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BJOG . Birth Outcomes After Pertussis and Influenza Diagnosed in Pregnancy: A Retrospective, Population-Based Study

tetano

Editor, Senior Moderator
BJOG


. 2024 Oct 18.
doi: 10.1111/1471-0528.17984. Online ahead of print. Birth Outcomes After Pertussis and Influenza Diagnosed in Pregnancy: A Retrospective, Population-Based Study

Jane E Frawley[SUP] 1 [/SUP], Wen-Qiang He[SUP] 2 [/SUP], Lisa McCallum[SUP] 2 [/SUP], Peter McIntyre[SUP] 3 [/SUP], Andrew Hayen[SUP] 4 [/SUP], Heather Gidding[SUP] 5 6 [/SUP], Elizabeth Sullivan[SUP] 7 [/SUP], Bette Liu[SUP] 2 [/SUP]



Affiliations
Abstract

Objective: Adverse birth outcomes and the maternal severity of influenza in pregnancy are well documented but information on pertussis is limited.
Design: Population-based linkage data were collected during 2001-2016.
Setting: New South Wales, Australia.
Population or sample: A total of 1 453 037 singleton births.
Methods: Cox regression was used to estimate the associations between pertussis or influenza during pregnancy and birth outcomes with adjustment of covariates.
Main outcome measures: Adverse birth outcomes (preterm birth and low birth weight).
Results: Among 1 453 037 singleton births over 16 years, we identified pertussis in 925 (49; 5.3% hospitalised) and influenza in 2850 (1092; 38.3% hospitalised) women during pregnancy. Cases of pertussis were similarly distributed by trimester (32% 3rd) whereas 46% of influenza cases were in the 3rd trimester. Younger age, previous birth, and being overseas-born were associated with both pertussis and influenza, whereas identifying as Aboriginal or Torres Strait Islander, hypertension or diabetes before and during pregnancy, and a number of other factors were only associated with influenza. Both pertussis and influenza in pregnancy were associated with increased risk of preterm birth (pertussis: aHR = 1.30, 95% CI 1.01-1.68; influenza: aHR = 1.56, 95% CI 1.36-1.79) and these increased risks were greater when infections in the period within 2 weeks of birth were considered (pertussis: aHR = 2.36, 95% CI 1.26-4.41; influenza: aHR = 2.29, 95% CI 1.78-2.96).
Conclusions: Maternal pertussis and influenza infections close to the time of birth were associated with adverse birth outcomes. These findings highlight the benefits of vaccination during pregnancy.

Keywords: infection; newborn; respiratory; vaccine; whooping cough.

 
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