evidence: Vaccination, in general, is usually safe during pregnancy, except for live attenuated vaccines9,10. However, the efficacy and safety of COVID-19 vaccination in pregnancy are unclear. Most COVID-19 vaccine trials failed to include pregnant women due to ethical concerns and the generalizability of the resulting data11,12. Animal data regarding the AstraZeneca vaccine’s usage in pregnancy has been reassuring, without any complications seen in comparable doses in mice13. In addition, data received from unintentionally vaccinated pregnant women from the COVID-19 immunization registry has thus far shown very few complications related to vaccine safety14. However, the lack of clinical trials still may make some women hesitant to receive COVID-19 vaccines, and this is an area where additional data is greatly needed15. Therefore, we performed this systematic review and meta-analysis to compare the maternal and neonatal outcomes between vaccinated pregnant and unvaccinated pregnant women, as well as to determine the antibody titers patterns of COVID-19 antibodies in both maternal and umbilical cord samples, and to determine the efficacy of vaccinations against COVID-19 administered during pregnancy to prevent COVID-19 infection.