26-05-2025
Study Finds Link Between COVID Infection and Miscarriage—Experts Weigh in on the Risks
Fact checked by Sarah Scott
A recent study found that people infected with COVID before or during pregnancy are two to three times more likely to experience a miscarriage before week 20 of pregnancy. The study, which involved nearly 27,000 pregnancies, used electronic health records to determine the relationship between COVID and miscarriage from 2019 to 2023. They also looked at the incidence of ectopic pregnancy and preterm delivery.
The news is troubling, and might have parents to be feeling anxious. Here, Parents spoke with Micaela Sandoval, PhD, MPH, one of the study authors and an epidemiologist with UTHealth Houston, to explain what the study's results mean, and how you can keep yourself safe if you're planning to become pregnant.
Dr. Sandoval says the study revealed that the overall proportion of pregnancies that ended in miscarriage was 6%—still a low number, but higher among people who had COVID in the past.
"In our models, the odds of a pregnancy ending in miscarriage were 2.81 times higher among women who had had moderate to severe COVID-19 before getting pregnant, compared to women who had not had COVID-19 before getting pregnant."
Additionally, she says pregnant people who had moderate to severe COVID-19 in early pregnancy had 2.45 times greater odds of miscarriage compared to women who had no COVID-19 during their pregnancy.
"This study reviewed the incidence of miscarriage over time in their group of patients with a COVID-19 diagnosis, and compared it to the group of patients that did not have a COVID-19 infection before or during pregnancy," says Sasha Andrews, MD, a board-certified maternal-fetal medicine specialist at Pediatrix Medical Group in Denver, Colorado who is not affiliated with the study. "Interestingly, the miscarriage rate in this study was lower than the rate generally quoted, which is approximately 15% of recognized pregnancies." Studies indicate that this percentage of pregnancies result in miscarriage during the first trimester.
That said, the actual incidence of miscarriage, related to COVID or not, is difficult to determine and varies by the study population, adds Dr. Andrews. Many losses occur before the diagnosis of pregnancy, she says—in other words, before the person even knows they are pregnant or has the chance to see a doctor.
The authors also found that increasing age, Black or Hispanic ethnicity, and medical conditions were associated with an increased risk of miscarriage. These findings are consistent with other studies of pregnancies and miscarriage rates not affected by COVID-19, says Dr. Andrews.
COVID-19 can place significant stress on the body, especially during early pregnancy, when the baby is developing, says Amanda P. Williams, MD, MPH, FACOG, interim chief medical officer for the March of Dimes.
"Pregnancy makes a person more vulnerable to viruses like COVID-19 because the immune system shifts to support the growing baby," she explains.
When someone becomes infected during pregnancy, Dr. Williams says the immune system causes a strong inflammatory response that can negatively impact the growing placenta and fetus.
"COVID-19 may also cause high fevers, which is an established risk factor for pregnancy loss," she says. "In more severe cases, infection can impair placental function or limit oxygen delivery to the fetus. While research is still emerging, studies like this one add to the growing body of evidence that COVID-19 negatively affects pregnancy outcomes for both mom and baby."
According to Dr. Sandoval, these results demonstrate the importance of vaccination and post-COVID management in pregnant people or those planning to get pregnant.
"Women who are pregnant or are planning a pregnancy should talk to their doctor about the COVID-19 vaccine and management options," says Dr. Sandoval. "Additionally, pregnant women who think they might have COVID-19 should inform their provider as soon as possible to discuss available treatment or management strategies."
This study, like others before it, reinforces that miscarriage risk is influenced by many factors, many of which existed long before COVID-19 infection was so widespread, explains Dr. Williams.
"Advanced maternal age, chronic health conditions, and systemic inequities, particularly among communities of color, can all compound the risk," she adds.
Even without COVID-19 being a factor in your life, being 35 or older, having high blood pressure or diabetes, or experiencing socioeconomic stressors can increase the likelihood of pregnancy loss.
"What COVID seems to do is amplify those existing risks. For example, people from historically marginalized communities already face higher rates of maternal complications due to longstanding structural inequities, and they've also been disproportionately affected by COVID-19," says Dr. Williams.
Risks of miscarriage can also be influenced by smoking, alcohol, and diabetes, says Lauren Demosthenes, MD, an OB-GYN, senior medical director with Babyscripts, and associate professor at the University of South Carolina School of Medicine, Greenville. "But the main cause of first-trimester miscarriage is genetic abnormalities, which increase with the age of the mother."
In fact, approximately 50% of all cases of early pregnancy loss are due to fetal chromosomal abnormalities.
Although having a miscarriage is not always something that can be prevented, and you should not blame yourself or something you did if you experience pregnancy loss, there are things you can do to make sure you have the healthiest pregnancy possible. Here are some strategies you can implement to ensure you have a healthy pregnancy.
Make prenatal care a priority. Schedule your first prenatal visit as soon as you find out you're pregnant, and go to all your checkups, even if you feel fine, says Dr. Williams. "Early and regular prenatal care helps identify and manage potential issues before they become serious.
Talk to your provider about your COVID exposure. If you get COVID-19 or think you've been exposed, let your OB-GYN or midwife know, says Dr. Williams. They can guide you on what steps to take.
Discuss vaccines recommended in pregnancy. The COVID-19 vaccine and other recommended immunizations, such as Influenza, RSV, and Pertussis, are safe during pregnancy and can help protect you and your baby, says Dr. Williams. "Vaccination during pregnancy not just decreases the chance of infection for the pregnant person, but the new baby also gains protective antibodies, which is particularly important as newborns cannot receive many vaccinations until months later."
Manage chronic health conditions. Work with your provider to keep conditions like high blood pressure, diabetes, thyroid disease, and autoimmune disorders under control, says Dr. Williams. "These can increase the risk of complications if not well-managed during pregnancy."
Take care of your body. Get plenty of rest, eat nutritious meals, stay hydrated, and take a prenatal vitamin with folic acid, suggests Dr. Williams. "These habits support both immune health and fetal development. "
Avoid harmful substances and exposures. Don't smoke, drink alcohol, or use drugs during pregnancy, says Dr. Williams. Also, steer clear of toxic chemicals like paint thinners, pesticides, and secondhand smoke, she says.
Have an appropriate view of miscarriage and get support. According to Katherine Wolfe, DO, a maternal-fetal specialist and the director of the Diabetes and Pregnancy Program at Akron Children's, often the cause of miscarriage is an underlying genetic condition, and chromosomal microarray—in these instances, the loss was out of your control. "Miscarriage can be a devastating event, and emotional support is imperative."Aside from getting vaccinated, there are other things you can do to prevent COVID, says Dr. Wolfe. These include:
Practicing good hand hygiene
Avoiding contact with people who are sick
Improving air quality by filtering indoor air with an air purifier
Cleaning or replacing HVAC filters regularly
Planning social gatherings outside
Wearing a mask in crowded areasIf you test positive for COVID-19 in early pregnancy, contact your OB-GYN or midwife. They can help you understand what the infection might mean for your pregnancy and determine if additional monitoring or care is needed based on your health history.
Sometimes healthcare providers will recommend treating COVID with Paxlovid during pregnancy.
"Having COVID during pregnancy increases the risk of adverse pregnancy outcomes like preeclampsia and preterm delivery. It can also increase the risk of a more serious illness," says Dr. Demosthenes.
While it's normal to have concerns, a COVID infection doesn't guarantee complications or a miscarriage, adds Dr. Williams.
"Staying informed and connected to your healthcare provider is the best way to protect your health and your baby's. They're there to answer your questions and support you throughout your pregnancy."According to Dr. Andrews, COVID-19 has not been associated with fetal malformations, even when an infection occurs early in the first trimester. "Additionally, there are other studies that have not demonstrated an increased risk of miscarriage." Having COVID during pregnancy does not automatically mean you will experience the original article on Parents
