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

Abstract

Purpose: To assess associations between influenza vaccination during etiologicallyrelevant 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

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

“…Across the current analysis of CHDs and our previous analysis of maternal influenza vaccination and non‐CHDs using NBDPS data (Palmsten et al, 2022 ), only the adjusted CIs for simple TAPVR excluded the null. The biologic plausibility of this association is unclear (Alvarado‐Terrones et al, 2018 ).…”

“…Furthermore, we observed modest associations (aOR's between 1.3 and 1.4) between maternal influenza vaccination and three specific CHD's (D-transposition of the great arteries, coarctation of the aorta, aortic stenosis) and approximately null or protective associations for four other specific CHD's, all with CIs including the null. Across the current analysis of CHDs and our previous analysis of maternal influenza vaccination and non-CHDs using NBDPS data (Palmsten et al, 2022), only the adjusted CIs for simple TAPVR excluded the null. The biologic plausibility of this association is unclear (Alvarado-Terrones et al, 2018).…”

“…We previously evaluated associations between early pregnancy influenza vaccination and a spectrum of major structural noncardiac birth defects or groups of defects in the National Birth Defects Prevention Study (NBDPS) and observed adjusted odds ratios (aORs) ranging from 0.53 to 1.74 with corresponding 95% confidence intervals (CIs) that included the null (Palmsten et al, 2022 ). The objective of our current analysis was to assess the association between early pregnancy influenza vaccination and specific CHDs, including those not previously examined in the literature.…”

Patofisiologi dan Faktor Predisposisi yang Berhubungan dengan Omphalocele

“…Kedekatan perumahan perinatal dengan lebih banyak ruang hijau dapat berkontribusi pada penurunan risiko cacat lahir tertentu, terutama di antara mereka yang tinggal di lingkungan pedesaan atau berpenghasilan tinggi. 15 Palmsten et al, 2022 23 Influenza vaccination during pregnancy and risk of selected major structural noncardiac birth defects, National Birth Defects Prevention Study 2006-2011.…”