Influenza Immunization in Pregnancy

Dalhousie University, IWK Health Center, Halifax, Nova Scotia, Canada.
Obstetrics and Gynecology (Impact Factor: 5.18). 09/2009; 114(2 Pt 1):365-8. DOI: 10.1097/AOG.0b013e3181af6ce8
Source: PubMed


Among healthy persons, two groups are notable for increased risk of serious illness and hospitalization with influenza infection: healthy women in pregnancy and their healthy infants (aged 0 to 6 months). Inactivated influenza vaccine has been used in pregnant women since the 1960s in both the United States and Canada; however, currently, only 15% of pregnant women receive the vaccine. A randomized, controlled trial has shown influenza immunization of pregnant women reduced influenza-like illness by more than 30% in both the mothers and the infants and reduced laboratory-proven influenza infections in 0- to 6-month-old infants by 63%. Physicians caring for pregnant women should be aware of the risks of influenza and of the availability of an effective and cost-saving intervention.

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Available from: Noni Macdonald, Oct 04, 2014
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    • "Previous narrative reviews concluded that influenza vaccination is safe, that there has been no evidence of teratogenicity, and that many countries recommend influenza vaccination among women with both healthy and high-risk pregnancies [9, 51–56]. The role of education of patients and doctors in increasing adherence to maternal vaccination was also emphasized [57–59]. One systematic review assessed the benefits and dangers of the influenza vaccine in special populations—pregnant women included—but limited the eligible studies to RCTs only [60]. "
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    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.
    Full-text · Article · Nov 2013
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    • "Among healthy individuals infected with the influenza virus, pregnant women and infants younger than 6 months of age are at increased risk for serious complications when compared to other groups [1]-[3]. These complications include preterm labor, preterm delivery, and pregnancy loss among pregnant women and pneumonia, dehydration, sinus problems and ear infections in infants [4]. "
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    ABSTRACT: With the emergence of H1N1 pandemic (pH1N1) influenza, the CDC recommended that pregnant women be one of five initial target groups to receive the 2009 monovalent H1N1 vaccine, regardless of prior infection with this influenza strain. We sought to compare the immune response of pregnant women to H1N1 infection versus vaccination and to determine the extent of passive immunity conferred to the newborn. During the 2009-2010 influenza season, we enrolled a cohort of women who either had confirmed pH1N1 infection during pregnancy, did not have pH1N1 during pregnancy but were vaccinated against pH1N1, or did not have illness or vaccination. Maternal and umbilical cord venous blood samples were collected at delivery. Hemagglutination inhibition assays (HAI) for pH1N1 were performed. Data were analyzed using linear regression analyses. HAIs were performed for matched maternal/cord blood pairs for 16 women with confirmed pH1N1 infection, 14 women vaccinated against pH1N1, and 10 women without infection or vaccination. We found that pH1N1 vaccination and wild-type infection during pregnancy did not differ with respect to (1) HAI titers at delivery, (2) HAI antibody decay slopes over time, and (3) HAI titers in the cord blood. Vaccination against pH1N1 confers a similar HAI antibody response as compared to pH1N1 infection during pregnancy, both in quantity and quality. Illness or vaccination during pregnancy confers passive immunity to the newborn.
    Full-text · Article · Mar 2012 · PLoS ONE
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    • "One important placental function is transfer of antibodies (IgGs) from the mother to the fetus, which can occur when the mother is immunized during pregnancy. This passive immunization of the fetus requires the expression of placental FcRn receptor3637383940. "

    Full-text · Article · Jan 2012
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