SynthesisObstetrics and gynecology2015
Risks Associated With Smallpox Vaccination in Pregnancy: A Systematic Review and Meta-analysis.
Synthesis in Obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Maternal and Pediatric Use of Vaccines for Mpox: A Living Systematic Review and Meta-analysis of Safety and Effectiveness.Drug safety · 2026Pooled it
- Paediatric, maternal, and congenital mpox: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- Viral threats to pregnancy: Global health risks in the era of pandemics.Advances in virus research · 2026Review
- The landscape of pregnancy and prepregnancy cohorts: a scoping review.BMC pregnancy and childbirth · 2025Article
- The mark of success: The role of vaccine-induced skin scar formation for BCG and smallpox vaccine-associated clinical benefits.Seminars in immunopathology · 2024Review
- Monkeypox disease and pregnancy. Where are we today? A review of literature.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Monkeypox and the perinatal period: what does maternal-fetal medicine need to know?World journal of pediatrics : WJP · 2023Review
- [Mpox and pregnancy: A neglected disease and its impact on perinatal health].Revista clinica espanola · 2023Review
- Monkeypox in pregnancy: virology, clinical presentation, and obstetric management.American journal of obstetrics and gynecology · 2022Review
- Monkeypox in Pregnancy: Susceptibility, Maternal and Fetal Outcomes, and One Health Concept.International journal of MCH and AIDS · 2022Article
- Fatal Cowpox Virus Infection in Human Fetus, France, 2017.Emerging infectious diseases · 2021Article
- Vaccines - safety in pregnancy.Best practice & research. Clinical obstetrics & gynaecology · 2021Review
- A reasoned approach towards administering COVID-19 vaccines to pregnant women.Prenatal diagnosis · 2021Review
- Pregnant women & vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response.Vaccine · 2021Review
- Plague and Pregnancy: Why Special Considerations Are Needed.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- General and reproductive health outcomes among female greenhouse workers: a comparative study.BMC women's health · 2020Article
- Vaccination strategies to enhance immunity in neonates.Science (New York, N.Y.) · 2020Review
- Precision immunization: a new trend in human vaccination.Human vaccines & immunotherapeutics · 2020Review
- Toward Understanding the Outcomes of Monkeypox Infection in Human Pregnancy.The Journal of infectious diseases · 2017Article
- Preparing for biological threats: Addressing the needs of pregnant women.Birth defects research · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo estimate the maternal and fetal risks of smallpox vaccination during pregnancy. DATA SOURCES: MEDLINE, Web of Science, EMBASE, Global Health, ClinicalTrials.gov, and CINHAL from inception to September 2014. METHODS OF STUDY SELECTION: We included published articles containing primary data regarding smallpox vaccination during pregnancy that reported maternal or fetal outcomes (spontaneous abortion, congenital defect, stillbirth, preterm birth, or fetal vaccinia). TABULATIONS, INTEGRATION, AND
resultsThe primary search yielded 887 articles. After hand-searching, 37 articles were included: 18 articles with fetal outcome data and 19 case reports of fetal vaccinia. Outcomes of smallpox vaccination in 12,201 pregnant women were included. Smallpox vaccination was not associated with an increased risk of spontaneous abortion (pooled relative risk [RR] 1.03, confidence interval [CI] 0.76-1.41), stillbirth (pooled RR 1.03, CI 0.75-1.40), or preterm birth (pooled RR 0.84, CI 0.62-1.15). When vaccination in any trimester was considered, smallpox vaccination was not associated with an increased risk of congenital defects (pooled RR 1.25, CI 0.99-1.56); however, first-trimester exposure was associated with an increased risk of congenital defects (2.4% compared with 1.5%, pooled RR 1.34, CI 1.02-1.77). No cases of fetal vaccinia were reported in the studies examining fetal outcomes; 21 cases of fetal vaccinia were identified in the literature, of which three neonates survived.
conclusionThe overall risk associated with maternal smallpox vaccination appears low. No association between smallpox vaccination and spontaneous abortion, preterm birth, or stillbirth was identified. First-trimester vaccination was associated with a small increase in congenital defects, but the effect size was small and based on limited data. Fetal vaccinia appears to be a rare consequence of maternal smallpox vaccination but is associated with a high rate of fetal loss.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.