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Int J Gynaecol Obstet. 2018 May;141(2):141-150. doi: 10.1002/ijgo.12394. Epub 2017 Dec 18.

A systematic review and meta-analysis of fetal outcomes following the administration of influenza A/H1N1 vaccination during pregnancy.

Zhang C1,2,3, Wang X3,4, Liu D1,2,3, Zhang L1,2,3, Sun X5.

Author information

1
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
2
Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
3
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
4
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
5
Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China.

Abstract

BACKGROUND:

Pregnant women were identified as a population of priority for vaccination during the H1N1 influenza pandemic outbreak in 2009.

OBJECTIVES:

To assess adverse fetal outcomes following the administration of H1N1 pandemic vaccination during pregnancy.

SEARCH STRATEGY:

PubMed, Embase, and Cochrane Library were searched up to January 2017.

SELECTION CRITERIA:

Cohort studies investigating fetal outcomes after H1N1 influenza vaccination during pregnancy were eligible. The language was limited to English.

DATA COLLECTION AND ANALYSIS:

Pairs of reviewers independently screened studies for eligibility, assessed the risk of bias, and extracted data from the included studies.

MAIN RESULTS:

A total of 19 cohort studies were eligible. The use of vaccines during any period of pregnancy was associated with lower risk of stillbirth (adjusted hazard ratio 0.80, 95% confidence interval 0.69-0.92). No significant differences were found between the vaccinated versus unvaccinated groups in terms of the risks of spontaneous abortion, premature birth, and small for gestational age.

CONCLUSIONS:

The administration of H1N1 vaccines during pregnancy might reduce the risk of stillbirth, a complication associated with H1N1 infection. The quality of evidence was, however, not adequate to reach a definitive conclusion.

KEYWORDS:

A/H1N1 pandemic vaccination; Congenital malformation; Fetal outcomes; Meta-analysis; Premature delivery; Stillbirth

PMID:
29149524
DOI:
10.1002/ijgo.12394
[Indexed for MEDLINE]

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