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

Smriti Prasad, Erkan Kalafat, Helena Blakeway, Rosemary Townsend, Pat O'Brien, Edward Morris, Tim Draycott, Shakila Thangaratinam, Kirsty Le Doare, Shamez Ladhani, Peter von Dadelszen, Laura A Magee, Paul Heath, Asma Khalil

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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.

Original languageEnglish
Article number2414
Pages (from-to)2414
JournalNature Communications
Issue number1
Publication statusPublished - 10 May 2022

Keywords / Materials (for Non-textual outputs)

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


Dive into the research topics of 'Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy'. Together they form a unique fingerprint.

Cite this