Safety of pertussis vaccination in pregnant women in UK: observational study - PubMed (original) (raw)

Observational Study

Safety of pertussis vaccination in pregnant women in UK: observational study

Katherine Donegan et al. BMJ. 2014.

Abstract

Objective: To examine the safety of pertussis vaccination in pregnancy.

Design: Observational cohort study.

Setting: The UK Clinical Practice Research Datalink.

Participants: 20,074 pregnant women with a median age of 30 who received the pertussis vaccine and a matched historical unvaccinated control group.

Main outcome measure: Adverse events identified from clinical diagnoses during pregnancy, with additional data from the matched child record identified through mother-child linkage. The primary event of interest was stillbirth (intrauterine death after 24 weeks' gestation).

Results: There was no evidence of an increased risk of stillbirth in the 14 days immediately after vaccination (incidence rate ratio 0.69, 95% confidence interval 0.23 to 1.62) or later in pregnancy (0.85, 0.44 to 1.61) compared with historical national rates. Compared with a matched historical cohort of unvaccinated pregnant women, there was no evidence that vaccination accelerated the time to delivery (hazard ratio 1.00, 0.97 to 1.02). Furthermore, there was no evidence of an increased risk of stillbirth, maternal or neonatal death, pre-eclampsia or eclampsia, haemorrhage, fetal distress, uterine rupture, placenta or vasa praevia, caesarean delivery, low birth weight, or neonatal renal failure, all serious events that can occur naturally in pregnancy.

Conclusion: In women given pertussis vaccination in the third trimester, there is no evidence of an increased risk of any of an extensive predefined list of adverse events related to pregnancy. In particular, there was no evidence of an increased risk of stillbirth. Given the recent increases in the rate of pertussis infection and morbidity and mortality in neonates, these early data provide initial evidence for evaluating the safety of the vaccine in pregnancy for health professionals and the public and can help to inform vaccination policy making.

© Donegan et al 2014.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi\_disclosure.pdf and declare: no support from any organisation for the submitted; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work. At the time of the study, all authors were employed by the Medicines and Healthcare products Regulatory Agency (MHRA) which is an Executive Agency of the Department of Health. The MHRA has statutory responsibility to monitor the safety of medicinal products, including vaccines, on the UK market, and the study was undertaken independently of the Department of Health.

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