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Impact of the COVID-19 pandemic on parvovirus B19 infection rates in pregnancy: is there a post-pandemic epidemic?

BMC Pregnancy and Childbirth volume 25, Article number: 512 (2025) Cite this article

Abstract

Objectives

Implemented public health measures to avoid the spread of SARS-CoV-2, influenced the circulation of various viral infections including parvovirus B19. Notably, pregnancies affected by parvovirus B19 have a high risk for severe fetal anemia and fetal demise. This study evaluates changes in parvovirus infection rates after the SARS-CoV-2 pandemic.

Methods

This was a retrospective cohort-study assessing the prevalence of parvovirus B19 among pregnant women at a tertiary referral center in Austria from January 2013 to December 2023 with particular interest in the influence of the COVID-19 pandemic on infection rates of parvovirus B19. Women who had PCR testing for parvovirus due to suspicion of infection were included in this study. To compare infection rates before, during, and after the pandemic, three study groups were defined in concordance with Austrian public health measures: A pre-pandemic group (Group 1) including all pregnant women who tested for parvovirus B19 from January 2013 to the beginning of the COVID-19 lockdown in March 2020, a pandemic group (Group 2) including all patients who had PCR testing during the COVID-19 lockdown and a post-pandemic group (Group 3) including all patients who had PCR testing from the end of the pandemic in April 2023 to December 2023.

Results

A total of 251 pregnant women who had PCR testing for parvovirus B19 during the study period were identified, including 27 women with a positive test result. In the pre-pandemic group (n = 141) 14 women had a positive test result, in the pandemic group (n = 83) 3 women tested positive and in the post-pandemic group (n = 27) 10 women tested positive. The overall prevalence of parvovirus B19 was 0.108, and annually, it varies from 0.000 in 2021 to 0.355 in 2023. Considering the predefined study groups, the highest prevalence was demonstrated in the post-pandemic group (0.370), whereas the lowest was in the pandemic group (0.036). In the pre-pandemic group, the prevalence was 0.099. Prevalence of the predefined study groups differed significantly (p ≤ 0.001).

Conclusion

This study demonstrates a significant rise of parvovirus B19 infections among pregnant women after the COVID-19 pandemic indicating a major impact of the pandemic and associated public health measures on parvovirus B19 infection rates.

Key message

The prevalence of parvovirus B19 among pregnant women increased significantly after the COVID-19 pandemic indicating a notable influence of implemented public health measures to reduce the spread of SARS-CoV-2 on the circulation of parvovirus B19. The reported findings should enhance clinicians’ awareness of parvovirus B19 infection among pregnant women, as the current risk for infections with parvovirus may be particularly pronounced.

Peer Review reports

Introduction

In December 2019 the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly known as coronavirus disease 2019 (COVID-19), began to spread around the world [1]. Implemented non-pharmaceutical interventions against SARS-CoV-2 including social distancing, heightened hand hygiene and the mandatory use of facemasks in public, have not only been effective against the targeted coronavirus but have also significantly altered incidences of various other viral infections. Recent studies reported that actions to reduce the spread of COVID-19 have also led to a reduction of other infections, including Influenza and parvovirus B19 [2,3,4,5]. The latter is of significant importance in pregnancy, since infections with parvovirus B19 can cause severe fetal complications such as fetal anemia [6].

The human parvovirus, widely known as the causative agent for erythema infectiosum [6, 7] is a single-stranded DNA virus [8] transmitted by respiratory droplets [9] or, in rare cases, by blood products [10]. Infections with parvovirus B19 occur globally following a seasonal variation with a peak during the spring and early summer months [7, 9, 11]. While most infections in immunocompetent adults remain asymptomatic, parvovirus can cause severe complications during pregnancy when it is vertically transmitted to the fetus [6, 7, 12]. In early pregnancy it can lead to pregnancy loss. In contrast, in later gestation it can cause fetal anemia, potentially resulting in fetal hydrops and intrauterine death [13] due to its tropism to erythroid precursors, leading to a suppression of erythropoiesis [12, 14].

Approximately 25% of all women of reproductive age have not been exposed to parvovirus B19 and, therefore, have not developed immunity against the virus [6]. Consequently, these women are at risk of being infected during pregnancy, especially if they have contact with children in preschool or school-age or are exposed to children at their workplace since parvovirus B19 infection is a common childhood disease typically occurring among children this age [6, 7, 15]. To prevent adverse fetal outcome, it is crucial to identify infections with parvovirus B19 early and to monitor affected women for signs of fetal anemia closely [16]. Yet, universal screening for parvovirus B19 is currently not recommended since routine screening may not yield significant benefits in reducing early pregnancy loss or fetal anemia [17].

However, in the clinical management of pregnant women it is essential to be aware of the current incidences and localized viral epidemics that may pose a risk to the patient ensuring a prompt initiation of appropriate diagnostic and therapeutic strategies. Despite historical periodic parvovirus B19 outbreaks [18], this study assumes a significant rise in parvovirus infections following the COVID-19 pandemic, potentially due to non-pharmaceutical actions. Due to the stringent actions implemented by the Austrian government on March 16th, 2020, to reduce the spread of SARS-CoV-2, including comprehensive lockdowns and the mandatory use of FFP2 masks in public lasting until April 30th, 2023 [19,20,21], consequences on the circulation of other viral infections may be particularly pronounced. Recently, Russcher et al. [22] reported an increased incidence of parvovirus B19 among pregnant women in Belgium, the Netherlands and France leading to severe fetal morbidity and mortality. However, studies investigating the incidences of parvovirus B19 infections among pregnant women after the COVID-19 pandemic are scarce.

The aim of this study is to assess the changes of parvovirus B19 infection rates among pregnant women after the SARS-CoV-2 pandemic.

Methods

Study design and participants

This was a retrospective cohort study evaluating infection rates of parvovirus B19 among pregnant women from January 2013 to December 2023. Pregnant women aged 18 years and older who had polymerase chain reaction (PCR) testing for parvovirus B19 of maternal blood or amniotic fluid samples at the Department of Obstetrics and Gynecology of the Medical University of Vienna, Austria during the defined study period were included. Testing for parvovirus was conducted due to suspected infection with parvovirus such as in the presence of maternal symptoms, contact with already infected individuals, or signs of existing fetal anemia since there is no routine screening for parvovirus implemented in Austria. However, in case of an intrauterine death routine testing for congenital infection is performed. This study defined three different study groups according to the Austrian public health regulations due to the COVID-19 pandemic. Study groups were specified as followed: A pre-pandemic group (Group 1) including all pregnant women who tested for parvovirus B19 from January 2013 to the beginning of the COVID-19 lockdown on March 16th, 2020; a pandemic group (Group 2) including all patients who had PCR testing during the COVID-19 lockdown lasting from March 16th, 2020 to the end of April 2023 and a post-pandemic group (Group 3) including all patients who had PCR testing from the beginning of May 2023 to December 2023.

Primary outcome data comprised the quantitative parvovirus B19 PCR result, parvovirus immunoglobin (Ig) M and G status, testing date, and reason for testing. Furthermore, collected data included patient characteristics such as maternal age, weight, height, and body mass index (BMI) as well as general obstetric data like gestational age (GA) at the time of testing, parity (parous or nulliparous), pregnancy complications including fetal anemia defined by a peak systolic flow (PSV) in the middle cerebral artery (MCA) > 1.5 mean multiples of the median (MoM) according to the current ISUOG practice guidelines [23], fetal treatment during pregnancy (intrauterine transfusion), GA at delivery, mode of delivery and reason for delivery. Neonatal outcome data that have been assessed included neonatal APGAR score, neonatal pH, neonatal intensive care unit (NICU) admission, and perinatal morbidity such as the need for blood transfusion postnatally, required ventilation postnatally, diagnosed respiratory distress syndrome (RDS) or diagnosed intraventricular hemorrhage (IVH). All data were retrospectively retrieved from the electronic patient records (© ViewPoint, Version 5.6.28.56).

Austrian public health regulations

Austrian legislative public health measures to contain infections with SARS-CoV-2 took effect on March 16th, 2020 [24]. Besides general hygienic measures such as heightened hand hygiene and quarantine in case of a positive COVID-19 test result, the implemented law included a strict curfew and closing of public facilities in the first pandemic peak. Leaving home was only permitted to shop food, care for people in need or go to work if it was declared as “essential” work such as health care work [25]. Furthermore, childcare facilities and schools were open only to children whose parents had to work, and school lessons took place virtually [25].

In May 2020, implementations were relaxed gradually for the first time. Further public health measures were constantly adapted to the respective viral circulation. However, when tested positive, essential interventions such as the mandatory filtering facepiece (FFP) 2 face mask in public places or legally obligatory quarantine were continued. The FFP 2 face mask requirement for COVID-negative individuals was dependent on the current infection rate. The first COVID-19 vaccine was available in December 2020 [26]. On April 30th, 2023, social distancing and non-pharmaceutical measures were definitively terminated in Austria, particularly marked by the end of the compulsory wearing of a filtering FFP 2 face mask.

Testing methods

In cases where parvovirus B19 infection is suspected (maternal symptoms, fetal abnormalities compatible with congenital infection or exposure to parvovirus B19), an initial blood sample is obtained for serological and PCR analysis. If the results are inconclusive, a follow-up blood sample is drawn for further evaluation. PCR and serological testing for parvovirus B19 was performed at the Department of Laboratory Medicine, Division of Clinical Virology, using a real-time qPCR assay (Altona RealStar Parvovirus B19 Kit 1.0 and starting from January 2023 the AltoStar Parvovirus B19 PCR Kit 1.5 on the AltoStar AM16 Automation System, all Altona Diagnostics, Hamburg, Germany) with a quantitative measurement range of 250 copies/mL to 109 copies/mL for both test kits. All patients had either serum or amniotic fluid samples analyzed. Newborns of women diagnosed with parvovirus B19 infection during pregnancy were tested after birth using neonatal blood for serology and PCR if admitted to the neonatal intensive care unit (NICU).

Statistical methods

For data analysis the IBM SPSS® software platform (SPSS 23.0; SPSS Inc, Chicago, IL) was used, as well as R version 4.4.1 [27] and packages ggplot2 version 3.5.1 [28], viridis version 0.6.5 [29], and Barnard version 1.8 [30].

The prevalence of parvovirus B19 infections was calculated for each predefined study group and each year from 2013 to 2023. For demographic characteristics as well as for secondary outcomes descriptive statistics were presented. Continuous data were given as mean ± standard deviation (SD). Discrete data were presented as numbers and percentages. Differences in study groups were analyzed using either ANOVA (numerical data) or the \(\:\chi\:2\)-test (categorical data). Additionally, for the primary outcome post hoc tests were employed (Barnard’s). A p-value below 0.05 was considered statistically significant for all testing.

Results

Participants

Throughout the study period a total of 251 pregnant women had PCR testing for parvovirus B19, of which 141 women were classified into study group one, 83 into study group two and 27 into study group

Three of the included patients, 243 (96.8%) patients had PCR testing of maternal blood samples, 7 women (2.8%) had PCR testing of the amniotic fluid and one patient (0.4%) had testing of both materials (Fig. 1). Included women had a mean (± SD) gestational age (GA) at the time of PCR testing of 24.3 (\(\:\pm\:\)6.58) gestational weeks. In group 1 mean GA (± SD) was 23.5 (±6.88), in group 2 25.7 (±5.34) and in group 3 23.6 (±7.81). GA at testing differed significantly between the study groups (p = 0.044). The minimum GA at the time of testing was 8.0 gestational weeks; the latest timepoint of testing during gestation was 40.1 gestational weeks. Baseline demographic characteristics and obstetric data of included women are shown in Table 1.

Table 1 Comparison of the demographic characteristics and parvovirus B19 prevalence of the three study groups
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Fig. 1
figure 1

Flow chart of all included and excluded patients

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Reason for testing

178 women (70.9%) had testing due to sonographic fetal abnormalities including fluid effusion in at least one fetal cavity (n = 61, 34.3%), polyhydramnios (n = 43, 24.2%), fetal growth bellow the 10th centile (n = 33, 18.5%), abnormal lateral ventricles (n = 23, 12.9%), hyperechogenic bowel (n = 15, 8.4%), cardiomegaly (n = 13, 7.3%), altered maximum flow velocity (Vmax) in the middle cerebral artery (n = 13, 7.3%), hepatomegaly (n = 6, 3.4%), cerebral bleeding (n = 6, 3.4%) or other fetal brain abnormalities (n = 5, 2.8%). 19 (10.7%) of the women who had testing due to fetal abnormalities had the diagnosis of intrauterine death. Further 19 women (7.6%) had testing due to prior exposure to parvovirus B19 and 22 women (8.8%) had testing because of maternal clinical symptoms such as rash, fever or joint pain. In 32 cases (12.7%) the reason for testing was unknown. (Table 2)

Table 2 Reason for parvovirus B19 testing in the three study groups
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When stratifying all cases by gestational age at the time of testing, dividing them into groups before and after the 20th week of gestation, reason for testing differed significantly between both groups (p < 0.001). Since reason for testing before the 20th week of gestation is homogeneous (fetal abnormality 39.2%, exposure to parvovirus B19 15.7%, maternal symptoms 17.6%, unknown 27.5%), testing due to fetal abnormalities dominates after 20th weeks of gestation (fetal abnormality 79.4%, exposure to parvovirus B19 5.5%, maternal symptoms 6.5%, unknown 8.5%).

Parvovirus B19 infection rates

In the observed study cohort, 27 women had a positive parvovirus PCR test, resulting in an overall parvovirus B19 prevalence of 0.108 in the observed study cohort. In the pre-pandemic study group (study group 1) 14 women tested positive, in the pandemic study group (study group 2) 3 women tested positive and in the post-pandemic study group (study group 3) 10 women tested positive. Therefore, prevalence based on the predefined study groups was 0.099 in group 1, 0.036 in group 2, and 0.370 in group 3. Hence, parvovirus B19 prevalence was highest in the post-pandemic group and lowest in the pandemic group. The Chi Square test showed a significant difference in the infection rates between the study groups (p \(\:\le\:\) 0.001). The post hoc tests (Bernard’s) showed a significant difference between group 1 and group 3 (p = 0.0014) as well as between group 2 and group 3 (p \(\:\le\:\) 0.001). The comparison of group 1 and group 2 did not reach significance (p= 0.0902) (Fig. 2).

Fig. 2
figure 2

Percentage of patients presenting with Parvovirus B19 before, during and after the COVID-19 pandemic

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The annual prevalence ranged from 0.000 in 2021 to 0.355 in 2023. Table 3 and Fig. 3 show the prevalence of parvovirus B19 per annum from 2013 to 2023. Overall quantitative PCR test results ranged from 200 copies/ml to 1.46*1011 copies/ml. All women who tested positive for parvovirus underwent maternal blood PCR testing only, no amniocentesis was performed to assess for congenital infection.

Table 3 Annual prevalence of parvovirus B19 during the study period (2013–2023)
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Fig. 3
figure 3

Annual prevalence of parvovirus B19 among pregnant women during the study period spanning from 2013 to 2013

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Immunoglobin levels

Immunoglobin levels were analyzed in 226 patients (90.04%). 168 (74.34%) had positive Ig-G levels, indicating a given immunity against parvovirus B19 at time of testing. Positive Ig-M levels were diagnosed in 24 patients (10.62%), and two women (0.88%) had borderline positive Ig-M levels. Seven patients had positive Ig-M levels despite no detectable viral load in PCR testing (3.13%). Thereof 6 women had consecutive positive Ig-G levels and one had negative Ig-G levels. Conversely, nine women had negative Ig-M levels despite a positive PCR test result (33.33%). Of these cases, 8 women had positive Ig-G levels and one had consecutive negative Ig-G levels.

Pregnancy complications and neonatal outcome

Pregnancy data were available for 202 patients (80.48%) including 18 women with a positive PCR test result (Table 4). In pregnancies with a positive PCR test result 9 women (50%) experienced serious pregnancy complications, including fetal anemia subsequently resulting in fetal hydrops (n = 5, 27.78%), hydrops fetalis only (n = 1, 5.56%), polyhydramnios (n = 1, 5.56%) and fetal growth restriction (n = 2, 11.12%). Mean PSV of the MCA in cases with anemia was 54.58 cm/sec with a range of 38.00 to 70.00 cm/sec. Mean multiples of the median (MoM) was 1.98 ranging from 1.50 to 2.49. Two of the five cases with fetal anemia experienced intrauterine death (IUD) (n = 2, 11.12%). Notably, the patient with fetal hydrops only experienced simultaneously hepatis B infection and was subsequently diagnosed with fetal hydrops most likely due to hepatitis without signs of fetal anemia. One patient (5.56%) had termination of pregnancy due to severe fetal hydrops and brain abnormalities caused by anemia. Intrauterine transfusion (IUT) was administered in 3 pregnancies (16.67%) with a positive PCR test result. Of those, one woman received only one IUT, one had two IUTs and one had three IUTs. The mean GA (± SD) at the time of the first IUT was 22.2 (± 2.81) gestational weeks.

Table 4 Pregnancy complications in women with a positive parvovirus B19 test result
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Outcome data were available in 191 patients (76.10%) (Table 5) including 18 women with a positive PCR test result and 19 fetuses (Table 6). Livebirth was conceived in 15 out of the 18 cases affected by parvovirus (83.33%), resulting in 16 liveborn neonates of which 5 women experienced preterm birth (31.25%). The mean arterial pH of the umbilical artery at birth was 7,28 (± 0,06), ranging from 7,17 to 7,36. All of the 16 newborns had an APGAR score > 7. In five neonates (31.25%), neonatal complications with admission to a neonatal intensive care unit (NICU) were reported. Neonatal infection with parvovirus B19 was confirmed only in two cases.

Table 5 Pregnancy outcomes of the three study groups
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Table 6 Neonatal outcomes in all livebirths with parvovirus B19 positive mothers
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Discussion

In this retrospective cohort study, rates of infection with parvovirus B19 among pregnant women at a tertiary referral center in Austria were analyzed over the last 10 years with particular interest in the influence of the COVID-19 pandemic on the circulation of parvovirus B19. Interestingly, it was shown that the prevalence of parvovirus B19 was significantly higher after the pandemic compared to earlier time periods during and before the COVID-19 pandemic, indicating a significant rise of parvovirus B19 infections possibly due to loosening of public health measures, including social distancing, heightened hygienic standards and the mandatory use of face-masks.

The reported study results implicate a significant influence of the COVID-19 pandemic on parvovirus B19 infection rates among pregnant women in Austria. Notably, a significant increase in parvovirus infection rates after the COVID-19 pandemic was demonstrated. Similar findings were reported by Russcher et al. [22] in Belgium, the Netherlands and France, Fourgeaud et al. [31] in France and Patalon et al. [32] in Israel. A potential cause for the observed increase may be a developed immune gap due to public health measures to contain the spread of SARS-CoV-19 and the subsequent low viral circulation during this period [32]. The significantly lower prevalence of parvovirus during the COVID-19 pandemic compared to pre- and post-pandemic time periods could also be shown in this study accordingly. The latter results are in line with the current literature demonstrating low parvovirus B19 rates during the COVID-19 pandemic [31, 33]. Furthermore, while no significant difference was observed between the pre-pandemic and pandemic group, a notable difference was found between the pre- and post-pandemic group, supporting the “immune-gap theory”. Since parvovirus B19 is a common childhood disease typically occurring among children in preschool or school-age [6, 7], closed schools and day care centers may have had a significant impact on altered parvovirus B19 infection rates. However, the influence of the COVID-19 pandemic on parvovirus B19 infection rates might be particularly pronounced in Austria since regulations have been relatively strict in comparison to other countries.

Interestingly, GA at the testing time significantly differed when comparing the three study groups. GA at the time of testing was significantly higher in the pandemic group compared to the pre- and post-pandemic group (p = 0.044). A potential reason could be a general delay in accessing medical facilities during the COVID-19 pandemic. However, studies investigating the impact of the pandemic on the time from symptom onset to diagnosis are currently scarce. Lee et al. demonstrated in a longitudinal cohort study that on-time routine childhood vaccinations were significantly reduced during the first wave of the COVID-19 pandemic [34]. In a systematic review that compared the initial tumor stage of the time of cancer diagnoses pre- and post-COVID-19 by Marty et al., a higher rate of metastatic tumors at the time of first diagnosis after the COVID-19 pandemic was reported [35]. These findings may indicate a potential delay in the initial presentation at a medical facility during the pandemic, but further investigations are needed to validate the reported study findings.

As reported in this study, there was a considerable discrepancy between the serological and PCR results in some cases. There were seven cases of positive Ig-M levels with no detectable viral load in the PCR testing which might be due to cross-reactivity with other pathogens, such as Epstein-Barr virus or autoimmune conditions, or persistent parvovirus B19-IgM levels [36]. In contrast, there were nine patients in this study who had negative Ig-M levels in spite of a positive PCR test. In acutely infected individuals, high levels of the virus can form immune complexes with parvovirus B19 specific antibodies, interfering with antibody detection and leading to false-negative results [36]. Furthermore, during the early phase of infection, parvovirus B19-IgM and IgG antibodies may not have reached detectable levels, resulting in false-negative serology [37, 38]. If the time of exposure during an epidemic cannot be precisely determined, parvovirus B19 Ig-G may be detectable, while parvovirus B19 Ig-M levels may already have fallen below detection limits. In some cases, the presence of parvovirus B19-IgG without IgM may indicate premature clearance of Parvovirus B19-IgM and might be misinterpreted [36]. However, this finding is in line with current literature [36, 37] and supports the approach of this study to refer to PCR results.

Among all reported study results, the increase in parvovirus infection rates after the COVID-19 pandemic is of particular clinical importance. Since screening for parvovirus B19 during pregnancy is currently not recommended by international guidelines [23], the potential clinical and economic advantages of a screening system should be reevaluated, considering the increased prevalence. Even though this change may be temporary, at least the awareness of practicing clinicians should be raised considering the currently higher viral circulation of parvovirus B19.

To the best of our knowledge, this is the first comprehensive cohort study investigating the influence of the COVID-19 pandemic on parvovirus B19 infection rates among pregnant women. The observed period of 10 years enabled a comprehensive analysis of parvovirus B19 rates and irregular outbreaks. Still, this study has some limitations: Due to the character of a tertiary center this study potentially misses data regarding pregnancy and neonatal outcomes of included patients with mild or uncomplicated pregnancy courses. Patients with parvovirus infection during early pregnancy who experienced pregnancy loss may be underrepresented in this study, potentially leading to a notable inclusion bias. However, loss of follow-ups did not influence the analysis of the primary outcome since participants with lacking data for secondary outcomes were included in the primary analysis. Furthermore, this was a monocentric study only. Given that COVID-19 occurred globally and affected pregnant women in multiple regions, external validation is needed to confirm the reported study results and the conclusions drawn on the influence of public health measures.

Conclusion

In conclusion, this study demonstrates a significant rise in parvovirus B19 infection rates among pregnant women after the COVID-19 pandemic. A potential reason for the reported increase in parvovirus B19 infection rates may be the implemented public health measures leading to a relevant immune gap and thereby influencing the circulation of other viruses, such as parvovirus B19.

Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at the Medical University of Vienna.

Abbreviations

COVID-19:

Coronavirus disease 2019

BMI:

Body mass index

FFP:

Filtering face piece

GA:

Gestational age

Ig:

Immunoglobin

IUD:

Intrauterine death

IUT:

Intrauterine transfusion

IVH:

Intraventricular hemorrhage

MoM:

Multiples of the median

NICU:

Neonatal intensive care unit

PCR:

Polymerase Chain Reaction

RDS:

Respiratory distress syndrome

Rt:

Reverse transcriptase

SARS-CoV-2:

Severe acute respiratory syndrome coronavirus 2

SD:

Standard deviation

Vmax:

Maximum flow velocity

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Christina Haberl, Nawa Schirwani-Hartl, Pilar Palmrich, Valentina Oblin, Florian Heinzl & Julia Binder

  2. Department of Laboratory Medicine, Division of Clinical Virology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Nicole Perkmann-Nagele

Authors
  1. Christina Haberl
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Contributions

All authors contributed either to research design (C.H. and J.B.) and/or the data acquisition (C.H., V.O., N.P.-N. and J.B.), analysis (C.H. and F.H.) or interpretation (all authors) of data. C.H. and J.B. drafted the manuscript, which was critically revised by all other authors.

Corresponding author

Correspondence to Julia Binder.

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Ethical approval

The study was approved by the local ethics committee of the Medical University of Vienna (1791/2023). The study was conducted in accordance with the current version of the Helsinki Declaration. Due to the retrospective study design the ethics committee waived the need for informed consent.

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Haberl, C., Schirwani-Hartl, N., Palmrich, P. et al. Impact of the COVID-19 pandemic on parvovirus B19 infection rates in pregnancy: is there a post-pandemic epidemic?. BMC Pregnancy Childbirth 25, 512 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12884-025-07575-3

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Keywords

BMC Pregnancy and Childbirth

ISSN: 1471-2393

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