evidence: A total of 15 studies were included. We found that maternal vaccination during pregnancy was related to the reduction rates of Preterm, SGA, Low Apgar score at 5 min (<7). In addition, there was no evidence of a higher risk of adverse neonatal outcomes after maternal vaccination of COVID-19 during pregnancy, including NICU admission, preterm birth with gestation <34 weeks, low birth weight, very low birth weight, congenital anomalies, and so on. [...] Thus, we conducted a systematic review and meta-analysis of published data mainly concerning neonatal outcomes after maternal COVID-19 vaccination. In the present study, the main neonatal outcomes are preterm, SGA, NICU admission, and low 5 min Apgar score (<7). In population-based larger cohorts published from Israel, Canada, Sweden, and Norway, and the US, except for data from Canada, all three other studies reported that COVID-19 vaccination during pregnancy was not significantly associated with an increased risk for adverse neonatal outcomes.27,29,31,32 After pooling all of these data, our results showed not only no increased risk from maternal vaccination but also lower rates of adverse neonatal outcomes among those born to individuals vaccinated during pregnancy. As shown in Fig. 2 and Table 2, 17%, 7%, and 8% decreases in the odds of preterm, SGA, and low 5 min Apgar score (<7) were associated with COVID-19 vaccination when compared with unvaccination during pregnancy, respectively. These results may gain confidence to improve the acceptance of vaccines among pregnant women.