TABLE 4.
Secondary analysis adjusted odds ratios (OR) and 95% confidence intervals (CI) for associations between influenza vaccination and non-cardiac birth defects, National Birth Defects Prevention Study 2006 to 2011
| Birth defectd | Case children with isolated defectsa |
Singletons onlyb |
First trimester overlapping with September–March Onlyc |
|||
|---|---|---|---|---|---|---|
| Case children exposed/unexposedd | Adjusted, limited modele,f OR (95% CI) | Case children exposed/unexposedd | Adjusted, limited modele,f OR (95% CI) | Case children exposed/unexposedd | Adjusted, limited modele,f OR (95% CI) | |
| Central nervous system | ||||||
| Any neural tube defectsg | 7/793 | 0.74 (0.32, 1.72) | 9/879 | 0.88 (0.42, 1.86) | 8/752 | 0.81 (0.37, 1.80) |
| Hydrocephaly | 6/126 | 1.27 (0.54, 3.00) | 7/177 | 0.91 (0.39, 2.13) | 7/158 | 0.92 (0.40, 2.15) |
| Eye and ear | ||||||
| Anophthalmia/microphthalmia | 5/50 | 2.22 (0.84, 5.88) | 5/81 | 1.82 (0.70, 4.72) | 5/76 | 1.60 (0.62, 4.15) |
| Cataracts | 5/137 | 0.79 (0.32, 2.00) | 4/150 | NA | 5/131 | 0.73 (0.29, 1.85) |
| Anotia/microtia | 6/175 | 0.84 (0.33, 2.10) | 6/252 | 0.59 (0.24, 1.47) | 7/222 | 0.68 (0.30, 1.58) |
| Orofacial | ||||||
| Choanal atresia | 3/35 | NA | 5/57 | 1.69 (0.65, 4.43) | 5/55 | 1.65 (0.63, 4.30) |
| Oral clefts | 61/1598 | 0.97 (0.71, 1.31) | 67/1774 | 0.94 (0.70, 1.26) | 69/1545 | 0.98 (0.74, 1.32) |
| Cleft lip w/wo cleft palate | 41/1096 | 0.96 (0.67, 1.36) | 45/1190 | 0.96 (0.68, 1.34) | 45/1050 | 0.97 (0.69, 1.36) |
| Cleft palate | 20/502 | 0.98 (0.61, 1.59) | 22/584 | 0.90 (0.56, 1.44) | 24/495 | 1.02 (0.65, 1.60) |
| Gastrointestinal | ||||||
| Esophageal atresia | 7/137 | 1.19 (0.54, 2.63) | 12/278 | 1.04 (0.56, 1.91) | 15/256 | 1.20 (0.69, 2.10) |
| Duodenal atresia/stenosis | 6/71 | 2.30 (0.94, 5.61) | 8/107 | 1.83 (0.85, 3.93) | 8/96 | 1.76 (0.82, 3.80) |
| Anorectal atresia/stenosis | 7/168 | 1.13 (0.51, 2.49) | 12/355 | 0.96 (0.53, 1.77) | 12/322 | 0.86 (0.47, 1.57) |
| Genitourinary | ||||||
| Hypospadias second/third degree | 53/1027 | 1.16 (0.81, 1.67) | 57/1079 | 1.18 (0.83, 1.68) | 61/966 | 1.24 (0.87, 1.76) |
| Bilateral renal agenesis or hypoplasia | 4/49 | NA | 5/56 | 1.79 (0.61, 5.26) | 5/51 | 1.61 (0.55, 4.70) |
| Musculoskeletal | ||||||
| Limb deficiencyh | 17/355 | 0.90 (0.51, 1.59) | 22/447 | 0.99 (0.60, 1.65) | 22/396 | 1.03 (0.63, 1.69) |
| Longitudinal limb deficiency | 6/96 | 1.60 (0.67, 3.81) | 9/162 | 1.35 (0.64, 2.86) | 10/145 | 1.47 (0.72, 3.01) |
| Transverse limb deficiency | 10/241 | 0.64 (0.29, 1.39) | 11/269 | 0.69 (0.33, 1.44) | 10/236 | 0.68 (0.33, 1.42) |
| Craniosynostosis | 42/683 | 1.25 (0.87, 1.77) | 42/709 | 1.22 (0.85, 1.73) | 44/613 | 1.30 (0.92, 1.85) |
| Diaphragmatic hernia | 10/244 | 1.23 (0.63, 2.41) | 12/323 | 1.13 (0.61, 2.08) | 14/281 | 1.28 (0.72, 2.28) |
| Omphalocele | 3/98 | NA | 5/128 | 0.41 (0.10, 1.68) | 5/125 | 0.34 (0.08, 1.42) |
| Gastroschisis | 19/600 | 0.82 (0.48, 1.40) | 18/660 | 0.72 (0.42, 1.23) | 19/578 | 0.76 (0.45, 1.29) |
Abbreviations: NA, not applicable as point estimates were not calculated when there were <5 exposed case children.
Neural tube defect analysis included 63 exposed and 4874 unexposed control children; hypospadias analysis included 87 exposed and 2457 unexposed control children; all other analyses included 197 exposed and 4740 unexposed control children.
Neural tube defect analysis included 62 exposed and 4728 unexposed control children; hypospadias analysis included 85 exposed and 2386 unexposed control children; all other analyses included 192 exposed and 4598 unexposed control children.
Neural tube defect analysis included 59 exposed and 4080 unexposed control children; hypospadias analysis included 85 exposed and 2043 unexposed control children; all other analyses included 189 exposed and 3950 unexposed control children.
Exposure window is 1 month before pregnancy through the first pregnancy month for neural tube defects and 1 month before pregnancy through the third pregnancy month for all other defects.
Counts in adjusted analyses were slightly lower than presented because of missing covariate values.
Adjusted for estimated date of delivery year and season, maternal age at delivery, maternal race/ethnicity, plurality, cigarette smoking, alcohol use, low folate intake, and, for neural tube defects, folate antagonist medication use.
Subtypes of neural tube defects with <5 exposed case children are not presented: anencephaly, encephalocele, spina bifida.
Subtypes of limb deficiency with <5 exposed case children are not presented: intercalary limb deficiency, NOS limb deficiency.