Monkeypox infection in pregnancy: a systematic review and metaanalysis

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Maternal-Fetal Medicine

Background:

• The World Health Organization declared monkeypox a public health emergency of global concern.
• Understanding the impact of monkeypox on pregnancy is crucial for maternal and infant health.
• Limited data exists on pregnancy outcomes complicated by monkeypox infection.

Purpose of the Study:

• To systematically review and ascertain maternal and perinatal outcomes in pregnancies affected by monkeypox.
• To analyze the risks associated with monkeypox infection during gestation.

Main Methods:

• Systematic review of Medline, Embase, and Cochrane databases.
• Search conducted on June 25, 2022, using keywords for monkeypox and pregnancy.
• Meta-analysis of proportions used to analyze data from included English-language studies.

Main Results:

• Four studies were included, all with symptomatic monkeypox infections; no maternal deaths reported.
• High rates of adverse outcomes: 39% miscarriage, 23% intrauterine fetal death, 77% perinatal loss.
• Significant vertical transmission (62%); fetal loss increased with earlier gestational infection (first trimester: 67%, second trimester: 82%).

Conclusions:

• Monkeypox infection during pregnancy is linked to substantial risks of perinatal loss and vertical transmission.
• Preliminary findings underscore the critical need for vigilant maternal and fetal surveillance in monkeypox-affected pregnancies.
• Further research with larger cohorts is warranted to fully understand and manage these risks.