McHugh Lisa, Andrews Ross M, Lambert Stephen B, Viney Kerri A, Wood Nicholas, Perrett Kirsten P, Marshall Helen S, Richmond Peter, O'Grady Kerry-Ann F
National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia; The University of Queensland Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia; Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.
Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.
Vaccine. 2017 Mar 7;35(10):1403-1409. doi: 10.1016/j.vaccine.2017.01.075. Epub 2017 Feb 9.
In Australia, influenza vaccination is recommended for all women who will be pregnant during the influenza season. Vaccine safety and effectiveness are key concerns and influencers of uptake for both vaccine providers and families. We assessed the safety of receiving an influenza vaccination during any trimester of pregnancy with respect to preterm births and infant birthweight.
We conducted a nested retrospective cohort study of 'FluMum' participants (2012-2014). Our primary exposure of interest was influenza vaccination during pregnancy. The primary outcomes of interest were infant birthweight and weeks' gestation at birth for live singleton infants. Analyses included comparisons of these birth outcomes by vaccination status and trimester of pregnancy an influenza vaccine was given. We calculated means, proportions, and relative risks and performed multivariable logistic regression for potential confounding factors.
In the 7126 mother-infant pairs enrolled in this study, mean maternal age at infant birth was 31.7years. Influenza vaccine uptake in pregnancy was 34%. Most mothers with a known date of vaccination received a vaccine in the second trimester (51%). Those mothers with a co-morbidity or risk factor were 13% more likely to have influenza vaccine during pregnancy compared to other mothers (RR 1.13, 95% CI 1.04-1.24, p=0.007). Mean weeks' gestation at birth was 38.7 for the vaccinated and 38.8 for the unvaccinated group (p=0.051). Infants in the vaccinated group weighed 15g less in birthweight compared to the unvaccinated infants (95% CI -12.8 to 42.2, p=0.29).
Results arising from this large Australian cohort study are reassuring with respect to two critical safety outcomes; preterm births and low infant birthweights. Studies examining a broader range of birth outcomes following influenza vaccination during pregnancy are required, particularly now that maternal vaccination in pregnancy has expanded to include pertussis as well as influenza.
在澳大利亚，建议所有在流感季节期间怀孕的女性接种流感疫苗。疫苗的安全性和有效性是疫苗提供者和家庭关注的关键问题，也是影响疫苗接种率的因素。我们评估了在孕期任何阶段接种流感疫苗对早产和婴儿出生体重的安全性。
我们对“流感妈妈”参与者（2012 - 2014年）进行了一项嵌套式回顾性队列研究。我们感兴趣的主要暴露因素是孕期接种流感疫苗。感兴趣的主要结局是单胎活产婴儿的出生体重和出生孕周。分析包括按疫苗接种状态和接种流感疫苗的孕期阶段比较这些出生结局。我们计算了均值、比例和相对风险，并对潜在混杂因素进行了多变量逻辑回归分析。
在本研究纳入的7126对母婴中，婴儿出生时母亲的平均年龄为31.7岁。孕期流感疫苗接种率为34%。大多数已知接种日期的母亲在孕中期接种了疫苗（51%）。与其他母亲相比，患有合并症或风险因素的母亲在孕期接种流感疫苗的可能性高13%（相对风险1.13，95%置信区间1.04 - 1.24，p = 0.007）。接种疫苗组的平均出生孕周为38.7周，未接种疫苗组为38.8周（p = 0.051）。接种疫苗组的婴儿出生体重比未接种疫苗的婴儿轻15克（95%置信区间 - 12.8至42.2，p = 0.29）。
这项大型澳大利亚队列研究的结果在早产和低出生体重这两个关键安全结局方面令人安心。需要开展研究以检查孕期接种流感疫苗后更广泛的出生结局范围，特别是现在孕期母亲接种疫苗已扩大到包括百日咳以及流感。
