Format

Send to

Choose Destination
Int J Gynaecol Obstet. 2018 Jan;140(1):65-72. doi: 10.1002/ijgo.12341. Epub 2017 Nov 9.

Impact of maternal vaccination timing and influenza virus circulation on birth outcomes in rural Nepal.

Author information

1
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
2
Seattle Children's Hospital and Research Foundation, University of Washington, Seattle, WA, USA.
3
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
4
Nepal Nutrition Intervention Project - Sarlahi, Kathmandu, Nepal.
5
Department of Pediatrics and Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
6
Molecular Virology Laboratory, School of Medicine, University of Washington, Seattle, WA, USA.
7
Harborview Medical Center, University of Washington, Seattle, WA, USA.
8
Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.

Abstract

OBJECTIVE:

To describe the effect of maternal vaccination on birth outcomes in rural Nepal, modified by timing of vaccination in pregnancy and influenza virus activity.

METHODS:

A secondary analysis was conducted using data from two annual cohorts of a randomized controlled trial. A total of 3693 pregnant women from Sarlahi District were enrolled between April 25, 2011, and September 9, 2013. All participants were aged 15-40 years and received a trivalent inactivated influenza vaccine or placebo. The outcome measures included birth weight, pregnancy length, low birth weight (<2500 g), preterm birth, and small-for-gestational-age birth.

RESULTS:

Data were available on birth weight for 2741 births and on pregnancy length for 3623 births. Maternal vaccination increased mean birthweight by 42 g (95% confidence interval [CI] 8-76). The magnitude of this increase varied by season but was greatest among pregnancies with high influenza virus circulation during the third trimester. Birth weight increased by 111 g (95% CI -51 to 273) when 75%-100% of a pregnancy's third trimester had high influenza virus circulation versus 38 g (95% CI -6 to 81) when 0%-25% of a pregnancy's third trimester had high influenza virus circulation. However, these results were nonsignificant.

CONCLUSION:

Seasonal maternal influenza vaccination in rural Nepal increased birth weight; the magnitude appeared larger during periods of high influenza virus circulation. CLINICALTRIALS.GOV: NCT01034254.

KEYWORDS:

Influenza; Low birth weight; Nepal; Pregnancy; Preterm; Small for gestational age; Vaccination

PMID:
28984909
PMCID:
PMC5765513
DOI:
10.1002/ijgo.12341
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center