tetano
Editor, Senior Moderator
Obstet Gynecol. 2013 Jan;121(1):159-165.
Trivalent Inactivated Influenza Vaccine and Spontaneous Abortion.
Irving SA, Kieke BA, Donahue JG, Mascola MA, Baggs J, Destefano F, Cheetham TC, Jackson LA, Naleway AL, Glanz JM, Nordin JD, Belongia EA; for the Vaccine Safety Datalink.
Source
Epidemiology Research Center, Marshfield Clinic Research Foundation, and Obstetrics and Gynecology, Marshfield Clinic, Marshfield, Wisconsin; the Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Kaiser Permanente of Southern California, Downey, California; the Group Health Research Institute, Seattle, Washington; Kaiser Permanente Northwest, Portland, Oregon; Kaiser Permanente Colorado, Denver, Colorado; and HealthPartners Research Foundation, Minneapolis, Minnesota.
Abstract
OBJECTIVE:: To estimate the association between spontaneous abortion and influenza vaccine receipt with a case-control study utilizing data from six health care organizations in the Vaccine Safety Datalink. METHODS:: Women aged 18-44 years with spontaneous abortion during the autumn of 2005 or 2006 were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. Cases of spontaneous abortion at 5-16 weeks of gestation were confirmed by medical record review; date of fetal demise was based on ultrasound information when available. Control group individuals with a live birth were individually matched to case group individuals by health care organization and date of last menstrual period (LMP). The primary exposure of interest was influenza vaccination during the 28 days preceding the date of spontaneous abortion of the matched pair. Conditional logistic regression models adjusted for maternal age, health care utilization, maternal diabetes, and parity. RESULTS:: Our final analysis included 243 women with spontaneous abortion and 243 matched control group women; 82% of women with spontaneous abortion had ultrasound confirmation of fetal demise. Using clinical diagnosis and ultrasound data, the mean gestational age at fetal demise was 7.8 weeks. Mean ages at LMP of case group women and control group women were 31.7 and 29.3 years, respectively (P<.001). Sixteen women with spontaneous abortion (7%) and 15 (6%) matched control group women received influenza vaccine within the 28-day exposure window. There was no association between spontaneous abortion and influenza vaccination in the 28-day exposure window (adjusted matched odds ratio 1.23, 95% confidence interval 0.53-2.89; P=.63). CONCLUSION:: There was no statistically significant increase in the risk of pregnancy loss in the 4 weeks after seasonal inactivated influenza vaccination. LEVEL OF EVIDENCE:: II.
PMID:
23262941
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23262941
Trivalent Inactivated Influenza Vaccine and Spontaneous Abortion.
Irving SA, Kieke BA, Donahue JG, Mascola MA, Baggs J, Destefano F, Cheetham TC, Jackson LA, Naleway AL, Glanz JM, Nordin JD, Belongia EA; for the Vaccine Safety Datalink.
Source
Epidemiology Research Center, Marshfield Clinic Research Foundation, and Obstetrics and Gynecology, Marshfield Clinic, Marshfield, Wisconsin; the Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Kaiser Permanente of Southern California, Downey, California; the Group Health Research Institute, Seattle, Washington; Kaiser Permanente Northwest, Portland, Oregon; Kaiser Permanente Colorado, Denver, Colorado; and HealthPartners Research Foundation, Minneapolis, Minnesota.
Abstract
OBJECTIVE:: To estimate the association between spontaneous abortion and influenza vaccine receipt with a case-control study utilizing data from six health care organizations in the Vaccine Safety Datalink. METHODS:: Women aged 18-44 years with spontaneous abortion during the autumn of 2005 or 2006 were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. Cases of spontaneous abortion at 5-16 weeks of gestation were confirmed by medical record review; date of fetal demise was based on ultrasound information when available. Control group individuals with a live birth were individually matched to case group individuals by health care organization and date of last menstrual period (LMP). The primary exposure of interest was influenza vaccination during the 28 days preceding the date of spontaneous abortion of the matched pair. Conditional logistic regression models adjusted for maternal age, health care utilization, maternal diabetes, and parity. RESULTS:: Our final analysis included 243 women with spontaneous abortion and 243 matched control group women; 82% of women with spontaneous abortion had ultrasound confirmation of fetal demise. Using clinical diagnosis and ultrasound data, the mean gestational age at fetal demise was 7.8 weeks. Mean ages at LMP of case group women and control group women were 31.7 and 29.3 years, respectively (P<.001). Sixteen women with spontaneous abortion (7%) and 15 (6%) matched control group women received influenza vaccine within the 28-day exposure window. There was no association between spontaneous abortion and influenza vaccination in the 28-day exposure window (adjusted matched odds ratio 1.23, 95% confidence interval 0.53-2.89; P=.63). CONCLUSION:: There was no statistically significant increase in the risk of pregnancy loss in the 4 weeks after seasonal inactivated influenza vaccination. LEVEL OF EVIDENCE:: II.
PMID:
23262941
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23262941