Impact of Maternal Immunization and Breastfeeding on Influenza-Like Illness and Lower Respiratory Tract Infections in Infants Open Access
Chen, Guan (2013)
Abstract
Background: Influenza is a highly infectious viral disease which creates a substantial burden on high risk populations such as pregnant women and young infants. Maternal immunization is an effective way to increase levels of influenza-specific antibodies in maternal serum and breast milk, providing passive protection to the infant in the months after birth, before the infant's immune system is fully developed or childhood vaccines can be administered.
Objective: The objective of the study was to evaluate the strength of association between the receipt of inactivated influenza vaccine during pregnancy and respiratory outcomes among breastfed infants and non-breastfed infants.
Methods: We conducted an analysis of surveillance data from the Georgia Pregnancy Risk Assessment Monitoring, Georgia Hospital Discharge Data, and Birth Certificate Data on infants born between January 1, 2005 and December 31, 2008. The primary exposure variable was maternal receipt of the influenza vaccine. The outcomes of interest were hospitalizations due to influenza/influenza-like illness (ILI) and pneumonia/lower respiratory tract infections (LRTI) in infants.
Results: A total of 8,393 women were included in the study. Influenza vaccine information was available for 5422 (64.6%) women; of these 916 (16.9%) women received the influenza vaccine during pregnancy. The magnitude of effect of maternal influenza vaccine on ILI was much stronger for breastfed newborns compared to newborns who were not breastfed during the period of at least local, at least regional, and widespread influenza activity. The presence of breastfeeding only influenced the magnitude of effect of maternal influenza vaccine on LRTI during the putative influenza season.
Conclusion: Maternal vaccination and breastfeeding provide infants greater protection than vaccination or breastfeeding alone. Multiple studies have found that full breastfeeding have been shown to confer lower overall illness rates in infants, whereas minimal breastfeeding have not been found to be protective. It is plausible that the association between immunization with the inactivated influenza vaccine during pregnancy and reduced likelihood of ILI or LRTI may be much stronger among exclusive breastfed infants. The results of this study need to be replicated in a larger population to assess the association among infants who were fully breastfed and minimally breastfed.
Table of Contents
Table of Contents
MANUSCRIPT
Title, Author(s), Abstract...1
Introduction...3
Methods...5
Results...11
Discussion...14
References...19
Tables...23
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