The Safety of Influenza and Pertussis Vaccination in Pregnancy in a Cohort of Australian Mother-Infant Pairs, 2012-2015: The FluMum Study.

IF 7.3 1区医学 Q1 IMMUNOLOGY Clinical Infectious Diseases Pub Date : 2019-01-18 DOI:10.1093/cid/ciy517

Lisa McHugh, Helen S Marshall, Kirsten P Perrett, Terry Nolan, Nicholas Wood, Stephen B Lambert, Peter Richmond, Robert S Ware, Paula Binks, Michael J Binks, Ross M Andrews

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引用次数: 27

Abstract

Background: Inactivated influenza vaccine (IIV) and pertussis vaccination are recommended in pregnancy. Limited safety data exist for women who received IIV vaccine during the first trimester of pregnancy or received both vaccines in pregnancy. We assessed adverse birth outcomes between vaccinated and unvaccinated pregnancies.

Methods: Among prospectively enrolled Australian "FluMum" participants (2012-2015), primary exposure was receipt and timing of IIV during pregnancy. Primary outcomes included preterm birth, low birthweight at term (LBWT), and small for gestational age (SGA). We compared birth outcomes for IIV in pregnancy with women unvaccinated in pregnancy using Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs). Adjusted HRs (aHRs) controlled for potential confounding variables. Sensitivity analyses were conducted in a subgroup of women who received pertussis vaccination during pregnancy to assess whether associations between IIV and adverse outcomes were maintained after adjusting for pertussis vaccination.

Results: Among 8827 participants in our study, women who received IIV in pregnancy did not have an elevated risk of an adverse birth outcome compared with unvaccinated pregnant women: preterm births (HR, 1.10 [95% CI, .92-1.31]; P = .28); LBWT (HR, 1.05 [95% CI, .76-1.44]; P = .77); or SGA (HR, 0.99 [95% CI, .86-1.15]; P = .94). Adjustment for pertussis vaccination during pregnancy yielded similar results: preterm births (aHR, 1.05 [95% CI, .82-1.34]; P = .69); LBWT (aHR, 0.81 [95% CI, .50-1.29]; P = .37); SGA (aHR, 0.92 [95% CI, .74-1.14]; P = .43). There was no evidence of elevated risk by trimester of IIV.

Conclusions: No significant associations were found between maternal IIV or pertussis vaccination in pregnancy and adverse birth outcomes, regardless of the trimester of pregnancy a vaccination was given compared to unvaccinated pregnancies.

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流感和百日咳疫苗接种在澳大利亚母婴队列中的安全性，2012-2015:流感研究

背景:建议在怀孕期间接种灭活流感疫苗和百日咳疫苗。关于在妊娠前三个月接种iv疫苗或在妊娠期间同时接种两种疫苗的妇女的安全性数据有限。我们评估了接种疫苗和未接种疫苗孕妇之间的不良分娩结局。方法:在前瞻性纳入的澳大利亚“流感”参与者(2012-2015)中，主要暴露是妊娠期间接受IIV的时间。主要结局包括早产、足月低出生体重(LBWT)和小于胎龄(SGA)。我们使用95%可信区间(ci)的Cox比例风险比(hr)比较妊娠期iv型和妊娠期未接种疫苗妇女的出生结局。校正hr (aHRs)控制了潜在的混杂变量。在一组怀孕期间接种百日咳疫苗的妇女中进行敏感性分析，以评估在调整百日咳疫苗接种后，IIV和不良结局之间的关联是否仍然存在。结果:在我们研究的8827名参与者中，与未接种疫苗的孕妇相比，妊娠期间接种疫苗的妇女发生不良出生结局的风险没有增加:早产(HR, 1.10 [95% CI, 0.92 -1.31];P = .28);LBWT (hr, 1.05 [95% ci, 0.76 -1.44];P = .77);或SGA (HR, 0.99 [95% CI, 0.86 -1.15];P = .94)。调整妊娠期百日咳疫苗接种的结果相似:早产(aHR, 1.05 [95% CI, 0.82 -1.34];P = 0.69);LBWT (aHR, 0.81 [95% CI, 0.50 -1.29];P = .37);SGA (aHR, 0.92 [95% CI, 0.74 -1.14];P = .43)。没有证据表明在iv期妊娠时风险升高。结论:与未接种疫苗的孕妇相比，无论在妊娠三个月接种疫苗，妊娠期接种疫苗的孕妇与未接种疫苗的孕妇相比，未发现妊娠期接种疫苗或百日咳疫苗与不良分娩结局之间存在显著关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Infectious Diseases 医学-传染病学

CiteScore

25.00

自引率

2.50%

发文量

900

审稿时长

3 months

期刊介绍： Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.