Influenza vaccination during pregnancy and risk of selected major structural noncardiac birth defects, National Birth Defects Prevention Study 2006–2011

Details

• Alternative Title:
  Pharmacoepidemiol Drug Saf
• Personal Author:
  Palmsten, Kristin ; Suhl, Jonathan ; Conway, Kristin M. ; Kharbanda, Elyse O. ; Ailes, Elizabeth C. ; Cragan, Janet D. ; Nestoridi, Eirini ; Papadopoulos, Eleni A. ; Kerr, Stephen M. ; Young, Sean G. ; DeStefano, Frank ; Romitti, Paul A.
• Corporate Authors:
  The National Birth Defects Prevention Study
• Description:
  Purpose:
  
  To assess associations between influenza vaccination during etiologically-relevant windows and selected major structural non-cardiac birth defects.
  
  Study Design:
  
  We analyzed data from the National Birth Defects Prevention Study, a multisite, population-based case–control study, for 8233 case children diagnosed with a birth defect and 4937 control children without a birth defect with delivery dates during 2006–2011. For all analyses except for neural tube defects (NTDs), we classified mothers who reported influenza vaccination 1 month before through the third pregnancy month as exposed; the exposure window for NTDs was 1 month before through the first pregnancy month. For defects with five or more exposed case children, we used logistic regression to estimate propensity score-adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusting for estimated delivery year and season; plurality; maternal age, race/ethnicity, smoking and alcohol use, low folate intake; and, for NTDs, folate antagonist medications.
  
  Results:
  
  There were 334 (4.1%) case and 197 (4.0%) control mothers who reported influenza vaccination from 1 month before through the third pregnancy month. Adjusted ORs ranged from 0.53 for omphalocele to 1.74 for duodenal atresia/stenosis. Most aORs (11 of 19) were ≤1 and all adjusted CIs included the null. The unadjusted CIs for two defects, hypospadias and craniosynostosis, excluded the null. These estimates were attenuated upon covariate adjustment (hypospadias aOR: 1.25 (95% CI 0.89, 1.76); craniosynostosis aOR: 1.23 (95% CI: 0.88, 1.74)).
  
  Conclusions:
  
  Results for several non-cardiac major birth defects add to the existing evidence supporting the safety of inactivated influenza vaccination during pregnancy. Under-reporting of vaccination may have biased estimates downward.
  
  
• Subjects:
  Article Birth Defects Case-Control Studies Child Congenital Abnormalities Craniosynostoses Duodenal Obstruction Female Folic Acid Humans Hypospadias Influenza, Human Influenza Vaccination Intestinal Atresia Male Pregnancy Risk Factors Vaccination

  More +
• Source:
  Pharmacoepidemiol Drug Saf. 31(8):851-862
• Pubmed ID:
  35366035
• Pubmed Central ID:
  PMC10331487
• Document Type:
  Journal Article
• Funding:
  U01 DD001223/DD/NCBDD CDC HHSUnited States/ ; U01 DD001224/DD/NCBDD CDC HHSUnited States/ ; U01 DD001229/DD/NCBDD CDC HHSUnited States/ ; U01DD001223/ACL/ACL HHSUnited States/
• Volume:
  31
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f394a180206c8849527a121ee206d5e29a6eec68d698e5da713e493ad69e36e6
• Download URL:
  https://stacks.cdc.gov/view/cdc/130852/cdc_130852_DS1.pdf
• File Type:
  [PDF - 383.52 KB ]