Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Nat Commun. 2022 May 10;13(1):2414. doi: 10.1038/s41467-022-30052-w.


Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73-0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Placenta
  • Pregnancy
  • Premature Birth* / epidemiology
  • RNA, Messenger
  • SARS-CoV-2
  • Stillbirth / epidemiology
  • Vaccination


  • COVID-19 Vaccines
  • RNA, Messenger

Associated data

  • figshare/10.6084/m9.figshare.19375493.v1