Influenza vaccination during pregnancy and risk of selected major structural noncardiac birth defects, National Birth Defects Prevention Study 2006-2011

被引:3
作者
Palmsten, Kristin [1 ]
Suhl, Jonathan [2 ]
Conway, Kristin M. [2 ]
Kharbanda, Elyse O. [1 ]
Ailes, Elizabeth C. [3 ]
Cragan, Janet D. [3 ,4 ]
Nestoridi, Eirini [5 ]
Papadopoulos, Eleni A. [6 ]
Kerr, Stephen M. [7 ]
Young, Sean G. [8 ,9 ]
DeStefano, Frank [10 ]
Romitti, Paul A. [2 ]
机构
[1] Hlth Partners Inst, Minneapolis, MN USA
[2] Univ Iowa, Dept Epidemiol, Coll Publ Hlth, 145 N Riverside Dr,S416 CPHB, Iowa City, IA 52242 USA
[3] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Div Birth Defects & Infant Disorders, Atlanta, GA USA
[4] Metropolitan Atlanta Congenital Defects Program, Atlanta, GA USA
[5] Massachusetts Dept Publ Hlth, Ctr Birth Defects Res & Prevent, Boston, MA USA
[6] New York State Dept Hlth, Birth Defects Registry, Albany, NY USA
[7] Boston Univ, Slone Epidemiol Ctr, Boston, MA 02215 USA
[8] Arkansas Ctr Birth Defects Res & Prevent, Little Rock, AR USA
[9] Univ Arkansas Med Sci, Fay W Boozman Coll Publ Heath, Dept Environm & Occupat Hlth, Little Rock, AR 72205 USA
[10] Ctr Dis Control & Prevent, Immunizat Safety Off, Atlanta, GA USA
关键词
influenza vaccination; pregnancy; birth defects; PRETERM DELIVERY; SPONTANEOUS-ABORTION; PROPENSITY SCORES; SAFETY; WOMEN; VACCINES; MALFORMATIONS; IMMUNIZATION; COVERAGE; INFANTS;
D O I
10.1002/pds.5435
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Purpose To assess associations between influenza vaccination during etiologically-relevant windows and selected major structural non-cardiac birth defects. Study Design We analyzed data from the National Birth Defects Prevention Study, a multisite, population-based case-control study, for 8233 case children diagnosed with a birth defect and 4937 control children without a birth defect with delivery dates during 2006-2011. For all analyses except for neural tube defects (NTDs), we classified mothers who reported influenza vaccination 1 month before through the third pregnancy month as exposed; the exposure window for NTDs was 1 month before through the first pregnancy month. For defects with five or more exposed case children, we used logistic regression to estimate propensity score-adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusting for estimated delivery year and season; plurality; maternal age, race/ethnicity, smoking and alcohol use, low folate intake; and, for NTDs, folate antagonist medications. Results There were 334 (4.1%) case and 197 (4.0%) control mothers who reported influenza vaccination from 1 month before through the third pregnancy month. Adjusted ORs ranged from 0.53 for omphalocele to 1.74 for duodenal atresia/stenosis. Most aORs (11 of 19) were <= 1 and all adjusted CIs included the null. The unadjusted CIs for two defects, hypospadias and craniosynostosis, excluded the null. These estimates were attenuated upon covariate adjustment (hypospadias aOR: 1.25 (95% CI 0.89, 1.76); craniosynostosis aOR: 1.23 (95% CI: 0.88, 1.74)). Conclusions Results for several non-cardiac major birth defects add to the existing evidence supporting the safety of inactivated influenza vaccination during pregnancy. Under-reporting of vaccination may have biased estimates downward.
引用
收藏
页码:851 / 862
页数:12
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