Fernández-García, SilviaDel Campo-Albendea, LauraSambamoorthi, DharshiniSheikh, JameelaLau, KarenOsei-Lah, NanaRamkumar, AnoushkaNaidu, HarshithaStoney, NicoleSundaram, PaulSengupta, PaulomiMehta, SamayAttarde, ShrutiMaddock, SophieManning, MillieMeherally, ZainitaAnsari, KehkashanLawson, HeidiYap, MagnusKew, TaniaPunnoose, AndriyaKnight, ChloeSadeqa, EynaCherian, JiyaRavi, SangamithraChen, WentinWalker, KateO'Donoghue, Keelinvan Wely, Madelonvan Leeuwen, ElizabethKostova, ElenaKunst, HeinkeKhalil, AsmaBrizuela, VanessaKara, EdnaKim, Caron RahnThorson, AnnaOladapo, Olufemi TMofenson, LynneGottlieb, Sami LBonet, MercedesMoss, NgawaiZamora, JavierAllotey, JohnThangaratinam, Shakila2024-05-222024-05-222024-04-04Fernández-García S, Del Campo-Albendea L, Sambamoorthi D, Sheikh J, Lau K, Osei-Lah N, Ramkumar A, Naidu H, Stoney N, Sundaram P, Sengupta P, Mehta S, Attarde S, Maddock S, Manning M, Meherally Z, Ansari K, Lawson H, Yap M, Kew T, Punnoose A, Knight C, Sadeqa E, Cherian J, Ravi S, Chen W, Walker K, O'Donoghue K, van Wely M, van Leeuwen E, Kostova E, Kunst H, Khalil A, Brizuela V, Kara E, Kim CR, Thorson A, Oladapo OT, Mofenson L, Gottlieb SL, Bonet M, Moss N, Zamora J, Allotey J, Thangaratinam S; PregCOV-19 Living Systematic Review Consortium. Effectiveness and safety of COVID-19 vaccines on maternal and perinatal outcomes: a systematic review and meta-analysis. BMJ Glob Health. 2024 Apr 4;9(4):e014247. doi: 10.1136/bmjgh-2023-014247.2059-790810.1136/bmjgh-2023-01424738580375http://hdl.handle.net/20.500.14200/4607Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women).en© World Health Organization 2024. Licensee BMJ.Obstetrics. MidwiferyArticleBMJ global health