The key COVID-19 findings in reproductive health, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.
INSIDE THIS MONITOR
34cited sources
21available findings
Study findings updated
AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.
THE SHORT VERSION
What’s worth knowing.
The key findings, what they mean, and the context that matters.
THE HEADLINE TAKEAWAY
Prior vaccination was linked to lower preterm-birth hazard after infection
In the Swedish register-based cohort, women infected during pregnancy who had prior vaccination had lower preterm-birth hazard than infected women without previous vaccination. Both groups had higher hazard than non-infected women.
This was an observational comparison, so it does not establish a causal vaccine effect. The reported measures were relative hazards against non-infected women, not absolute risk differences.
See the evidence
Preterm-birth hazard among vaccinated and unvaccinated infected women, each compared with non-infected women; vaccinated infected women had significantly lower risk than women infected without prior vaccination.
aHR 1.6 for vaccinated infected women versus 3.2 for infected women without previous vaccination; p for homogeneity=0.007 95% CI: 1.2-2.2 and 2.3-4.3, respectively
Berglin, Lisa et al.. Severe acute respiratory syndrome coronavirus 2 and preterm birth, clinical implications-A register-based cohort study from Sweden.. Pregnancy (Hoboken, N.J.). 2025.
COVID-19 in pregnancy was linked to intensive care and preterm birth
A living systematic review and meta-analysis associated COVID-19 in pregnancy with higher maternal intensive care admission and higher odds of preterm birth.
The reference groups for these odds estimates are not available in this summary, so their magnitudes are not featured.
See the evidence
Maternal ICU
+404% OR 5.04 (95% CI: 3.13-8.10)
Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
Higher maternal ICU admission risk with COVID-19 in pregnancy
5x
Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
Maternal COVID-19 was associated with mortality across variant periods
In delivery-related hospitalizations in the United States, maternal COVID-19 was associated with higher adjusted odds of in-hospital mortality in the Pre-Alpha, Alpha, Delta, and first Omicron periods.
The same study reported higher adjusted odds of fetal death at 20 or more weeks in the Pre-Alpha and Delta periods. The reference group for these associations is not available in this summary, so magnitudes are not featured.
See the evidence
Adjusted odds of in-hospital mortality associated with COVID-19 during the Delta period among delivery-related hospitalizations
aOR 29.47; adjusted p<.001
Kilday, Deborah et al.. Association between COVID-19 by variant period and delivery-related outcomes in the United States.. PloS one. 2026.
Pandemic-era birth outcomes diverged by country income
18%higher relative odds
Stillbirth had 18% higher relative odds in low- and middle-income countries during pandemic versus prepandemic periods; neonatal-death odds were lower in high-income countries over the same periods.
This systematic review and meta-analysis compared pandemic with prepandemic periods; it did not compare pregnancies by infection status. Overall preterm-birth odds and births before 28 weeks in high-income countries were also lower.
See the evidence
18% higher relative odds, calculated from OR 1.18. This is not an absolute percentage-point difference.
Stillbirth rates increased in low- and middle-income countries during pandemic
OR 1.18 95% CI 1.02-1.36
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Neonatal deaths reduced in high-income countries during pandemic
OR 0.78 95% CI 0.64-0.95
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Preterm births decreased during pandemic period compared to pre-pandemic
OR 0.95 95% CI 0.94-0.97
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Greatest reduction for births <28 weeks' gestation in high-income countries
OR 0.92 95% CI 0.88-0.96
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Likely Long COVID showed no clear preterm-delivery difference
No clear difference
Among previously infected participants, the primary analysis found no clear difference in preterm delivery between those with likely Long COVID and those without it.
A sensitivity analysis also found no clear preterm-delivery difference. Higher rates of hypertensive disorders of pregnancy with likely Long COVID than without it appeared only in the average treatment effect among the treated sensitivity analysis. This does not prove equal risk.
See the evidence
The reported result does not establish a difference; it does not prove equivalence.
No significant association between likely Long COVID and preterm delivery in the primary average treatment effect analysis among previously infected participants
Increased risk of hypertensive disorders of pregnancy with likely Long COVID, observed only in the average treatment effect among the treated sensitivity analysis
Likely Long COVID showed no clear preterm-delivery difference
No clear difference
Among previously infected participants, adjusted preterm-delivery rates were 8.1% with likely Long COVID and 9.6% without it; the primary analysis found no clear difference.
A sensitivity analysis also found no clear preterm-delivery difference. Higher rates of hypertensive disorders of pregnancy with likely Long COVID than without it appeared only in the average treatment effect among the treated sensitivity analysis.
Study details & original results
Metz, Torri D et al.. Pregnancy Outcomes in Individuals With Long COVID.. Obstetrics and gynecology. 2026.
No significant association between likely Long COVID and preterm delivery in the primary average treatment effect analysis among previously infected participants
No significant association between likely Long COVID and preterm delivery in the average treatment effect among the treated sensitivity analysis
ARR 1.11 95% CI: 0.60-2.06
Increased risk of hypertensive disorders of pregnancy with likely Long COVID, observed only in the average treatment effect among the treated sensitivity analysis
The Swedish register-based cohort reported elevated preterm-birth hazard within 2 weeks of SARS-CoV-2 infection after excluding women admitted for infection; elevation was also reported at 2 weeks or more.
The reference group for the timing analyses is not available in this summary. Separately, prior vaccination was linked to lower hazard among infected women than no previous vaccination; each infected group was compared with non-infected women.
Study details & original results
Berglin, Lisa et al.. Severe acute respiratory syndrome coronavirus 2 and preterm birth, clinical implications-A register-based cohort study from Sweden.. Pregnancy (Hoboken, N.J.). 2025.
Preterm birth within 2 weeks of infection after excluding women admitted for SARS-CoV-2 infection.
aHR 2.8 95% CI: 2.4-3.3
Preterm-birth hazard 2 weeks or more after the start of SARS-CoV-2 infection.
aHR 1.2; p=0.016 95% CI: 1.0-1.4
Preterm-birth hazard among vaccinated and unvaccinated infected women, each compared with non-infected women; vaccinated infected women had significantly lower risk than women infected without prior vaccination.
aHR 1.6 for vaccinated infected women versus 3.2 for infected women without previous vaccination; p for homogeneity=0.007 95% CI: 1.2-2.2 and 2.3-4.3, respectively
COVID-19 was associated with severe delivery outcomes across variant periods
In delivery-related hospitalizations in the United States, COVID-19 was associated with higher adjusted odds of in-hospital mortality in the Pre-Alpha, Alpha, Delta, and first Omicron periods.
Fetal death at 20 or more weeks also had higher adjusted odds in the Pre-Alpha and Delta periods. The reference group for these associations is not available in this summary.
Study details & original results
Kilday, Deborah et al.. Association between COVID-19 by variant period and delivery-related outcomes in the United States.. PloS one. 2026.
Adjusted odds of in-hospital mortality associated with COVID-19 during the Delta period among delivery-related hospitalizations
aOR 29.47; adjusted p<.001
Adjusted odds of in-hospital mortality associated with COVID-19 during the first Omicron period among delivery-related hospitalizations
aOR 3.55; adjusted p=.04
Adjusted odds of in-hospital mortality associated with COVID-19 during the Alpha period among delivery-related hospitalizations
aOR 13.03; adjusted p<.001
Adjusted odds of in-hospital mortality associated with COVID-19 during the Pre-Alpha period among delivery-related hospitalizations
aOR 13.11; adjusted p<.001
Adjusted odds of fetal death at 20 or more weeks associated with maternal COVID-19 during the Delta period
aOR 3.37; p<.001 CI: 2.95-3.84
Adjusted odds of fetal death at 20 or more weeks associated with maternal COVID-19 during the Pre-Alpha period
No significant association between likely Long COVID and preterm delivery in the primary average treatment effect analysis among previously infected participants
Increased risk of hypertensive disorders of pregnancy with likely Long COVID, observed only in the average treatment effect among the treated sensitivity analysis
Berglin, Lisa et al.. Severe acute respiratory syndrome coronavirus 2 and preterm birth, clinical implications-A register-based cohort study from Sweden.. Pregnancy (Hoboken, N.J.). 2025.
Preterm birth within 2 weeks of a positive SARS-CoV-2 test at 22-27, 28-31, and 32-36 gestational weeks, respectively; gestational age at infection significantly interacted with the hazard ratio.
Added
aHR 6.0, 6.1, and 3.2; interaction p=0.04795% CI: 3.9-9.2, 4.4-8.4, and 2.7-3.7, respectivelySource [33]
Preterm-birth hazard 2 weeks or more after the start of SARS-CoV-2 infection.
Preterm-birth hazard among vaccinated and unvaccinated infected women, each compared with non-infected women; vaccinated infected women had significantly lower risk than women infected without prior vaccination.
Added
aHR 1.6 for vaccinated infected women versus 3.2 for infected women without previous vaccination; p for homogeneity=0.00795% CI: 1.2-2.2 and 2.3-4.3, respectivelySource [33]
SOURCE 326 findings
Kilday, Deborah et al.. Association between COVID-19 by variant period and delivery-related outcomes in the United States.. PloS one. 2026.
Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
-26%WMD -25.56 M/mL (95% CI: -33.56 to -17.55)Source [2]
SOURCE 031 finding
Li K, et al. The effect of SARS-CoV-2 infection and COVID-19 vaccination on menstrual cycle: a systematic review and meta-analysis. Reproductive Biology and Endocrinology. 2022;20(1):112.
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Browse the 34 original sourcesThe complete bibliography behind this monitor.
[1]
Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
Huang C, et al. Effect of COVID-19 on male reproductive system - A systematic review. Human Reproduction Update. 2022;28(1):1-17.
Original source link unavailable
[3]
Li K, et al. The effect of SARS-CoV-2 infection and COVID-19 vaccination on menstrual cycle: a systematic review and meta-analysis. Reproductive Biology and Endocrinology. 2022;20(1):112.
Original source link unavailable
[4]
Villar J, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatrics. 2021;175(8):817-826.
Original source link unavailable
[5]
Tur-Kaspa I, et al. COVID-19 may transiently affect male fertility. Fertility and Sterility. 2022;117(3):e6-e7.
Original source link unavailable
[6]
Salonia A, et al. SARS-CoV-2 infection and male reproductive health: a one-year follow-up study. Andrology. 2022;10(1):64-72.
Original source link unavailable
[7]
Phelan N, et al. The impact of COVID-19 infection on menstrual patterns and reproductive health. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2022;269:49-53.
Original source link unavailable
[8]
Edelman A, et al. Association between menstrual cycle length and coronavirus disease 2019 (COVID-19) vaccination: A U.S. cohort. Obstetrics & Gynecology. 2022;139(4):481-489.
Original source link unavailable
[9]
Alviggi C, et al. ART and reproductive outcomes in COVID-19 recovered patients: a systematic review. Reproductive BioMedicine Online. 2022;45(3):555-566.
Original source link unavailable
[10]
Kotlyar AM, et al. Vertical transmission of coronavirus disease 2019: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology. 2021;224(1):35-53.e3.
Original source link unavailable
[11]
Wesselink AK, et al. A prospective cohort study of COVID-19 vaccination, SARS-CoV-2 infection, and fertility. American Journal of Epidemiology. 2022;191(8):1383-1395.
Original source link unavailable
[12]
Bowe B, et al. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. 2022;28(11):2398-2405.
Male V. Menstrual changes after COVID-19 vaccination. BMJ. 2022;376:o142.
Original source link unavailable
[14]
Sansone A, et al. Mask up to keep it up: Preliminary evidence of the association between erectile dysfunction and COVID-19. Andrology. 2021;9(4):1053-1059.
Original source link unavailable
[15]
Nguyen NT, et al. Association of COVID-19 with erectile dysfunction. JAMA Network Open. 2022;5(1):e2143843.
Original source link unavailable
[16]
Yang M, et al. Pathological findings in the testes of COVID-19 patients: clinical implications. Cellular and Molecular Immunology. 2020;17(7):762-764.
Original source link unavailable
[17]
Ediz C, et al. Is there any association of COVID-19 with testicular pain and epididymo-orchitis? Andrologia. 2022;54(1):e14302.
Original source link unavailable
[18]
Wang M, et al. Impact of COVID-19 on ovarian reserve markers. Journal of Ovarian Research. 2022;15(1):78.
Original source link unavailable
[19]
Cavalcante MB, et al. COVID-19 and female fertility: A systematic review. Reproductive BioMedicine Online. 2022;44(4):567-579.
Original source link unavailable
[20]
Kolanska K, et al. Impact of prior COVID-19 infection on IVF outcomes. Human Reproduction. 2021;36(6):1696-1704.
Original source link unavailable
[21]
DeSisto CL, et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization. MMWR Morb Mortal Wkly Rep. 2021;70(47):1640-1645.
Original source link unavailable
[22]
Zambrano LD, et al. Update: Characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-1647.
Original source link unavailable
[23]
Gacci M, et al. Semen impairment and occurrence of SARS-CoV-2 virus in semen after recovery from COVID-19. World Journal of Men's Health. 2022;40(2):287-296.
Original source link unavailable
[24]
Kresch E, et al. COVID-19 endothelial dysfunction can cause erectile dysfunction: histopathological, immunohistochemical, and ultrastructural study of the human penis. World Journal of Men's Health. 2021;39(3):466-469.
Original source link unavailable
[25]
Shimabukuro TT, et al. Preliminary findings of mRNA COVID-19 vaccine safety in pregnant persons. New England Journal of Medicine. 2021;384(24):2273-2282.
Original source link unavailable
[26]
Kharbanda EO, et al. Spontaneous abortion following COVID-19 vaccination during pregnancy. JAMA. 2021;326(16):1629-1631.
Original source link unavailable
[27]
American Society for Reproductive Medicine (ASRM). ASRM patient management and clinical recommendations during the coronavirus (COVID-19) pandemic: Update #18. 2022.
Original source link unavailable
[28]
Royal College of Obstetricians and Gynaecologists (RCOG). Coronavirus (COVID-19) infection in pregnancy. Information for healthcare professionals. Version 15. 2022.
Original source link unavailable
[29]
European Society of Human Reproduction and Embryology (ESHRE). ESHRE guidance on recommencing ART treatments. 2022.
Original source link unavailable
[30]
Society for Maternal-Fetal Medicine (SMFM). Management considerations for pregnant patients with COVID-19. 2022.
Original source link unavailable
[31]
Peart, S R et al.. Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.. Journal of paediatrics and child health. 2026.
Berglin, Lisa et al.. Severe acute respiratory syndrome coronavirus 2 and preterm birth, clinical implications-A register-based cohort study from Sweden.. Pregnancy (Hoboken, N.J.). 2025.
This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.
Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.