title: Safety of influenza vaccination during pregnancy: a review of subsequent maternal obstetric events and findings from two recent cohort studies.
abstract: Pregnant women and their infants are vulnerable to severe disease and secondary complications from influenza infection. For this reason, annual influenza vaccination is recommended for all pregnant women in the United States. Women frequently cite concerns about vaccine safety as a barrier to vaccination. This review describes the safety of inactivated influenza vaccination during pregnancy with a focus on maternal obstetric events, including hypertensive disorders, gestational diabetes, and chorioamnionitis. Included in the review are new findings from two studies which examined the safety of seasonal inactivated influenza vaccination during pregnancy. The first study enrolled 641 pregnant women during the 2010-2011 season and prospectively followed them until delivery or pregnancy termination. The second study enrolled 1616 pregnant women during the 2010-2011 influenza season, and followed the women and their infants for six months after delivery. No associations between inactivated influenza vaccination and gestational diabetes, gestational hypertension, preeclampsia/eclampsia, or chorioamnionitis were observed in either cohort. When considered as a whole, these studies should further reassure women and clinicians that influenza vaccination during pregnancy is safe for mothers.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR 97227, USA. Electronic address: allison.naleway@kpchr.org.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Naleway
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR 97227, USA. Electronic address: stephanie.irving@kpchr.org.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Irving
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR 97227, USA. Electronic address: michelle.henninger@kpchr.org.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Henninger
authors.affiliation: Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA. Electronic address: de-kun.li@kp.org.
authors.forename: De-Kun
authors.initials: DK
authors.lastname: Li
authors.affiliation: Abt Associates, 55 Wheeler Street, Cambridge, MA 02138, USA. Electronic address: pat_shifflett@abtassoc.com.
authors.forename: Pat
authors.initials: P
authors.lastname: Shifflett
authors.affiliation: Abt Associates, 55 Wheeler Street, Cambridge, MA 02138, USA. Electronic address: sarah_ball@abtassoc.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ball
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA. Electronic address: znv8@cdc.gov.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Williams
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA. Electronic address: jdc9@cdc.gov.
authors.forename: Janet
authors.initials: J
authors.lastname: Cragan
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA. Electronic address: dzg2@cdc.gov.
authors.forename: Julianne
authors.initials: J
authors.lastname: Gee
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA. Electronic address: isq8@cdc.gov.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Thompson
mesh_terms: D002821:Chorioamnionitis / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology; D004461:Eclampsia / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000517:prevention & control; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D014611:Vaccination / Q000009:adverse effects*; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D007252:Influenza Vaccines; D015164:Vaccines, Inactivated
keywords: Influenza vaccine; Obstetric outcomes; Pregnancy; Safety
references.citation: Obstet Gynecol. 2013 Jan;121(1):159-65
references.pmid: 23262941
references.citation: Am J Obstet Gynecol. 2012 Sep;207(3 Suppl):S33-7
references.pmid: 22920057
references.citation: Obstet Gynecol. 2013 Mar;121(3):511-518
references.pmid: 23635612
references.citation: Obstet Gynecol. 2013 Apr;121(4):741-749
references.pmid: 23635673
references.citation: Vaccine. 2012 Jun 22;30(30):4445-52
references.pmid: 22564554
references.citation: Prev Chronic Dis. 2008 Jul;5(3):A77
references.pmid: 18558027
references.citation: Obstet Gynecol. 2004 Mar;103(3):526-33
references.pmid: 14990417
references.citation: Am J Obstet Gynecol. 2006 Apr;194(4):921-31
references.pmid: 16580277
references.citation: Lancet Infect Dis. 2008 Jan;8(1):44-52
references.pmid: 18156088
references.citation: JAMA. 1996 Apr 17;275(15):1165-70
references.pmid: 8609683
references.citation: Am J Obstet Gynecol. 2009 Dec;201(6):547-52
references.pmid: 19850275
references.citation: Diabetes Care. 1998 Aug;21 Suppl 2:B142-9
references.pmid: 9704242
references.citation: Arch Pediatr Adolesc Med. 2010 Feb;164(2):187-92
references.pmid: 20124149
references.citation: PLoS Med. 2011 May;8(5):e1000441
references.pmid: 21655318
references.citation: JAMA. 1993 Feb 3;269(5):609-15
references.pmid: 8421365
references.citation: PLoS One. 2011;6(8):e23049
references.pmid: 21850250
references.citation: Ethn Dis. 1999 Autumn;9(3):369-76
references.pmid: 10600059
references.citation: Obstet Gynecol. 2013 Sep;122(3):659-67
references.pmid: 23921876
references.citation: Am J Obstet Gynecol. 2005 Apr;192(4):1098-106
references.pmid: 15846187
references.citation: MMWR Morb Mortal Wkly Rep. 2013 Sep 27;62(38):787-92
references.pmid: 24067583
references.citation: Diabetes Care. 1995 Jul;18(7):1029-33
references.pmid: 7555537
references.citation: Am J Obstet Gynecol. 2000 Jul;183(1):S1-S22
references.pmid: 10920346
references.citation: Am J Obstet Gynecol. 2011 Nov;205(5):473.e1-9
references.pmid: 21861964
references.citation: Int J Gynaecol Obstet. 2001 Dec;75(3):221-8
references.pmid: 11728481
references.citation: BMJ. 2013 Feb 04;346:f393
references.pmid: 23381200
references.citation: Vaccine. 2011 Aug 26;29(37):6358-65
references.pmid: 21596080
references.citation: Diabetes. 2000 Dec;49(12):2208-11
references.pmid: 11118027
references.citation: Am J Public Health. 2005 Sep;95(9):1536-9
references.pmid: 16051928
references.citation: MMWR Recomm Rep. 2013 Sep 20;62(RR-07):1-43
references.pmid: 24048214
references.citation: Perm J. 2013 Spring;17(2):31-6
references.pmid: 23704840
references.citation: BJOG. 2012 Dec;119(13):1583-90
references.pmid: 22901103
references.citation: Obstet Gynecol. 2010 Oct;116(4):1006-1007
references.pmid: 20859176
references.citation: Am J Obstet Gynecol. 2011 Feb;204(2):146.e1-7
references.pmid: 20965490
references.citation: Am J Obstet Gynecol. 2011 Jun;204(6 Suppl 1):S69-76
references.pmid: 21411050
references.citation: Epidemiol Rev. 2006;28:47-53
references.pmid: 16731574
references.citation: Am J Perinatol. 2013 Jan;30(1):59-68
references.pmid: 22773280
references.citation: Vaccine. 2011 Nov 8;29(48):8982-7
references.pmid: 21945263
references.citation: Obstet Gynecol. 2000 Jan;95(1):24-8
references.pmid: 10636496
references.citation: Hypertens Pregnancy. 2007;26(1):67-76
references.pmid: 17454219
references.citation: Am J Obstet Gynecol. 2012 Sep;207(3):177.e1-8
references.pmid: 22939717