Objective. To assess the effects of the inactivated influenza virus vaccine on influenza outcomes in pregnant women and their infants. Methods. We performed a systematic review of the literature. We searched for randomized controlled trials and cohort studies in the MEDLINE, Embase, and other relevant databases (inception to September 2013). Two researchers selected studies and extracted the data independently. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of the evidence. Results. We included eight studies out of 1,967 retrieved records. Influenza vaccination in pregnant women significantly reduced the incidence of influenza-like illness in mothers and their infants when compared with control groups (high-quality evidence) and reduced the incidence of laboratory-confirmed influenza in infants (moderate-quality evidence). No difference was found with regard to influenza-like illness with fever higher than 38°C (moderate-quality evidence) or upper respiratory infection (very-low-quality evidence) in mothers and infants. Conclusions. Maternal vaccination against influenza was shown to prevent influenza-like illness in women and infants; no differences were found for other outcomes. As the quality of evidence was not high overall, further research is needed to increase confidence and could possibly change these estimates. 1. Introduction Pregnant women and neonates are at greater risk for influenza-related complications than the general population [1, 2]. Most institutions and organizations recommend that all pregnant women receive the trivalent inactivated influenza virus vaccine [3–8]. Such endorsements rely on the immunogenic response of the mothers, the lack of teratogenicity, and the contrandication of immunization in children younger than six months [7, 9–11]. Despite the broad recommendation to vaccinate pregnant women against influenza, coverage is still limited. A survey held by the Centers for Disease Control and Prevention involving women who were pregnant from October 2011 to January 2012 showed that only half of the respondents had been vaccinated and fewer than 10% had received the vaccine before giving birth [12]. Similar patterns were found in previous studies [13]. Although there is clear evidence of the efficacy of the influenza vaccine for the general population [14], to our knowledge, a systematic approach with regard to the evidence of the therapeutic effects of influenza vaccination in pregnant women is lacking. Our objective is to review the effects of influenza
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