While we do not advocate changes in vaccine policy or practice, we believe that additional studies are warranted to further evaluate any potential associations between first - trimester
maternal influenza vaccination and autism.
Exposures Data on
maternal influenza infection and vaccination from conception date to delivery date, obtained from Kaiser Permanente Northern California inpatient and outpatient databases.
Findings In a cohort study of 196 929 children, of whom 3103 had austism spectrum disorder,
maternal influenza infection during pregnancy was not associated with increased autism risk.
After adjustment for covariates,
maternal influenza vaccination anytime during pregnancy was not significantly associated with increased ASD risk (AHR, 1.10 [95 % CI, 1.00 - 1.21]-RRB-(Table 3).
Maternal influenza infection during pregnancy was not associated with increased ASD risk in this study, and the association did not vary by the timing of influenza infection.
In a cohort study of 196 929 children, of whom 3103 had austism spectrum disorder,
maternal influenza infection during pregnancy was not associated with increased autism risk.
Is there an association between
maternal influenza infection and vaccination and autism risk?
Question Is there an association between
maternal influenza infection and vaccination and autism risk?
Conclusions and Relevance There was no association between
maternal influenza infection anytime during pregnancy and increased ASD risk.
These findings do not call for changes in vaccine policy or practice, but do suggest the need for additional studies on
maternal influenza vaccination and autism.
There was also no association between
maternal influenza infection during the first, second, or third trimester and ASD risk (Table 3).
Maternal influenza vaccination was defined as receipt of an influenza vaccination from conception date to delivery date.
Maternal influenza vaccination in the second or third trimester was not associated with increased ASD risk.
After adjusting for covariates, we found that
maternal influenza infection (adjusted hazard ratio, 1.04; 95 % CI, 0.68 - 1.58) or influenza vaccination (adjusted hazard ratio, 1.10; 95 % CI, 1.00 - 1.21) anytime during pregnancy was not associated with increased ASD risk.
Different Scenarios of the Effect of an Unmeasured Confounder on an Adjusted Measure of Association Between
Maternal Influenza Vaccination During the First Trimester and Risk of ASD.
After controlling for maternal and child covariates, we found that
maternal influenza infection anytime during pregnancy was not associated with increased ASD risk (adjusted HR [AHR], 1.04 [95 % CI, 0.68 - 1.58]-RRB-.
Not exact matches
Of note, our point estimate for premature death exceeds the annual number of U.S. deaths from cervical cancer (3,909), asthma (3,361), or
influenza (3,055).45 If a randomized control trial were to demonstrate similar effects to those reported in the observational literature, the «number needed to treat» with optimal breastfeeding to prevent a case of
maternal hypertension would be 35, to prevent a
maternal MI would be 135, and to prevent a case of breast cancer would be 385.
This is the largest study to date to show that
maternal vaccination against
influenza is feasible and effective, even in one of the world's least developed countries.
Previous studies have also indicated that
maternal Abs did not suppress infant Ab responses to H.
influenzae type B vaccines (132).
To assess the impact of
maternal Abs on vaccine commonly administered in infancy, Jones et al. (131) examined the relationship between the concentration of Abs against pertussis, H.
influenzae type B, tetanus toxoid, and pneumococcal Ags at birth and after primary immunization.
Each study participant's mother was identified from KPNC electronic medical records and data on
maternal exposures during pregnancy (eg,
influenza infection and
influenza vaccination), and covariates were extracted.
Although vaccination induces an inflammatory response during pregnancy, the magnitude and the duration of response is much lower and shorter, respectively, for
influenza vaccination than viral infection.27 Like infection,
influenza vaccination during pregnancy has been reported to induce a transient increase in the levels of a number of proinflammatory cytokines, including interleukin 6, tumor necrosis factor α, and C - reactive protein.27 - 30 Studies on mice found an association between high interleukin - 6 levels during pregnancy and abnormal behavior and brain structure.19 However, in epidemiological studies, associations between
maternal cytokine levels and ASD have been mixed.
Kitikoon P, Nilubol D, Vincent A, Yu S, Erickson B, Janke B, Hoover T, Sornsen S, Thacker E. Immune response and effect of
maternal antibody interference on vaccination with a bivalent swine
influenza vaccine.