3 years ago

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

Jane Kuypers, Subarna K Khatry, Joanne Katz, Naoko Kozuki, Luke C Mullany, Laxman Shrestha, Janet A Englund, James M Tielsch, Steven C LeClerq, Helen Y Chu, Mark C Steinhoff
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. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/ijgo.12341

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