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Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study

OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN: Retrospective cohort study. SETTING: Population based birth registry linked with health administrative...

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Autores principales: Walsh, Laura K, Donelle, Jessy, Dodds, Linda, Hawken, Steven, Wilson, Kumanan, Benchimol, Eric I, Chakraborty, Pranesh, Guttmann, Astrid, Kwong, Jeffrey C, MacDonald, Noni E, Ortiz, Justin R, Sprague, Ann E, Top, Karina A, Walker, Mark C, Wen, Shi Wu, Fell, Deshayne B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614795/
https://www.ncbi.nlm.nih.gov/pubmed/31292120
http://dx.doi.org/10.1136/bmj.l4151
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author Walsh, Laura K
Donelle, Jessy
Dodds, Linda
Hawken, Steven
Wilson, Kumanan
Benchimol, Eric I
Chakraborty, Pranesh
Guttmann, Astrid
Kwong, Jeffrey C
MacDonald, Noni E
Ortiz, Justin R
Sprague, Ann E
Top, Karina A
Walker, Mark C
Wen, Shi Wu
Fell, Deshayne B
author_facet Walsh, Laura K
Donelle, Jessy
Dodds, Linda
Hawken, Steven
Wilson, Kumanan
Benchimol, Eric I
Chakraborty, Pranesh
Guttmann, Astrid
Kwong, Jeffrey C
MacDonald, Noni E
Ortiz, Justin R
Sprague, Ann E
Top, Karina A
Walker, Mark C
Wen, Shi Wu
Fell, Deshayne B
author_sort Walsh, Laura K
collection PubMed
description OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN: Retrospective cohort study. SETTING: Population based birth registry linked with health administrative databases in the province of Ontario, Canada. PARTICIPANTS: 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. MAIN OUTCOME MEASURES: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-66147952019-07-23 Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study Walsh, Laura K Donelle, Jessy Dodds, Linda Hawken, Steven Wilson, Kumanan Benchimol, Eric I Chakraborty, Pranesh Guttmann, Astrid Kwong, Jeffrey C MacDonald, Noni E Ortiz, Justin R Sprague, Ann E Top, Karina A Walker, Mark C Wen, Shi Wu Fell, Deshayne B BMJ Research OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN: Retrospective cohort study. SETTING: Population based birth registry linked with health administrative databases in the province of Ontario, Canada. PARTICIPANTS: 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. MAIN OUTCOME MEASURES: 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. RESULTS: 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. CONCLUSIONS: 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. BMJ Publishing Group Ltd. 2019-07-10 /pmc/articles/PMC6614795/ /pubmed/31292120 http://dx.doi.org/10.1136/bmj.l4151 Text en 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 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Research
Walsh, Laura K
Donelle, Jessy
Dodds, Linda
Hawken, Steven
Wilson, Kumanan
Benchimol, Eric I
Chakraborty, Pranesh
Guttmann, Astrid
Kwong, Jeffrey C
MacDonald, Noni E
Ortiz, Justin R
Sprague, Ann E
Top, Karina A
Walker, Mark C
Wen, Shi Wu
Fell, Deshayne B
Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title_full Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title_fullStr Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title_full_unstemmed Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title_short Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study
title_sort health outcomes of young children born to mothers who received 2009 pandemic h1n1 influenza vaccination during pregnancy: retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614795/
https://www.ncbi.nlm.nih.gov/pubmed/31292120
http://dx.doi.org/10.1136/bmj.l4151
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