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Neonatal outcomes after antenatal influenza immunization during the 2009 H1N1 influenza pandemic: impact on preterm birth, birth weight, and small for gestational age birth.
MedLine Citation:
PMID:  23378281     Owner:  NLM     Status:  Publisher    
Background. Influenza infection during pregnancy is associated with adverse fetal outcomes such as preterm birth and small for gestational age (SGA). Maternal influenza immunization may prevent these adverse infant outcomes during periods of influenza circulation.Methods. We conducted a retrospective cohort study of live births within Kaiser Permanente (KP) Georgia and Mid-Atlantic States (n=3,327) during the period of 2009 influenza A (H1N1) virus circulation. Primary outcomes were third trimester preterm birth (27-36 weeks), birth weight, low birth weight (LBW, <2500 grams), and SGA.Results. There were 327 (9.8%) preterm, 236 (7.4%) LBW, and 267 (8.4%) SGA births. Among H1N1-vaccinated mothers (n=1125), there were 86 (7.6%) preterm, 68 (6.4%) LBW, and 99 (9.3%) SGA births, and the mean birth weight was 3308.5 grams (95% CI: 3276.6-3340.4). Among unvaccinated mothers (n=1581), there were 191 (12.1%) preterm, 132 (8.8%) LBW, and 123 (8.2%) SGA births, and the mean birth weight was 3245.3 grams (95% CI: 3216.5-3274.2). Infants of H1N1-vaccinated mothers had 37% lower odds of being born preterm than infants of unvaccinated mothers (aOR: 0.63, 95% CI: 0.47-0.84). The mean birth weight difference between infants of H1N1-vaccinated mothers and infants of unvaccinated mothers was 45.1 grams (95% CI: 1.8-88.3). There was no significant association between maternal H1N1 influenza immunization and LBW or SGA.Conclusions. Pregnant women who received H1N1 influenza vaccine were less likely to give birth preterm, and gave birth to heavier infants. The findings validate U.S. vaccine policy choices to prioritize pregnant women during the 2009 influenza A (H1N1) pandemic.
Jennifer L Richards; Craig Hansen; Christine Bredfeldt; Robert A Bednarczyk; Mark C Steinhoff; Dzifa Adjaye-Gbewonyo; Kevin Ault; Mia Gallagher; Walter Orenstein; Robert L Davis; Saad B Omer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-1
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Center for Health Research-Southeast, Kaiser Permanente, Atlanta GA.
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