No association between influenza vaccination during pregnancy and adverse birth outcomes |
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| Institution: | 1. Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16B, Oakland, CA 94612, USA;2. National Vaccine Program Office, Office of the Assistant Secretary for Health, US Department of Health and Human Services, USA;1. Service de Pharmacologie Médicale, CHU Toulouse, Université de Toulouse, Inserm 1027, Toulouse, France;2. Caisse Primaire d’Assurance Maladie de la Haute-Garonne, CPAM, Toulouse, France;3. Service de Protection Maternelle et Infantile, Conseil Général de la Haute-Garonne, Toulouse, France;4. Centre de Diagnostic Anténatal, CDA, CHU Toulouse, Toulouse, France;5. Programme de Médicalisation des Systèmes d’Information; PMSI, CHU Toulouse, Toulouse, France;1. Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium;2. Agency for Care and Health, Infectious Disease Control and Vaccination, Brussels, Belgium;1. Global Health Center, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;2. Division of Infectious Disease, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;3. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;4. Seattle Children''s Hospital and Research Foundation, University of Washington, Seattle, WA, USA;5. School of Medicine, University of Washington, Seattle, WA, USA;6. Nepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal;7. Tribhuvan University, Department of Pediatrics and Child Health, Institute of Medicine, Kathmandu, Nepal;8. School of Medicine, University of Washington, Molecular Virology Laboratory, Seattle, WA, USA;9. Harborview Medical Center, Seattle, WA, USA;10. Department of Global Health Milken Institute School of Public Health, George Washington University, Washington, DC, USA;1. KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Leuven University Vaccinology Center (LUVAC), B-3000 Leuven, Belgium;2. KU Leuven, University of Leuven, Department of Public Health and Primary Care, Centre for Environment and Health, Youth Health Care, B-3000 Leuven, Belgium;3. KU Leuven, University of Leuven, Department of Development and Regeneration, Department of Obstetrics and Gynaecology, University Hospitals Leuven, B-3000 Leuven, Belgium;1. Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR 97227, USA;2. Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA;3. Abt Associates, 55 Wheeler Street, Cambridge, MA 02138, USA;4. Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA |
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| Abstract: | BackgroundPregnant women are recommended to receive inactivated influenza vaccination anytime during pregnancy. Studies have investigated the impact of influenza vaccination during pregnancy on birth outcomes and results on preterm birth have been inconsistent.MethodsWe conducted a retrospective cohort study among children born at a gestational age ≥ 24 weeks from January 1, 2010 to December 31, 2015 at Kaiser Permanente Northern California facilities (KPNC). We evaluated the association between maternal influenza vaccination during pregnancy and risk of preterm birth, small and large for gestational age, admission to the neonatal intensive care unit (NICU), respiratory distress syndrome, low birth weight, and low Apgar score. We ascertained the dates of maternal influenza vaccination, conception, and delivery, as well as birth outcomes from KPNC inpatient and outpatient databases. Conditional multivariate Cox regression and logistic regression analyses were used to determine the association between maternal vaccination during pregnancy and risk of each birth outcome.ResultsThe study included 145,869 children. Maternal influenza vaccination during pregnancy was not associated with risk of small or large for gestational age births, preterm birth, need for mechanical ventilation at birth, respiratory distress syndrome, admission to the NICU, low birth weight, or low Apgar score. However, when we did not control for immortal time bias, the risk of preterm birth (odds ratio OR] = 0.69, 95% confidence interval CI] 0.66–0.72) was lower among infants of vaccinated mothers.ConclusionWe found no association between maternal influenza vaccination during pregnancy and adverse birth outcomes. When investigating preterm birth outcome in association with vaccination during pregnancy, immortal time bias should be taken into account in the analysis. |
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| Keywords: | Maternal Influenza Vaccination Pregnancy Small for gestational age Preterm birth Low birth weight Immortal time bias |
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