MSAF was associated with an increase in the rate of pathological fetal heart rate patterns, intrapartum fevers, operative vaginal and cesarean section deliveries, need for neonatal resuscitation, low Apgar scores and higher fetal-neonatal mortality. Moreover, we found that the risks increase as the staining and consistency of the amniotic fluid evolves so it should alert the obstetrician and paediatrician to the potential adverse outcomes.

Research Question: Is there an association between SARS-CoV-2 infection and firsttrimester miscarriage?Design: Multicenter prospective study of a cohort of first-trimester miscarriages registered consecutively by seven Spanish hospitals, where universal PCR screening for SARS-CoV-2 infection was implemented for both, miscarriages and deliveries. The incidence of SARS-CoV-2 infection among first-trimester miscarriages was compared to the one registered in women at admission on delivery ward within the same timeframe using a mixed-effects Poisson regression analysis, considering hospital as random effect. On the other hand, the characteristics of SARS-CoV-2 positive and negative patients who miscarried were compared through two-sided univariable analyses.Results: 301 miscarriages were registered, 11 (3.7%) SARS-CoV-2 infected and 290 non-infected. No differences in terms of SARS-CoV-2 infection incidence were observed between miscarriages and deliveries [1,936 deliveries were registered at the same time of miscarriages and 44 (2.3%) were SARS-CoV-2 infected] (p= 0.233). Regarding the differences observed between SARS-CoV-2 positive and negative patient miscarriages, more inevitable miscarriages occurred in the group of infected women (36.4% vs 16.5% in non-infected, p= 0.004), as well as more surgical management of miscarriages (27.3% vs 8.2% in non-infected, p= 0.036), which is probably in line with the greater number of inevitable miscarriages observed in this group.Conclusions: No association between SARS-CoV-2 infection and risk of first-trimester miscarriage has been observed; however, the type of miscarriage seems to be different between SARS-CoV-2 positive and negative women, with inevitable miscarriage being more frequent among infected women.

MSAF was associated with an increase in the rate of pathological fetal heart rate patterns, intrapartum fevers, operative vaginal and cesarean section deliveries, need for neonatal resuscitation, low Apgar scores and higher fetal-neonatal mortality. Moreover, we found that the risks increase as the staining and consistency of the amniotic fluid evolves so it should alert the obstetrician and paediatrician to the potential adverse outcomes.

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