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Grand Rounds

More Evidence: Flu Vaccination During Pregnancy Reduces the Risk for Adverse Pregnancy Outcomes

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BACKGROUND AND PURPOSE:

  • Duque et al. (Influenza, 2022) aimed to substantiate the value of the flu vaccine in pregnant individuals by measuring the effects of vaccination on pregnancy outcomes

METHODS:

  • Retrospective cohort study
  • Population
    • New Zealand residents
    • Pregnancy between 2003 and 2018
  • Exposures
    • Influenza-associated maternal acute respiratory infection (ARI)
    • Flu vaccination
  • Study design
    • Cox proportional hazards models were used to calculate crude and adjusted hazard ratios (aHRs)
  • Primary outcomes
    • Pregnancy outcomes (e.g., fetal death and preterm birth)
    • Birth outcomes (e.g., low birthweight)

RESULTS:

  • 822,391 pregnancies
    • ≥1 associated ARI hospitalization during the flu season: 0.6%
  • Pregnancies with an ARI hospitalization were at an increased risk for
    • Preterm birth
      • aHR 1.50 (95% CI, 1.39 to 1.61)
    • Low birth weight
      • aHR 1.64 (95% CI, 1.51 to 1.79)
  • There was no association between ARI hospitalization and fetal death
    • aHR 0.96 (95% CI, 0.69 to 1.34)
  • Maternal influenza vaccination was associated with reduced risk for
    • Preterm birth
      • aHR 0.79 (95% CI, 0.77 to 0.82)
    • Low birthweight
      • aHR 0.87 (95% CI, 0.83 to 0.90)
    • Fetal death
      • aHR 0.50 (95% CI, 0.44 to 0.57)

CONCLUSION:

  • An acute respiratory infection hospitalization during the flu season was associated with an increased risk for preterm birth and low birthweight
  • Pregnant individuals who received a flu vaccine had lower risks for preterm birth, low birthweight, and fetal death
  • The authors state

The value of influenza vaccination, in this case, goes beyond preventing mostly self-limited ARIs and seems to extend to the prevention of expensive and potentially deadly birth outcomes during influenza epidemic periods 

Learn More – Primary Sources:

Multi-decade national cohort identifies adverse pregnancy and birth outcomes associated with acute respiratory illness hospitalisations during the influenza season

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Related ObG Topics:

Hospitalized Pregnant Women with Influenza: Outcomes over the Last 9 Flu Seasons
Does Influenza Vaccination Actually Reduce or Prevent the Flu in Older Adults?
More Evidence that Maternal Influenza Vaccination is Safe and Effective

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