tetano
Editor, Senior Moderator
Deshayne B. Fell, Ann E. Sprague, Ning Liu, Abdool S. Yasseen III, Shi-Wu Wen, Graeme Smith, and Mark C. Walker. (2012). H1N1 Influenza Vaccination During Pregnancy and Fetal and Neonatal Outcomes. American Journal of Public Health. e-View Ahead of Print.
doi: 10.2105/AJPH.2011.300606
Accepted on: Nov 26, 2011
H1N1 Influenza Vaccination During Pregnancy and Fetal and Neonatal Outcomes
Deshayne B. Fell, MSc, Ann E. Sprague, PhD, Ning Liu, MSc, Abdool S. Yasseen III, MSc, Shi-Wu Wen, PhD, Graeme Smith, MD, PhD, and Mark C. Walker, MD, MSc,
Deshayne B. Fell, Ann E. Sprague, and Mark C. Walker are with Better Outcomes Registry & Network (BORN) Ontario and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Ning Liu is with the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Abdool S. Yasseen III and Shi-Wu Wen are with the Ottawa Hospital Research Institute. Graeme Smith is with the Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.
Correspondence should be sent to Ann E. Sprague, PhD, Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Centre for Practice Changing Research, Ottawa, Ontario, Canada K1H 8L1 (e-mail: asprague@bornontario.ca). Reprints can be ordered at http://www.ajph.org by clicking the ?Reprints? link.
Contributors
D. B. Fell, A. E. Sprague, N. Liu, S. W. Wen, G. Smith, and M. C. Walker planned the study and developed the protocol. D. B. Fell, N. Liu, and A. S. Yasseen III developed the analysis plan, and A. S. Yasseen III analyzed the data under the supervision of D. B. Fell. D. B. Fell, A. E. Sprague, and N. Liu drafted the initial article, and all of the authors helped critically revise the article throughout the development and peer review process.
ABSTRACT
Objectives. We evaluated the relationship between maternal H1N1 vaccination and fetal and neonatal outcomes among singleton births during the 2009?2010 H1N1 pandemic.
Methods. We used a population-based perinatal database in Ontario, Canada, to examine preterm birth (PTB), small-for-gestational-age (SGA) births, 5-minute Apgar score below 7, and fetal death via multivariable regression. We compared outcomes between women who did and did not receive an H1N1 vaccination during pregnancy.
Results. Of the 55 570 mothers with a singleton birth, 23 340 (42.0%) received an H1N1 vaccination during pregnancy. Vaccinated mothers were less likely to have an SGA infant based on the 10th (adjusted risk ratio [RR] = 0.90; 95% confidence interval [CI] = 0.85, 0.96) and 3rd (adjusted RR = 0.81; 95% CI = 0.72, 0.92) growth percentiles; PTB at less than 32 weeks? gestation (adjusted RR = 0.73; 95% CI = 0.58, 0.91) and fetal death (adjusted RR = 0.66; 95% CI = 0.47, 0.91) were also less likely among these women.
Conclusions. Our results suggest that second- or third-trimester H1N1 vaccination was associated with improved fetal and neonatal outcomes during the recent pandemic. Our findings need to be confirmed in future studies with designs that can better overcome concerns regarding biased estimates of vaccine efficacy. (Am J Public Health. Published online ahead of print April 19, 2012: e1-e8. doi:10.2105/AJPH.2011.300606)
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300606
doi: 10.2105/AJPH.2011.300606
Accepted on: Nov 26, 2011
H1N1 Influenza Vaccination During Pregnancy and Fetal and Neonatal Outcomes
Deshayne B. Fell, MSc, Ann E. Sprague, PhD, Ning Liu, MSc, Abdool S. Yasseen III, MSc, Shi-Wu Wen, PhD, Graeme Smith, MD, PhD, and Mark C. Walker, MD, MSc,
Deshayne B. Fell, Ann E. Sprague, and Mark C. Walker are with Better Outcomes Registry & Network (BORN) Ontario and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Ning Liu is with the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Abdool S. Yasseen III and Shi-Wu Wen are with the Ottawa Hospital Research Institute. Graeme Smith is with the Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.
Correspondence should be sent to Ann E. Sprague, PhD, Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Centre for Practice Changing Research, Ottawa, Ontario, Canada K1H 8L1 (e-mail: asprague@bornontario.ca). Reprints can be ordered at http://www.ajph.org by clicking the ?Reprints? link.
Contributors
D. B. Fell, A. E. Sprague, N. Liu, S. W. Wen, G. Smith, and M. C. Walker planned the study and developed the protocol. D. B. Fell, N. Liu, and A. S. Yasseen III developed the analysis plan, and A. S. Yasseen III analyzed the data under the supervision of D. B. Fell. D. B. Fell, A. E. Sprague, and N. Liu drafted the initial article, and all of the authors helped critically revise the article throughout the development and peer review process.
ABSTRACT
Objectives. We evaluated the relationship between maternal H1N1 vaccination and fetal and neonatal outcomes among singleton births during the 2009?2010 H1N1 pandemic.
Methods. We used a population-based perinatal database in Ontario, Canada, to examine preterm birth (PTB), small-for-gestational-age (SGA) births, 5-minute Apgar score below 7, and fetal death via multivariable regression. We compared outcomes between women who did and did not receive an H1N1 vaccination during pregnancy.
Results. Of the 55 570 mothers with a singleton birth, 23 340 (42.0%) received an H1N1 vaccination during pregnancy. Vaccinated mothers were less likely to have an SGA infant based on the 10th (adjusted risk ratio [RR] = 0.90; 95% confidence interval [CI] = 0.85, 0.96) and 3rd (adjusted RR = 0.81; 95% CI = 0.72, 0.92) growth percentiles; PTB at less than 32 weeks? gestation (adjusted RR = 0.73; 95% CI = 0.58, 0.91) and fetal death (adjusted RR = 0.66; 95% CI = 0.47, 0.91) were also less likely among these women.
Conclusions. Our results suggest that second- or third-trimester H1N1 vaccination was associated with improved fetal and neonatal outcomes during the recent pandemic. Our findings need to be confirmed in future studies with designs that can better overcome concerns regarding biased estimates of vaccine efficacy. (Am J Public Health. Published online ahead of print April 19, 2012: e1-e8. doi:10.2105/AJPH.2011.300606)
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300606