title: Tetanus, diphtheria, acellular pertussis vaccine during pregnancy: pregnancy and infant health outcomes.
abstract: OBJECTIVE
  To assess pregnancy and birth outcomes in infants born to women who did or did not receive tetanus, diphtheria, acellular pertussis (Tdap) vaccine during pregnancy.
  
  
  METHODS
  Retrospective cohort. Pregnant women 12-45 years of age who received Tdap at Intermountain Healthcare facilities and their infants were identified and compared with mother-infant pairs without documented Tdap from May 2005 through August 2009. Primary measures included pregnancy outcomes and infant health outcomes at birth through 12 months.
  
  
  RESULTS
  From 162,448 pregnancies we identified 138 women (0.08%) with documented Tdap administration during pregnancy (cases); 552 pregnant women without documented Tdap were randomly selected as controls. Of 138 immunized women, 63% received Tdap in the first trimester and 37% after. Tdap was given most commonly as wound prophylaxis. The incidence of spontaneous or elective abortion was no greater in Tdap cases than in controls. There were no significant differences in preterm delivery, gestational age, or birth weight between groups. One or more congenital anomaly was identified in 3.7% (95% CI 1.2%-8.5%) of case infants and 4.4% (95% CI 2.7%-6.5%) of control infants (P = .749). In infants born to women receiving Tdap during pregnancy, 3.6% (0.8%-10.2%) had International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses consistent with complex chronic conditions within 12 months compared with 10.4% (95% CI 7.2%-14.4%) of infants of controls (P = .054).
  
  
  CONCLUSIONS
  Documented Tdap administration during pregnancy was uncommon and occurred most often in the first trimester as prophylaxis following trauma. No increase in adverse outcomes was identified in infants born to women receiving Tdap compared with infants of controls.
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, UT. Electronic address: Julie.Shakib@hsc.utah.edu.
authors.forename: Julie H
authors.initials: JH
authors.lastname: Shakib
authors.forename: Kent
authors.initials: K
authors.lastname: Korgenski
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sheng
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Pavia
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Byington
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D018811:Maternal Exposure; D061214:Patient Safety; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines
keywords: ACIP; Advisory Committee on Immunization Practices; EDW; Enterprise Data Warehouse; ICD-9-CM; International Classification of Diseases, Ninth Revision, Clinical Modification; Tdap; Tetanus, diphtheria, acellular pertussis
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