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Influenza during pregnancy

Mariam Dvalishvili, Darejan Mesxishvili, Maia Butsashvili, George Kamkamidze, Deborah McFarland, Robert A Bednarczyk
OBJECTIVE: To document knowledge, attitudes, and practices of Georgian obstetrician-gynecologists concerning influenza infection and vaccination during pregnancy. METHODS: We conducted a cross-sectional study of obstetrician-gynecologists in 8 cities in the country of Georgian, from June to July, 2015, using an anonymous, self-administered, written survey. Collected data included demographics; knowledge, attitudes, and practices related to influenza vaccination during pregnancy; perceptions of influenza infection in pregnancy; perceived barriers to influenza vaccination during pregnancy; and willingness to receive education about influenza infection and vaccination during pregnancy...
October 20, 2016: Vaccine
N M Scott, J F Lauzon-Joset, A C Jones, K T Mincham, N M Troy, J Leffler, M Serralha, S L Prescott, S A Robertson, C Pasquali, A Bosco, P G Holt, D H Strickland
Infection-associated inflammatory stress during pregnancy is the most common cause of fetal growth restriction and/or miscarriage. Treatment strategies for protection of at-risk mothers are limited to a narrow range of vaccines, which do not cover the bulk of the common pathogens most frequently encountered. Using mouse models, we demonstrate that oral treatment during pregnancy with a microbial-derived immunomodulator (OM85), currently used clinically for attenuation of infection-associated airway inflammatory symptoms in infants-adults, markedly reduces risk for fetal loss/growth restriction resulting from maternal challenge with bacterial lipopolysaccharide or influenza...
October 19, 2016: Mucosal Immunology
Kirsten Maertens, Tessa Braeckman, Geert Top, Pierre Van Damme, Elke Leuridan
In Belgium, pertussis vaccination is recommended for all pregnant women in every pregnancy. Adults in close contact with young infants are equally advised to receive a pertussis containing booster dose. Maternal influenza vaccination is likewise recommended in Belgium in the second or third trimester of pregnancy, within the influenza season. A quantitative multicenter survey study has been performed between October 2014 and May 2015 in both postpartum women (N=823, response rate=89.2%) and health care workers (HCWs) (N=261) to assess the coverage of both vaccines during pregnancy along with the coverage of the pertussis cocoon strategy, and to evaluate the knowledge and recommending attitude of HCWs towards the maternal vaccination strategies and the cocoon strategy among surveyed women and HCWs...
October 11, 2016: Vaccine
Shaun K Morris, Lisa G Pell, Mohammed Ziaur Rahman, Michelle C Dimitris, Abdullah Mahmud, M Munirul Islam, Tahmeed Ahmed, Eleanor Pullenayegum, Tahmid Kashem, Shaila S Shanta, Jonathan Gubbay, Eszter Papp, Michelle Science, Stanley Zlotkin, Daniel E Roth
BACKGROUND: Early infancy is a high-risk period for severe acute respiratory infection (ARI), particularly in low-income countries with resource-limited health systems. Lower respiratory tract infection (LRTI) is commonly preceded by upper respiratory infection (URTI), and often caused by respiratory syncytial virus (RSV), influenza and other common community-acquired viral pathogens. Vitamin D status is a candidate modifiable early-life determinant of the host antiviral immune response and thus may influence the risk of ARI-associated morbidity in high-risk populations...
October 13, 2016: BMC Pregnancy and Childbirth
Thomas Harder, Cornelius Remschmidt, Sebastian Haller, Tim Eckmanns, Ole Wichmann
BACKGROUND: Given limited resources and time constraints, the use of existing systematic reviews (SR) for the development of evidence-based public health recommendations has become increasingly important. Recently, a five-step approach for identifying, analyzing, appraising and using existing SRs based on recent guidance by the US Agency for Healthcare Research and Quality (AHRQ) was proposed within the Project on a Framework for Rating Evidence in Public Health (PRECEPT). However, case studies are needed to test whether this approach is useful, what challenges arise and how problems can be solved...
October 11, 2016: Systematic Reviews
Juliana G Barnard, Amanda F Dempsey, Sarah E Brewer, Jennifer Pyrzanowski, Sara E Mazzoni, Sean T O'Leary
BACKGROUND: Many young and middle aged women receive their primary health care from their obstetrician-gynecologists (ob-gyn). A recent change to vaccination recommendations during pregnancy has forced the integration of new clinical processes at ob-gyn practices. Evidence-based best practices for vaccination delivery include the establishment of vaccination standing orders. OBJECTIVES: As part of an intervention to increase adoption of evidence-based vaccination strategies for women in safety-net and private ob-gyn settings, we conducted a qualitative study to identify the facilitators and barriers experienced by ob-gyn sites when establishing vaccination standing orders...
September 26, 2016: American Journal of Obstetrics and Gynecology
Valerie Wing Yu Wong, Daniel Yee Tak Fong, Kris Yuet Wan Lok, Janet Yuen Ha Wong, Chu Sing, Alice Yin-Yin Choi, Carol Yuet Sheung Yuen, Marie Tarrant
BACKGROUND: Although pregnant women are the highest priority group for seasonal influenza vaccination, maternal influenza vaccination rates remain suboptimal. The purpose of this study was to evaluate the effect of a brief education intervention on maternal influenza vaccine uptake. METHODS: During the 2013-14 and 2014-15 influenza seasons, we recruited 321 pregnant women from the antenatal clinics of 4 out of 8 public hospitals in Hong Kong with obstetric services...
October 17, 2016: Vaccine
Marcel Verweij, Philipp Lambach, Justin R Ortiz, Andreas Reis
There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial since regulators, professionals, and the public are often reluctant to accept pharmaceutical interventions during pregnancy...
September 20, 2016: Lancet Infectious Diseases
Marta C Nunes, Anushka R Aqil, Saad B Omer, Shabir A Madhi
Objective Numerous observational studies have evaluated the relationship between influenza vaccination during pregnancy and birth outcomes. The number of studies on this subject has increased, especially after the 2009 A/H1N1 pandemic (A/H1N1pdm09). This meta-analysis aims to determine the impact of maternal vaccination with either seasonal trivalent inactivated influenza vaccines (IIV) or A/H1N1pdm09 monovalent vaccines on the rates of preterm (PTB), small for gestational age (SGA), and low birth weight (LBW) births...
September 2016: American Journal of Perinatology
J Gaudelus, A Martinot, F Denis, J-P Stahl, O Chevaillier, T Lery, P Pujol, R Cohen
OBJECTIVE: Vaccination of pregnant women against seasonal influenza is recommended in France since 2010. We currently do not have any vaccination coverage (VC) data to assess the implementation of this recommendation. METHODS: Vaccinoscopie(®) is an annual study conducted online using a self-administered questionnaire. A section dedicated to parents' vaccination was included in 2014 and aimed at interviewing 300 mothers of infants aged<12 months to assess their opinion of vaccination with regard to their last and future pregnancies...
September 1, 2016: Médecine et Maladies Infectieuses
Annette K Regan
Maternal vaccination offers the opportunity to protect pregnant women and their infants against potentially serious disease. As both pregnant women and their newborns are vulnerable to severe illness, the potential public health impact of mass maternal vaccination programs is remarkable. Several high-income countries recommend seasonal influenza and acellular pertussis vaccines, and many developing countries recommend immunization against tetanus during pregnancy. There is a significant amount of literature supporting the safety of vaccination during pregnancy...
August 19, 2016: Human Vaccines & Immunotherapeutics
Titus H Divala, Linda Kalilani-Phiri, Patricia Mawindo, Osward Nyirenda, Atupele Kapito-Tembo, Miriam K Laufer
Pregnant women with influenza infection are at increased risk of developing complications compared with other adults. Information about burden of influenza in pregnant women in Africa is limited. To determine incidence and seasonality of influenza-like illness (ILI) in pregnant women in Blantyre, Malawi, we recruited a cohort of 450 pregnant women and conducted surveillance for ILI and malaria infection. We recorded gestational age and birthweight. We accrued 157 person-years of observation (PYO) and detected 37 episodes of ILI (24/100 PYO) and 83 episodes of malaria infection (including all new episodes of parasitemia) (53/100 PYO)...
October 5, 2016: American Journal of Tropical Medicine and Hygiene
N A T van der Maas, K van Aerde, L J Bont, M N Bekker, N Rots, H E de Melker
- In the first few months of life, newborns are vulnerable to infections.- Vaccination of the pregnant mother leads to transplacental antibody transfer, resulting in the best possible protection of the newborn.- Maternal vaccination has long been given for the prevention of tetanus in developing countries, and for the prevention of pertussis and influenza in developed countries, such as the United States, England and Belgium. These vaccinations give newborns good protection and, to date, no adverse effects are known for the foetus or the pregnancy...
2016: Nederlands Tijdschrift Voor Geneeskunde
Isaac G Sakala, Yoshikazu Honda-Okubo, Johnson Fung, Nikolai Petrovsky
The serious consequences of influenza infection during pregnancy have been recognized for almost a century. In this article, we reviewed the evidence on the immunogenicity, safety and impact of maternal influenza immunization for both mother and child. After vaccination, pregnant women have similar protective titers of anti-influenza antibodies as non-pregnant women, demonstrating that pregnancy does not alter the trivalent inactivated influenza vaccine immune response. Studies from the United States, Europe and resource-constrained regions demonstrate that maternal vaccination is associated with increased anti-influenza antibody concentrations and protection in the newborn child as well as the immunized mother...
August 5, 2016: Human Vaccines & Immunotherapeutics
Deshayne B Fell, Kumanan Wilson, Robin Ducharme, Steven Hawken, Ann E Sprague, Jeffrey C Kwong, Graeme Smith, Shi Wu Wen, Mark C Walker
BACKGROUND: Infants are at high risk for influenza illness, but are ineligible for vaccination before 6 months. Transfer of maternal antibodies to the fetus has been demonstrated for 2009 A/H1N1 pandemic vaccines; however, clinical effectiveness is unknown. Our objective was to evaluate the association between 2009 A/H1N1 pandemic vaccination during pregnancy and rates of infant influenza and pneumonia. METHODS: We linked a population-based birth cohort to administrative databases to measure rates of influenza and pneumonia diagnosed during ambulatory physician visits, hospitalizations and emergency department visits during one year of follow-up...
2016: PloS One
Keely Cheslack-Postava, Serge Cremers, Yuanyuan Bao, Ling Shen, Catherine A Schaefer, Alan S Brown
Prenatal exposure to influenza has previously been associated with increased risk of bipolar disorder (BD), an association that may be mediated by maternal cytokines. The objective of this study was to determine the association between maternal levels of cytokines measured during each trimester of pregnancy and the risk of BD in offspring. We conducted a case-control study nested in the Child Health and Development Study, a birth cohort that enrolled pregnant women in 1959-1966. Potential cases with DSM-IV-TR bipolar I disorder, bipolar II disorder, BD not otherwise specified, and BD with psychotic features were ascertained through electronic medical records, a public agency database, and a mailing to the cohort...
July 29, 2016: Brain, Behavior, and Immunity
Asher Ornoy, Liza Weinstein-Fudim, Zivanit Ergaz
Autism spectrum disorder (ASD) affecting about 1% of all children is associated, in addition to complex genetic factors, with a variety of prenatal, perinatal, and postnatal etiologies. In addition, ASD is often an important clinical presentation of some well-known genetic syndromes in human. We discuss these syndromes as well as the role of the more important prenatal factors affecting the fetus throughout pregnancy which may also be associated with ASD. Among the genetic disorders we find Fragile X, Rett syndrome, tuberous sclerosis, Timothy syndrome, Phelan-McDermid syndrome, Hamartoma tumor syndrome, Prader-Willi and Angelman syndromes, and a few others...
2016: Frontiers in Neuroscience
Christina D Chambers, Diana L Johnson, Ronghui Xu, Yunjun J Luo, Carol Louik, Allen A Mitchell, Michael Schatz, Kenneth L Jones
INTRODUCTION: There is a need for pregnancy safety information overall and for each seasonal formulation of the influenza vaccine. METHODS: As part of the cohort arm of the Vaccines and Medications in Pregnancy Surveillance System, vaccine-exposed and unexposed women in the U.S. or Canada were recruited during pregnancy in the 2010-2014 vaccine seasons and followed to pregnancy outcome. For the four seasons combined, crude and adjusted relative risks (RRs) were estimated with 95% confidence intervals (CIs) for major birth defects overall and infants small for gestational age...
August 17, 2016: Vaccine
Deshayne B Fell, David L Buckeridge, Robert W Platt, Jay S Kaufman, Olga Basso, Kumanan Wilson
Individual-level epidemiologic studies of pregnancy outcomes after maternal influenza are limited in number and quality and have produced inconsistent results. We used a time-series design to investigate whether fluctuation in influenza virus circulation was associated with short-term variation in population-level rates of preterm birth, stillbirth, and perinatal death in Ontario between 2003 and 2012. Using Poisson regression, we assessed the association between weekly levels of circulating influenza virus and counts of outcomes offset by the number of at-risk gestations during 3 gestational exposure windows...
August 1, 2016: American Journal of Epidemiology
Gabriela Vazquez-Benitez, Elyse O Kharbanda, Allison L Naleway, Heather Lipkind, Lakshmi Sukumaran, Natalie L McCarthy, Saad B Omer, Lei Qian, Stanley Xu, Michael L Jackson, Vinutha Vijayadev, Nicola P Klein, James D Nordin
Vaccines are increasingly targeted toward women of reproductive age, and vaccines to prevent influenza and pertussis are recommended during pregnancy. Prelicensure clinical trials typically have not included pregnant women, and when they are included, trials cannot detect rare events. Thus, postmarketing vaccine safety assessments are necessary. However, analysis of observational data requires detailed assessment of potential biases. Using data from 8 Vaccine Safety Datalink sites in the United States, we analyzed the association of monovalent H1N1 influenza vaccine (MIV) during pregnancy with preterm birth (<37 weeks) and small-for-gestational-age birth (birth weight < 10th percentile)...
August 1, 2016: American Journal of Epidemiology
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