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Monkeypox virus in pregnancy, do we have sufficient evidence?

Published:November 09, 2022DOI:https://doi.org/10.1016/j.ajogmf.2022.100806
      The article of D'Antonio and colleagues 1, demonstrated the effect of monkeypox infection on both maternal and fetal outcomes. Despite that the authors gathered all the relevant literature regarding the specified outcomes, the results of this paper should be interpreted with severe caution. Firstly, the authors did a meta-analysis of four case reports in which three case reports contained only one patient. According to Murad et al 2, single case report's inclusion in meta-analysis progress to biased results in either positive or negative directions. Therefore, meta-analysis is not the right approach to report the literature review regarding maternal and fetal outcomes in monkeypox infected pregnancies, and only qualitative approach is recommended for such scarcity of data -ie too many single case reports- based upon Murad et al recommendations 2. Secondly, there is a high probability of a duplicate patient in the studies of, Ogoina et al 3, and Yinka-Ogunleye et al 4, as both studies conducted in Nigeria in the same outbreak (2017-2018) and the outcomes were the same in both studies.

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      R eferences

      • 1. D'Antonio F, Pagani G, Buca D, Khalil A. Monkeypox infection in pregnancy: a systematic review and meta-analysis. American journal of obstetrics & gynecology MFM. 2022:100747.
      • 2. Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ evidence-based medicine. 2018;23(2):60-63.
      • 3. Ogoina D, Iroezindu M, James HI, et al. Clinical Course and Outcome of Human Monkeypox in Nigeria. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2020;71(8):e210-e214.
      • 4. Yinka-Ogunleye A, Aruna O, Dalhat M, et al. Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report. The Lancet Infectious diseases. 2019;19(8):872-879.