{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:56:42Z","timestamp":1790708202708,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007083","name":"Orionin Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) is a major cause of infant morbidity and mortality worldwide. Recent preventive strategies include maternal vaccination and monoclonal antibodies. However, maternal RSV vaccination has raised safety concerns due to possible associations with preterm birth. This systematic review and meta\u2010analysis evaluated whether maternal RSV vaccination increases the risk of preterm birth and neonatal intensive care unit (NICU) admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Scopus, and Web of Science was conducted on August 1st, 2025. We used the following keywords in the search: RSV, vaccine, preterm, and neonate. Eligible studies included randomized controlled trials (RCTs) and observational studies assessing currently approved RSV\u2010PreF vaccines in pregnancy and reporting preterm birth (&lt;\u200937 weeks) or NICU admission. Data extraction and risk of bias assessments (RoB 2.0, ROBINS\u2010I) were performed independently by two reviewers. Meta\u2010analyses were conducted using random\u2010effects models with risk ratios (RRs) as effect measures, and the certainty of evidence was graded using the GRADE framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven studies met inclusion criteria: three RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912,833 births) and four observational studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094245 births). In RCTs, RSV vaccination was associated with an increased risk of preterm birth (RR 1.26, 95% CI 1.08\u20131.46), while observational studies showed no association (RR 0.78, 95% CI 0.46\u20131.32). Pooled analysis revealed no overall association (RR 0.96, 95% CI 0.68\u20131.38). NICU admission risk was not significantly affected (RR 0.74, 95% CI 0.34\u20131.61). Certainty of evidence was rated low to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta\u2010analysis found no overall evidence linking maternal RSV vaccination to preterm birth, though RCT subgroup findings suggest a potential increased risk. Continued surveillance and long\u2010term safety monitoring are essential as global implementation expands.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Open Science Framework (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/osf.io\/3tfkn\/\">https:\/\/osf.io\/3tfkn\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70510","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:12:05Z","timestamp":1788937925000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["RSV\u2010Pre\u2010F Vaccination During Pregnancy and Neonatal Outcomes\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"14","author":[{"given":"Niko","family":"Leskinen","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjut","family":"Haapanen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Mikkeli Central Hospital Mikkeli Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-9610","authenticated-orcid":false,"given":"Ilari","family":"Kuitunen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"},{"name":"Department of Pediatrics and Neonatology Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa754"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30938-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00138-7"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.60735"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2216480"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens14020104"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.24082"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2025.2521912"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2305478"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p1021"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.17595"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-081903"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2024.114144"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1101\/2024.07.14.24310390"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.19268"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005817"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad024"},{"key":"e_1_2_12_23_1","unstructured":"\u201c150 Million Babies Born Preterm in the Last Decade \u201d cited August 7 2025 https:\/\/www.unicef.org\/press-releases\/150-million-babies-born-preterm-last-decade."},{"key":"e_1_2_12_24_1","unstructured":"\u201cRespiratory Syncytial Virus (RSV) \u201d cited August 8 2025 https:\/\/www.who.int\/groups\/global-advisory-committee-on-vaccine-safety\/topics\/rsv."},{"key":"e_1_2_12_25_1","unstructured":"\u201cWER10031\u2010eng\u2010fre.pdf \u201d cited August 8 2025 https:\/\/iris.who.int\/bitstream\/handle\/10665\/382141\/WER10031-eng-fre.pdf."},{"key":"e_1_2_12_26_1","unstructured":"\u201cWER10022\u2010eng\u2010fre.pdf \u201d cited August 8 2025 https:\/\/iris.who.int\/bitstream\/handle\/10665\/381539\/WER10022-eng-fre.pdf?sequence=1."},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(25)00155-5"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2024.126164"}],"container-title":["Immunity, Inflammation and 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