Influenza vaccination during pregnancy and risk of selected major structural noncardiac birth defects, National Birth Defects Prevention Study 2006–2011
Year: 2022
Type: article
Study design: Observational Study
Abstract: 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.
DOI: 10.1002/pds.5435
Authors: Kristin Palmsten, Jonathan Suhl, Kristin M. Conway, Elyse O. Kharbanda, Elizabeth C. Ailes, Janet D. Cragan, Eirini Nestoridi, Eleni A. Papadopoulos, Stephen M. Kerr, Sean G. Young, Frank DeStefano, Paul A. Romitti, The National Birth Defects Prevention Study
Institutions: HealthPartners, University of Iowa, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Massachusetts Department of Public Health, New York State Department of Health, Boston University, University of Arkansas for Medical Sciences
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1145863725, BD-STEPS II (BIRTH DEFECTS STUDY TO EVALUATE PREGNANCY EXPOSURES) - CORE, COMPONENT A: ARKANSAS PROPOSAL TO PARTICIPATE IN THE BIRTH DEFECTS STUDY TO EVALUATE PREGNANCY EXPOSURES (BD-STEPS II), NEW YORK STATE COMPONENT A: BD-STEPS II CORE, RFA-DD-18-001 BIRTH DEFECTS STUDY TO EVALUATE PREGNANCY EXPOSURES (BD-STEPS) II CORE & COMPONENT B STEPS -STILLBIRTH, G3957572416, G450552803, G6423872778, BIRTH DEFECTS STUDY TO EVALUATE PREGNANCY EXPOSURES (BD-STEPS) CORE? ARKANSAS CENTER AND STILLBIRTH - BIRTH DEFECTS STUDY TO EVALUATE PREGNANCY EXPOSURES (BD-STEPS) CORE- ARKANSAS CENTER AND STILLBIRTH, IOWA CBDRP: COMPONENT A BD-STEPS II CORE
OpenAlex ID: W4224284802