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Type: Journal article
Title: Safety and protective effects of maternal influenza vaccination on pregnancy and birth outcomes: A prospective cohort study
Author: Mohammed, H.
Roberts, C.T.
Grzeskowiak, L.E.
Giles, L.C.
Dekker, G.A.
Marshall, H.S.
Citation: EClinicalMedicine, 2020; 26:1-9
Publisher: Elsevier
Issue Date: 2020
ISSN: 2589-5370
Statement of
Hassen Mohammed, Claire T.Roberts, Luke E. Grzeskowiak, Lynne C. Giles, Gustaaf A. Dekker ... et al.
Abstract: Background Our study aimed to assess the safety and protective effect of maternal influenza vaccination on pregnancy and birth outcomes. Methods The study population comprised 1253 healthy nulliparous pregnant women in South Australia between 2015 and 2018. Participants were followed prospectively, with vaccination status (confirmed by medical records), pregnancy, and birth outcome data collected by midwives. Adjusted relative risks (aRRs) and adjusted hazard ratios (aHRs) were estimated accounting for time-varying vaccine exposure and temporal nature of each outcome. Findings Maternal influenza vaccination (48%, 603 of 1253) reduced the risk for pre-delivery hospitalisation with influenza like illness (aHR 0•61; 95% CI 0•39, 0•97). Maternal influenza vaccination was not associated with spontaneous abortion (aHR 0•42, 95% CI 0•12, 1•45), chorioamnionitis (aRR 0•78, 95% CI, 0•32, 1•88), gestational hypertension (aHR 0•78, 95% CI 0•47, 1•29), pre-eclampsia (aHR 0.84, 95% CI 0•54, 1•27), gestational diabetes (aHR 1•16, 95% CI 0•82, 1•66) nor preterm birth (aHR 0•94, 95% CI 0•59, 1•49). No associations between antenatal influenza vaccination and congenital anomalies, admission to the neonatal care unit, low Apgar scores, and mechanical ventilation were observed. Results were not materially changed after adjustment for pertussis vaccination. We observed a protective effect of maternal influenza vaccination on low birth weight (aHR 0•46, 95% CI 0•23, 0•94) and a marginal protective effect on small for gestational age births (aHR 0•65, 95% CI 0•40, 1•04) during periods of high influenza activity. Interpretation These results support the safety of maternal influenza vaccination and suggest a protective effect in reducing the rates of low birthweight and small for gestational age births. Funding There was no funding for this study.
Rights: © 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY licens
DOI: 10.1016/j.eclinm.2020.100522
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