The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, was first identified after a cluster of cases in Wuhan, China in December 2019. Whether vertical transmission or placental pathology might occur following maternal infection during pregnancy remains unknown. This review aimed to summarise all studies that examined the placenta or neonates following infection with SARS-CoV-2, or closely related highly pathogenic coronavirus (SARS-CoV-1, or the Middle East respiratory syndrome coronavirus (MERS-CoV)). Structured literature searches found 50 studies that met the inclusion criteria. Twenty studies reported placental histopathology findings in third trimester placentas following maternal SARS-CoV-2 infection. Using the Amsterdam Consensus criteria to categorise the histopathology results, evidence of both fetal vascular malperfusion (35.3% of cases; 95% Confidence Interval (CI) 27.7–43.0%) and maternal vascular malperfusion (46% of cases; 95% CI 38.0–54.0%) were reported, along with evidence of inflammation in the placentas (villitis 8.7% cases, intervillositis 5.3% of cases, chorioamnionitis 6% of cases). The placental pathologies observed in SARS-CoV-2 were consistent with findings following maternal SARS-CoV-1 infection. Of those tested, a minority of neonates (2%) and placental samples tested positive for SARS-CoV-2 infection (21%). Limited conclusions can be drawn about the effect of maternal SARS-CoV-2 infection on placental pathology as most lack control groups and the majority of reports followed third trimester infection. Collaboration to maximise the number of samples examined will increase the reliability and generalisability of findings. A better understanding of the association between maternal SARS-CoV-2 infection and placental pathology will inform maternity care during the coronavirus pandemic.

Abstract1. Understanding how plant diversity influences higher trophic levels is important for predicting the consequences of global biodiversity loss. While early studies have focused on the effects of plant species richness, more recently a growing number of experiments have explored the effects of plant intraspecific diversity by manipulating the genotypic richness of plant communities.2. By combining 162 estimates of effect size from 60 experimental studies, we examined the effects of plant genotypic richness on arthropods, one of the most diverse and abundant taxa which play a crucial role in many ecosystem processes and services. We have also compared the effects of plant genetic and species diversity on arthropods when both were manipulated within the same study.3. Species richness and abundance of most trophic groups of arthropods were higher in genetically diverse plant stands. Interestingly, the effects of plant genetic diversity on natural enemies of herbivores were stronger than the effects of plant genetic diversity on herbivores, suggesting that plant genetic diversity effects on predators might be driven by mechanisms independent of herbivores.4. Herbivore and predator abundance increased with plant genetic diversity in studies using wild plants whereas predator abundance was unaffected and herbivore abundance was reduced by crop genetic diversity. Damage by generalist herbivores was reduced by plant genetic diversity whereas damage by specialist herbivores was not affected.5. When the effects of plant genetic and species diversity on arthropods were compared within the same study, the magnitude of plant genetic diversity effects was comparable to that of plant species diversity. 6. Our results suggest that plant genetic diversity has significant effects on the diversity of arthropods across several trophic levels, thus highlighting the importance of maintaining high levels of both plant species and genetic diversity for arthropod conservation. However, the potential of using crop genetic mixtures in agriculture for pest control appears to be limited as even though herbivore abundance was reduced in genetically diverse plots, herbivore damage and predator abundance were not affected by crop genotypic richness. K E Y W O R D Sassociational resistance, biodiversity, community genetics, genetic diversity, herbivory, natural enemies, plant-insect interactions, tritrophic interactionsThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

BackgroundAlthough exempt, many pregnant Muslim women partake in the daily fast during daylight hours during the month of Ramadan. In other contexts an impoverished diet during pregnancy impacts on birth weight. The aim of this systematic review was to determine whether Ramadan fasting by pregnant women affects perinatal outcomes. Primary outcomes investigated were perinatal mortality, preterm birth and small for gestational age (SGA) infants. Secondary outcomes investigated were stillbirth, neonatal death, maternal death, hypertensive disorders of pregnancy, gestational diabetes, congenital abnormalities, serious neonatal morbidity, birth weight, preterm birth and placental weight.MethodsSystematic review and meta-analysis of observational studies and randomised controlled trials was conducted in EMBASE, MEDLINE, CINAHL, Web of Science, Google Scholar, the Health Management Information Consortium and Applied Social Sciences Index and Abstracts. Studies from any year were eligible. Studies reporting predefined perinatal outcomes in pregnancies exposed to Ramadan fasting were included. Cohort studies with no comparator group or that considered fasting outside pregnancy were excluded, as were studies assuming fasting practice based solely upon family name. Quality of included studies was assessed using the ROBINS-I tool for assessing risk of bias in non-randomised studies. Analyses were performed in STATA.ResultsFrom 375 records, 22 studies of 31,374 pregnancies were included, of which 18,920 pregnancies were exposed to Ramadan fasting. Birth weight was reported in 21 studies and was not affected by maternal fasting (standardised mean difference [SMD] 0.03, 95% CI 0.00 to 0.05). Placental weight was significantly lower in fasting mothers (SMD -0.94, 95% CI -0.97 to  -0.90), although this observation was dominated by a single large study. No data were presented for perinatal mortality. Ramadan fasting had no effect on preterm delivery (odds ratio 0.99, 95% CI 0.72 to 1.37) based on 5600 pregnancies (1193 exposed to Ramadan fasting).ConclusionsRamadan fasting does not adversely affect birth weight although there is insufficient evidence regarding potential effects on other perinatal outcomes. Further studies are needed to accurately determine whether Ramadan fasting is associated with adverse maternal or neonatal outcome.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2048-y) contains supplementary material, which is available to authorized users.