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Review
. 2025 Jun 24:2025:6115890.
doi: 10.1155/cjid/6115890. eCollection 2025.

The Effectiveness and Influence of COVID-19 Vaccination on Perinatal Individuals and Their Newborns: An Updated Meta-Analysis

Zi-Jin Lei  1 , Min-Xi Bai  2 , Min-Jue Li  1 , Peng Jin  1 , Yu-Bin Ding  3   4
Affiliations
Review

The Effectiveness and Influence of COVID-19 Vaccination on Perinatal Individuals and Their Newborns: An Updated Meta-Analysis

Zi-Jin Lei et al. Can J Infect Dis Med Microbiol. .

Abstract

Background: The COVID-19 pandemic has disproportionately affected pregnant individuals, increasing risks of severe illness and adverse outcomes. While vaccination is a key mitigation strategy, initial exclusion from clinical trials led to limited safety data. Despite evidence of vaccine effectiveness, hesitancy persists in this population. Objective and Sources: This meta-analysis aims to evaluate the efficacy and impact of COVID-19 vaccination in pregnant individuals, synthesizing evidence from 82 studies (3,676,654 participants) retrieved from PubMed, Embase, Cochrane Library, and Scopus (2019-2024). Study quality was assessed using the Newcastle-Ottawa scale (80/82 scored ≥ 7). Key Findings: Vaccination reduced maternal SARS-CoV-2 infection risk by 48% (odds ratio [OR] = 0.52), with mRNA vaccines showing higher efficacy (52% vs. 43% for inactivated). Maternal hospitalization risk decreased by 42% (OR = 0.58), and severe outcomes by 50% (OR = 0.50). Furthermore, neonatal outcomes improved, including reduced infection (OR = 0.69), preterm birth (OR = 0.87), stillbirth (OR = 0.64), and neonatal death (OR = 0.47). Protection against neonatal death was stronger in individuals without prior infection (OR = 0.43). Third-trimester vaccination may offer better protection against preterm birth. Conclusion: Overall, COVID-19 vaccination during pregnancy effectively mitigates infection and adverse maternal/neonatal outcomes, supporting its clinical recommendation.

Keywords: COVID-19 vaccination; neonatal health; obstetric outcomes; pregnancy; vaccine efficacy; vaccine safety.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram documenting study identification, screening, and analysis. PRISMA, preferred reporting items for systematic reviews and meta-analyses.
Figure 2
Figure 2
Forest plots showing the results of meta-analyses for maternal outcomes. (a) Infections in mother, (b) maternal hospitalization, (c) severe maternal outcomes.
Figure 3
Figure 3
Forest plots showing the results of meta-analyses for neonatal outcomes. (a) Infant infection, (b) neonatal hospitalization, (c) NICU (neonatal intensive care unit).
Figure 4
Figure 4
Forest plots showing the results of meta-analyses for preterm birth.
Figure 5
Figure 5
Forest plots showing the results of meta-analyses for neonatal death.
Figure 6
Figure 6
Forest plots showing the results of meta-analyses for stillbirth.
See this image and copyright information in PMC

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