{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:25:18Z","timestamp":1791404718815,"version":"4.3.3"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) is a leading cause of hospitalization and mortality in early infancy. Maternal immunization offers a preventive strategy, but uncertainties regarding safety and economic value have limited its implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To synthesize phase 3 randomized trial evidence on the efficacy and safety of maternal RSV vaccination and to estimate its potential population and economic impact. By integrating a scenario\u2010based modeling framework derived from pooled meta\u2010analytic estimates, this review provides high\u2010certainty, policy\u2010relevant evidence to guide maternal immunization strategies in diverse settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>PubMed, MEDLINE, Scopus, and Google Scholar were searched up to April 2025 using predefined terms for RSV vaccination, pregnancy, and randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Phase 3 RCTs comparing maternal RSV vaccination with placebo and reporting neonatal or maternal outcomes were included. Non\u2010randomized studies, monoclonal antibody trials, or reports lacking extractable data were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Two reviewers independently screened studies, extracted data, and assessed risk of bias (RoB\u20102). Pooled risk ratios (RR) and absolute risk differences were calculated with random\u2010effects models. Certainty of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE). A scenario\u2010based cost\u2010effectiveness model was applied to the Mexican birth cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Four phase 3 RCTs (17\u2009391 women) were included. Maternal RSV vaccination halved the risk of infant RSV infection (risk ratio [RR] 0.47, 95% confidence interval [CI]: 0.29\u20130.76; number needed to vaccinate [NNV] 85) and reduced severe disease by 64% (RR 0.36, 95% CI: 0.21\u20130.60; NNV 127). No increased risks were observed for preterm birth, pre\u2010eclampsia, or stillbirth. Certainty was moderate (any RSV) to high (severe RSV). In Mexico, universal vaccination at list price (US$295 per dose) would prevent approximately 20\u2009769 infections and 228 neonatal deaths annually, though with high costs per case averted. At public\u2010sector pricing (US$50 per dose), cost\u2010effectiveness improved substantially.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maternal RSV vaccination is effective, safe, and potentially cost\u2010justifiable in high\u2010burden settings, supporting its integration into national immunization programs.<\/jats:p>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content>\n                      registration: CRD420251014636 (March 2025).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70641","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:53:01Z","timestamp":1762325581000},"page":"63-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Maternal\n                    <scp>RSV<\/scp>\n                    vaccination for infant protection: A systematic review and meta\u2010analysis of phase 3 trials with an integrated economic evaluation"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9524-4133","authenticated-orcid":false,"given":"Johnatan","family":"Torres\u2010Torres","sequence":"first","affiliation":[{"name":"Department of Reproductive and Perinatal Health Research Instituto Nacional de Perinatolog\u00eda Isidro Espinosa de los Reyes  Mexico City Mexico"},{"name":"Obstetric and Gynecology Department Hospital General de M\u00e9xico \u201cDr Eduardo Liceaga\u201d  Mexico City Mexico"},{"name":"Iberoamerican Research Network in Obstetrics Gynecology and Translational Medicine  Mexico City 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