An analysis of data from over 1.2 million pregnant women found that those who received a COVID-19 vaccination had a 58% lower risk of being infected with the virus, as well as a lower risk of experiencing a stillbirth or preterm birth, according to research presented during the American Academy of Pediatrics 2025 National Conference & Exhibition at the Colorado Convention Center from Sept. 26-30.
For the study, “Safety and Efficacy of Maternal COVID-19 Vaccination During Pregnancy: Umbrella Review & Meta-Analyses,” the author conducted a systematic search of PubMed, Scopus, Web of Science, and Embase from Jan. 1, 2021, to Sep. 13, 2023. She included 23 meta-analyses inclusive of over 200 studies and 1,250,000 pregnant individuals with documented COVID-19 vaccination.
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“We found that the COVID-19 vaccination during pregnancy offers significant protections to newborns and mothers,” said Nikan Zargarzadeh, study author and Harvard University research fellow. “This information can help support informed decision-making for pregnant individuals and their care teams.”
Preterm birth
The review found those who received a COVID-19 vaccination during pregnancy had an 8% lower risk of preterm birth before 37 weeks and a 34% lower risk of preterm birth before 28 weeks.
Vaccination was also associated with an 25% lower risk of stillbirth and an 9% lower risk of neonatal intensive care admission, as well as a 17% lower risk of congenital anomalies, according to the study abstract. There were no increased risks observed for maternal hospitalization, intensive care admission, gestational diabetes, hypertension, or pre-eclampsia.
The authors did not receive financial support for this research.
Study author Nikan Zargarzadeh is scheduled to present her research, which is below, on Saturday, Sept. 27, 2025, 3:45 p.m. – 3:55 p.m. in the Colorado Convention Center, Mile High Ballroom 2A-3A.
The abstract
The safety & efficacy of COVID-19 vaccination during pregnancy are critical not only for maternal and fetal health, but also for informing public health policy and preparedness for future pandemics. To date, no comprehensive umbrella review has synthesized meta-analysis evidence on both the safety and efficacy of COVID-19 vaccination in this population. This study aims to address this significant knowledge gap.
We conducted a systematic search of PubMed, Scopus, Web of Science, and Embase from 01/01/2021 to 09/13/2023. We included 23 meta-analyses inclusive of over 200 studies and 1,250,000 pregnant individuals with documented COVID-19 vaccination. Risk Ratios (RRs) and pooled proportions were calculated using R, employing random-effects models and Egger’s test for publication bias (PROSPERO registration: CRD42024519174).
COVID vaccination during pregnancy reduced maternal COVID-19 infection rates (Risk Ratio [RR] 0.41, 95% CI 0.30-0.57), stillbirth (RR 0.75, 95% CI 0.58-0.98), PTB ≤37 weeks (RR 0.92, 95% CI 0.86-0.99). No significant risk differences were observed among other outcomes, except for a marginal increased risk of cesarean delivery (RR 1.07, 95% CI 1.01-1.12).
Through this umbrella review of comprehensive meta-analyses, including data from over 1.2 million pregnant individuals, we demonstrate significant benefits of COVID-19 vaccination with high confidence and no associated increase in risk. These quantifiable benefits can support informed shared decision-making and enhance public health communication strategies during this and future pandemics.
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