title: Influenza vaccination in pregnant women: a systematic review.
abstract: Objective. To assess the effects of the inactivated influenza virus vaccine on influenza outcomes in pregnant women and their infants. Methods. We performed a systematic review of the literature. We searched for randomized controlled trials and cohort studies in the MEDLINE, Embase, and other relevant databases (inception to September 2013). Two researchers selected studies and extracted the data independently. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of the evidence. Results. We included eight studies out of 1,967 retrieved records. Influenza vaccination in pregnant women significantly reduced the incidence of influenza-like illness in mothers and their infants when compared with control groups (high-quality evidence) and reduced the incidence of laboratory-confirmed influenza in infants (moderate-quality evidence). No difference was found with regard to influenza-like illness with fever higher than 38°C (moderate-quality evidence) or upper respiratory infection (very-low-quality evidence) in mothers and infants. Conclusions. Maternal vaccination against influenza was shown to prevent influenza-like illness in women and infants; no differences were found for other outcomes. As the quality of evidence was not high overall, further research is needed to increase confidence and could possibly change these estimates.
authors: Faculty of Medicine, University of Brasilia, Campus Universitario, Conj 16, Sala 77, 70904-970 Brasilia, DF, Brazil ; Getulio Vargas University Hospital, Federal University of Amazonas, Rua Apurina 4, Centro, 69020-170 Manaus, AM, Brazil.
authors: Tais F
authors: TF
authors: Galvao
authors: Faculty of Medicine, Federal University of Amazonas, Rua Afonso Pena 1053, Centro, 69020-160 Manaus, AM, Brazil.
authors: Marcus T
authors: MT
authors: Silva
authors: Faculty of Medicine, University of Brasilia, Campus Universitario, Conj 16, Sala 77, 70904-970 Brasilia, DF, Brazil.
authors: Ivan R
authors: IR
authors: Zimmermann
authors: State Health Department, LACEN, Setor de Areas Isoladas Norte, Bloco B, 70086-900 Brasilia, DF, Brazil.
authors: Luiz Antonio B
authors: LA
authors: Lopes
authors: State Health Department, LACEN, Setor de Areas Isoladas Norte, Bloco B, 70086-900 Brasilia, DF, Brazil.
authors: Eneida F
authors: EF
authors: Bernardo
authors: Faculty of Medicine, University of Brasilia, Campus Universitario, Conj 16, Sala 77, 70904-970 Brasilia, DF, Brazil.
authors: Mauricio G
authors: MG
authors: Pereira