.0"},"reference-count":64,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Monoclonal antibodies (mAbs) have been used as a rescue strategy for pregnant women affected by COVID-19. To explore its impact on maternal-fetal health, we included all observational studies reporting maternal, fetal, delivery and neonatal outcomes in women who underwent mAbs infusion for COVID-19. Primary outcome was the percentage of preterm delivery. We used meta-analyses of proportions to combine data for maternal, fetal, delivery and neonatal outcome of women treated with mAbs for COVID-19 and reported pooled proportions and their 95% confidence intervals (CIs) for categorical variables or mean difference (MD) with their 95% confidence intervals for continuous variables. Preterm birth was observed in 22.8% of cases (95% CI 12.9\u201334.3). Fetal distress was reported in 4.2% (95% CI 1.6\u20138.2). Gestational hypertension and pre-eclampsia were observed in 3.0% (95% CI 0.8\u20136.8) and 3.4% (95% CI 0.8\u20137.5) of cases, respectively. Fetal growth restriction was observed in 3.2% of fetuses (95% CI 0.8\u20137.0). Secondary prophylaxis with mAbs is currently considered the best treatment option for people with mild to moderate COVID-19 disease. More attention should be paid to infants born from mothers who were treated with mAbs, for the risk of immunosuppression.<\/jats:p>","DOI":"10.3390\/vaccines11020344","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T03:04:23Z","timestamp":1675393463000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Do Anti-SARS-CoV-2 Monoclonal Antibodies Have an Impact on Pregnancy Outcome? A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Ennio","family":"Conte","sequence":"first","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8893-454X","authenticated-orcid":false,"given":"Raffaella","family":"Di Girolamo","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"D\u2019Antonio","sequence":"additional","affiliation":[{"name":"Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5443-2333","authenticated-orcid":false,"given":"Antonio","family":"Raffone","sequence":"additional","affiliation":[{"name":"Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant\u2019Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Neola","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Saccone","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Dell\u2019Aquila","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-7946","authenticated-orcid":false,"given":"Laura","family":"Sarno","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5806-1488","authenticated-orcid":false,"given":"Marco","family":"Miceli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"},{"name":"CEINGE Biotecnologie Avanzate, 80145 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2127-1876","authenticated-orcid":false,"given":"Luigi","family":"Carbone","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Maria","family":"Maruotti","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e3303","DOI":"10.1002\/jgm.3303","article-title":"COVID-19: Virology, biology and novel laboratory diagnosis","volume":"23","author":"Mohamadian","year":"2021","journal-title":"J. Gene Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.23736\/S2724-606X.21.04870-3","article-title":"The negative impact of most relevant infections on fertility and assisted reproduction technology","volume":"74","author":"Carbone","year":"2022","journal-title":"Minerva Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3002","DOI":"10.1080\/14767058.2020.1793325","article-title":"Proposal for radiologic diagnosis and follow-up of COVID-19 in pregnant women","volume":"35","author":"Carbone","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12958-020-00605-z","article-title":"COVID-19 and assisted reproductive technology services: Repercussions for patients and proposal for individualized clinical management","volume":"18","author":"Alviggi","year":"2020","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.36129\/jog.32.04.01","article-title":"IVF during coronavirus pandemic: Who comes first? The POSEIDON viewpoint","volume":"32","author":"Picarelli","year":"2020","journal-title":"Italian J. Gynaecol. Obstet."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100717","DOI":"10.1016\/j.ajogmf.2022.100717","article-title":"Changes in obstetrical practices during the 2020 COVID-19 pandemic","volume":"4","author":"Gilroy","year":"2022","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s00404-021-06276-4","article-title":"Invasive prenatal diagnosis during COVID-19 pandemic","volume":"305","author":"Carbone","year":"2022","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s00404-021-06212-6","article-title":"Obstetric A&E unit admission and hospitalization for obstetrical management during COVID-19 pandemic in a third-level hospital of southern Italy","volume":"305","author":"Carbone","year":"2022","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"WAPM (World Association of Perinatal Medicine) Working Group on COVID-19 (2021). Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection. Ultrasound Obstet. Gynecol., 57, 232\u2013241.","DOI":"10.1002\/uog.23107"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Aabakke, A.J.M., Petersen, T.G., W\u00f8jdemann, K., Ibsen, M.H., Jonsdottir, F., R\u00f8nneberg, E., Andersen, C.S., Hammer, A., Clausen, T.D., and Milbak, J. (2023). Risk factors for and pregnancy outcomes after SARS-CoV-2 in pregnancy according to disease severity: A nationwide cohort study with validation of the SARS-CoV-2 diagnosis. Acta Obstet. Gynecol. Scand., 1\u201312. epub ahead of print.","DOI":"10.1111\/aogs.14512"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sirico, A., Carbone, L., Avino, L., Buonfantino, C., De Angelis, M.C., Di Cresce, M., Fabozzi, A., Improda, F.P., Legnante, A., and Riccardi, C. (2022). Trends in caesarean section rate according to Robson group classification among pregnant women with SARS-CoV-2 infection: A single-center large cohort study in Italy. J. Clin. Med., 11.","DOI":"10.2139\/ssrn.4011901"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100468","DOI":"10.1016\/j.ajogmf.2021.100468","article-title":"Placental histopathology after SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis","volume":"3","author":"Khalil","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100352","DOI":"10.1016\/j.ajogmf.2021.100352","article-title":"Pregnant women\u2019s perspectives on severe acute respiratory syndrome coronavirus 2 vaccine","volume":"3","author":"Carbone","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"6302","DOI":"10.1080\/14767058.2021.1910672","article-title":"Women perception of SARS-CoV-2 vaccination during pregnancy and subsequent maternal anxiety: A prospective observational study","volume":"35","author":"Mappa","year":"2021","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.ejogrb.2021.12.003","article-title":"Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: A systematic review","volume":"268","author":"Carbone","year":"2022","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100616","DOI":"10.1016\/j.ajogmf.2022.100616","article-title":"COVID-19 vaccination among pregnant people in the United States: A systematic review","volume":"4","author":"Rawal","year":"2022","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100403","DOI":"10.1016\/j.ajogmf.2021.100403","article-title":"COVID-19 vaccine acceptance among pregnant, breastfeeding, and nonpregnant reproductive-aged women","volume":"3","author":"Sutton","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1002\/ijgo.14336","article-title":"COVID-19 vaccine and pregnancy outcomes: A systematic review and meta-analysis","volume":"159","author":"Carbone","year":"2022","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"100654","DOI":"10.1016\/j.ajogmf.2022.100654","article-title":"Systematic review and critical evaluation of quality of clinical practice guidelines on the management of SARS-CoV-2 infection in pregnancy","volume":"4","author":"Khalil","year":"2022","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1007\/s40121-021-00487-7","article-title":"Clinical management of adult patients with COVID-19 outside intensive care units: Guidelines from the Italian society of anti-infective therapy (SITA) and the Italian society of pulmonology (SIP)","volume":"10","author":"Bassetti","year":"2021","journal-title":"Infect. Dis. Ther."},{"key":"ref_21","unstructured":"RECOVERY Collaborative Group (2022). Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): A randomised, controlled, open-label, platform trial. Lancet, 399, 665\u2013676."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sodagar, A., Javed, R., Tahir, H., Razak, S.I.A., Shakir, M., Naeem, M., Yusof, A.H.A., Sagadevan, S., Hazafa, A., and Uddin, J. (2022). Pathological features and neuroinflammatory mechanisms of SARS-CoV-2 in the brain and potential therapeutic approaches. Biomolecules, 12.","DOI":"10.3390\/biom12070971"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"E1129","DOI":"10.1503\/cmaj.202391","article-title":"The use and impact of monoclonal antibody biologics during pregnancy","volume":"193","author":"Top","year":"2021","journal-title":"Can. Med Assoc. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1600-0897.1996.tb00172.x","article-title":"Evolution of maternofetal transport of immunoglobulins during human pregnancy","volume":"36","author":"Malek","year":"1996","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1053\/j.gastro.2016.04.002","article-title":"Concentrations of adalimumab and infliximab in mothers and newborns, and effects on infection","volume":"151","author":"Julsgaard","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1053\/j.gastro.2020.11.038","article-title":"Pregnancy and neonatal outcomes after fetal exposure to biologics and thiopurines among women with inflammatory bowel disease","volume":"160","author":"Mahadevan","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1002\/pds.4930","article-title":"Anti-TNF treatment during pregnancy and birth outcomes: A population-based study from Denmark, Finland, and Sweden","volume":"29","author":"Kieler","year":"2020","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1080\/1744666X.2019.1561282","article-title":"From mother to baby: Antenatal exposure to monoclonal antibody biologics","volume":"15","author":"Sadarangani","year":"2019","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1056\/NEJMoa2035002","article-title":"REGN-COV2, a Neutralizing antibody cocktail, in outpatients with Covid-19","volume":"384","author":"Weinreich","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/AOG.0000000000004603","article-title":"Monoclonal antibodies casirivimab and imdevimab in pregnancy for Coronavirus Disease 2019 (COVID-19)","volume":"138","author":"Mayer","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1136\/archdischild-2021-323628","article-title":"Use of single-dose tocilizumab for treatment of severe COVID-19 in pregnancy: Implications for the timing of live infant vaccines","volume":"107","author":"Burkhardt","year":"2022","journal-title":"Arch. Dis. Child."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1097\/TP.0000000000004083","article-title":"Sotrovimab use for COVID-19 infection in pregnant kidney transplant recipient","volume":"106","author":"AlKindi","year":"2022","journal-title":"Transplantation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"W-64","DOI":"10.7326\/0003-4819-151-4-200908180-00136","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lo, C.K., Mertz, D., and Loeb, M. (2014). Newcastle-Ottawa Scale: Comparing reviewers\u2019 to authors\u2019 assessments. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-45"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018","journal-title":"BMJ Evid. Based Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"6047","DOI":"10.1016\/j.vaccine.2016.03.045","article-title":"Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data","volume":"34","author":"Quinn","year":"2016","journal-title":"Vaccine"},{"key":"ref_38","unstructured":"Safe Motherhood and Newborn Health Committee (2022, September 25). FIGO Consensus Guidelines on Intrapartum Fetal Monitoring. Available online: https:\/\/www.jsog.or.jp\/international\/pdf\/CTG.pdf."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Wan, X., Wang, W., Liu, J., and Tong, T. (2014). Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-135"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1186\/s13256-021-03010-1","article-title":"Use of intravenous tocilizumab in pregnancy for severe Coronavirus Disease 2019 pneumonia: Two case reports","volume":"15","author":"Abdullah","year":"2021","journal-title":"J. Med. Case Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ajog.2022.01.018","article-title":"A real-world assessment of tolerability and treatment outcomes of COVID-19 monoclonal antibodies administered in pregnancy","volume":"226","author":"Chang","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.ajog.2021.08.025","article-title":"Monoclonal antibody treatment of symptomatic COVID-19 in pregnancy: Initial report","volume":"225","author":"Hirshberg","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s15010-022-01777-z","article-title":"Treatment with anti-SARS-CoV-2 monoclonal antibodies in pregnant and postpartum women: First experiences in Florence, Italy","volume":"50","author":"Manciulli","year":"2022","journal-title":"Infection"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1111\/jcpt.13394","article-title":"Safety of tocilizumab in COVID-19 pregnant women and their newborn: A retrospective study","volume":"46","author":"Miarons","year":"2021","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/AOG.0000000000004689","article-title":"Neutralizing monoclonal antibodies for Coronavirus Disease 2019 (COVID-19) in pregnancy: A case series","volume":"139","author":"Richley","year":"2022","journal-title":"Obstet. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1097\/AOG.0000000000004700","article-title":"Anti-spike monoclonal antibody therapy in pregnant women with mild-to-moderate Coronavirus Disease 2019 (COVID-19)","volume":"139","author":"Thilagar","year":"2022","journal-title":"Obstet. Gynecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1097\/AOG.0000000000004050","article-title":"Tocilizumab and remdesivir in a pregnant patient with Coronavirus Disease 2019 (COVID-19)","volume":"136","author":"Naqvi","year":"2020","journal-title":"Obstet. Gynecol."},{"key":"ref_48","first-page":"113","article-title":"Monoclonal SARS-CoV-2 antibodies in pregnancy-a case series","volume":"119","author":"Reuken","year":"2022","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.jiac.2022.02.023","article-title":"Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review","volume":"28","author":"Ogawa","year":"2022","journal-title":"J. Infect. Chemother."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1111\/jog.14701","article-title":"Severe Coronavirus Disease pneumonia in a pregnant woman at 25\u2009weeks\u2019 gestation: A case report","volume":"47","author":"Waratani","year":"2021","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s15010-022-01829-4","article-title":"Treatment of COVID-19 with monoclonal antibodies casirivimab and imdevimab in pregnancy","volume":"51","author":"Folkman","year":"2022","journal-title":"Infection"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100673","DOI":"10.1016\/j.ajogmf.2022.100673","article-title":"Outcomes of pregnant patients treated with REGEN-COV during the COVID-19 pandemic","volume":"4","author":"Levey","year":"2022","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1111\/jog.15338","article-title":"Evaluation of the tolerability of monoclonal antibody therapy for pregnant patients with COVID-19","volume":"48","author":"Magawa","year":"2022","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e13559","DOI":"10.1111\/aji.13559","article-title":"Complement blockade with eculizumab for treatment of severe Coronavirus Disease 2019 in pregnancy: A case series","volume":"88","author":"Burwick","year":"2022","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_55","unstructured":"National Institutes of Health (NIH) (2022, September 27). COVID-19 Treatment Guidelines, Available online: https:\/\/www.covid19treatmentguidelines.nih.gov\/special-populations\/pregnancy\/?utm_source=site&utm_medium=home&utm_campaign=highlights."},{"key":"ref_56","unstructured":"(2022, September 27). American College of Obstetricians and Gynecologists (ACOG). Available online: https:\/\/www.acog.org\/clinical-information\/physician-faqs\/covid-19-faqs-for-ob-gyns-obstetrics."},{"key":"ref_57","unstructured":"(2022, September 27). Society for Maternal-Fetal Medicine (SMFM). Available online: https:\/\/www.smfm.org\/covidclinical."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.cmi.2021.08.016","article-title":"Tocilizumab for Coronavirus Disease 2019 in pregnancy and lactation: A narrative review","volume":"28","author":"Jorgensen","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"100715","DOI":"10.1016\/j.ajogmf.2022.100715","article-title":"Characteristics and treatment of hospitalized pregnant women with COVID-19","volume":"4","author":"Sekkarie","year":"2022","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Fallach, N., Segal, Y., Agassy, J., Perez, G., Peretz, A., Chodick, G., Gazit, S., Patalon, T., Ben Tov, A., and Goldshtein, I. (2022). Pregnancy outcomes after SARS-CoV-2 infection by trimester: A large, population-based cohort study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0270893"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"226.e1","DOI":"10.1016\/j.ajog.2022.08.009","article-title":"First- or second-trimester SARS-CoV-2 infection and subsequent pregnancy outcomes","volume":"228","author":"Hughes","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/ene.15559","article-title":"Pregnancy outcomes after early fetal exposure to injectable first-line treatments, dimethyl fumarate or natalizumab in Danish women with multiple sclerosis","volume":"30","author":"Andersen","year":"2022","journal-title":"Eur. J. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s13311-022-01224-9","article-title":"Monoclonal antibodies in the treatment of relapsing multiple sclerosis: An overview with emphasis on pregnancy, vaccination, and risk management","volume":"19","author":"Krajnc","year":"2022","journal-title":"Neurotherapeutics"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"100728","DOI":"10.1016\/j.ajogmf.2022.100728","article-title":"Examining the impact of trimester of diagnosis on COVID-19 disease progression in pregnancy","volume":"4","author":"Schell","year":"2022","journal-title":"Am. J. Obstet. Gynecol. 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