Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.
Adult
Asthma
/ epidemiology
Child Health
Child, Preschool
Female
Gastrointestinal Diseases
/ epidemiology
Humans
Infant
Infant, Newborn
Infections
/ epidemiology
Influenza A Virus, H1N1 Subtype
Influenza Vaccines
/ adverse effects
Influenza, Human
/ prevention & control
Ontario
/ epidemiology
Pandemics
/ prevention & control
Pregnancy
Pregnancy Complications, Infectious
/ prevention & control
Prenatal Exposure Delayed Effects
Propensity Score
Registries
Retrospective Studies
Young Adult
Journal
BMJ (Clinical research ed.)
ISSN: 1756-1833
Titre abrégé: BMJ
Pays: England
ID NLM: 8900488
Informations de publication
Date de publication:
10 07 2019
10 07 2019
Historique:
entrez:
12
7
2019
pubmed:
12
7
2019
medline:
17
7
2019
Statut:
epublish
Résumé
To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. Retrospective cohort study. Population based birth registry linked with health administrative databases in the province of Ontario, Canada. All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes. Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding. Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups. No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.
Identifiants
pubmed: 31292120
doi: 10.1136/bmj.l4151
pmc: PMC6614795
doi:
Substances chimiques
Influenza Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
l4151Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Déclaration de conflit d'intérêts
Competing interests: All authors have completed and submitted the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: support for the work as described above; KAT has received grants from GlaxoSmithKline and personal fees and non-financial support from Pfizer, both of which were unrelated to the submitted work; no other relationships or activities that could appear to have influenced the submitted work.
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