Do Prenatal Tdap Vaccines Increase Risk for Autism?
BACKGROUND AND PURPOSE:
Becerra-Culqui et al. (Pediatrics, 2018) examined the association between prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccination and autism spectrum disorder (ASD)
Retrospective cohort study
Mother-child pairs, members in an integrated healthcare system (15 hospitals/approximately 4.4 members)
Restricted to live singleton infants 22 to 45 weeks’ gestation
Mothers had to be members from start of pregnancy | Infants had to be members for at least 90 days after 1st birthday
Maternal Tdap vaccination from pregnancy start to delivery date obtained from electronic medical records
Children were managed from birth to first ASD diagnosis, end of membership, or end of follow-up (3 years)
Adjustments were made for
Child’s birth year | Gestational age at birth (<37 or ≥37 wk) | Maternal age, race and/or ethnicity, and education | Medicaid insurance | Medical center of delivery | Parity | Start of prenatal care | Flu vaccine during pregnancy
Primary outcome was diagnosis of autism spectrum disorder (ASD)
12-month minimum for ASD diagnosis based on Autism Diagnostic Observation Schedule (Gold Standard diagnostic instrument)
81,993 children included in the study
Prenatal Tdap vaccination
26% for the 2012 birth cohort to 79% for the 2014 birth cohort
Mean age of vaccination: 28 weeks to 29 weeks, respectively
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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