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J Obstet Gynaecol Can . Impact of the coronavirus disease-2019 (COVID-19) pandemic on reproductive outcomes in patients with recurrent pregnancy lo

tetano

Editor, Senior Moderator
J Obstet Gynaecol Can


. 2026 Jul 13:103457.
doi: 10.1016/j.jogc.2026.103457. Online ahead of print.
Impact of the coronavirus disease-2019 (COVID-19) pandemic on reproductive outcomes in patients with recurrent pregnancy loss

Savitha Balachandran[SUP] 1 [/SUP], Bahi Fayek[SUP] 1 [/SUP], Sabina Dobrer[SUP] 2 [/SUP], Sarka Lisonkova[SUP] 3 [/SUP], Paul J Yong[SUP] 1 [/SUP], K S Joseph[SUP] 3 [/SUP], Mohamed A Bedaiwy[SUP] 4 [/SUP]


Affiliations
Abstract

Objectives: To assess the impact of the COVID-19 pandemic on reproductive outcomes in patients with recurrent pregnancy loss (RPL) and the influence of material and social deprivation on these outcomes.
Methods: This retrospective cohort study included RPL patients seen at a specialized clinic between March 1, 2018, and February 28, 2022. Patients were categorized into two groups based on care period: pre-pandemic (March 1, 2018-February 29, 2020) and pandemic (March 1, 2020-February 28, 2022). Cumulative probabilities of birth were estimated using the cumulative incidence function within a competing risk framework, treating pregnancy loss as a competing event. Fine and Gray regression models calculated sub-distribution hazard ratio (sHR) of birth.
Results: 544 patients were included in the study, with 255 in the pre-pandemic group and 289 in the pandemic group. Individuals in the pandemic group were less likely to achieve pregnancy than those in the pre-pandemic group (relative risk = 0.50, 95% confidence interval [CI] 0.39 - 0.66). Among those who conceived, the cumulative probability of live birth was 0.77 in both groups. Relative to individuals residing in high-social deprivation neighborhoods, those living in moderately deprived areas had higher sub-distribution hazards of live birth (adjusted sHR = 1.97, 95% CI 1.25 - 3.10; P = 0.003).
Conclusion: Within specialized RPL care and a universal maternity care system, pregnancy rates were lower during the first two years of the COVID-19 pandemic. However, among those who conceived, the probability of achieving a live birth remained similar between the pre-pandemic and pandemic periods.

Keywords: COVID-19 pandemic; Recurrent Pregnancy Loss; live birth; material deprivation; pregnancy loss; social deprivation.

 
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