Risk of Miscarriage in Relation to Seasonal Influenza Vaccination Before or During Pregnancy.
Risk of Miscarriage in Relation to Seasonal Influenza Vaccination Before or During Pregnancy.
复制标题
DOI：
10.1097/aog.0000000000005279
复制
发表时间：
2023-09-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
--
作者：
在怀孕开始时接种季节性灭活流感疫苗与流产率增加无关。使用一项正在进行的前瞻性队列研究的数据，评价季节性流感疫苗接种与流产之间的相关性。我们分析了PRESTO（妊娠研究在线）2013-2022年的数据，这是一项针对美国和加拿大女性妊娠计划者及其男性伴侣的前瞻性孕前队列研究。女性参与者完成了一份基线问卷，然后每8周进行一次随访问卷，直到怀孕，怀孕早期和晚期以及产后期间。疫苗信息在所有问卷中自我报告。流产是在随访期间根据自我报告的信息确定的。仅邀请男性伴侣填写一份基线问卷。我们使用考克斯比例风险模型估计妊娠检测前3个月内至妊娠第19周接种疫苗与流产之间相关性的风险比（HR）和95% CI，以孕周作为时间尺度。我们将疫苗接种建模为随时间变化的暴露，并使用倾向评分精细分层来控制季节和女性伴侣因素的混杂。在6，946例妊娠中，23.3%的女性伴侣报告在妊娠前或妊娠期间暴露于流感疫苗：3.2%在妊娠期间（胎龄4-19周），20.1%在妊娠检测前3个月内。未接种疫苗的流产率为16.2%，接种疫苗的流产率为17.0%。与未接触疫苗相比，在怀孕前（HR 0.99，95%CI 0.81-1.20）或怀孕期间（HR 0.83，95%CI 0.47-1.47）接种流感疫苗与流产率增加无关。在有男性伴侣疫苗接种数据的1，135对夫妇中，10.8%的人报告在怀孕前不到3个月接种疫苗。男性伴侣接种疫苗与流产之间相关性的HR为1.17（95% CI 0.73-1.90）。怀孕前或怀孕期间接种流感疫苗与流产无关。
Receipt of seasonal inactivated influenza vaccines around the start of pregnancy was not associated with an increased rate of miscarriage. To evaluate the association between seasonal influenza vaccination and miscarriage using data from an ongoing, prospective cohort study. We analyzed 2013–2022 data from PRESTO (Pregnancy Study Online), a prospective prepregnancy cohort study of female pregnancy planners and their male partners in the United States and Canada. Female participants completed a baseline questionnaire and then follow-up questionnaires every 8 weeks until pregnancy, during early and late pregnancy, and during the postpartum period. Vaccine information was self-reported on all questionnaires. Miscarriage was identified from self-reported information during follow-up. Male partners were invited to complete a baseline questionnaire only. We used Cox proportional hazard models to estimate the hazard ratio (HR) and 95% CI for the association between vaccination less than 3 months before pregnancy detection through the 19th week of pregnancy and miscarriage, with gestational weeks as the time scale. We modeled vaccination as a time-varying exposure and used propensity-score fine stratification to control for confounding from seasonal and female partner factors. Of 6,946 pregnancies, 23.3% of female partners reported exposure to influenza vaccine before or during pregnancy: 3.2% during pregnancy (gestational age 4–19 weeks) and 20.1% during the 3 months before pregnancy detection. The miscarriage rate was 16.2% in unvaccinated and 17.0% among vaccinated participants. Compared with no vaccine exposure, influenza vaccination was not associated with increased rate of miscarriage when administered before (HR 0.99, 95% CI 0.81–1.20) or during (HR 0.83, 95% CI 0.47–1.47) pregnancy. Of the 1,135 couples with male partner vaccination data available, 10.8% reported vaccination less than 3 months before pregnancy. The HR for the association between male partner vaccination and miscarriage was 1.17 (95% CI 0.73–1.90). Influenza vaccination before or during pregnancy was not associated with miscarriage.
影响因子：
5.5
作者：
O'Leary ST;Cataldi JR;Lindley MC;Hurley LP;Riley LE;Brtnikova M;Crane LA;Beaty B;Stokley S;Fisher A;Kempe A
通讯作者：
Kempe A