ObjectiveAdverse birth outcomes and the maternal severity of influenza in pregnancy are well documented but information on pertussis is limited.DesignPopulation‐based linkage data were collected during 2001–2016.SettingNew South Wales, Australia.Population or SampleA total of 1 453 037 singleton births.MethodsCox regression was used to estimate the associations between pertussis or influenza during pregnancy and birth outcomes with adjustment of covariates.Main Outcome MeasuresAdverse birth outcomes (preterm birth and low birth weight).ResultsAmong 1 453 037 singleton births over 16 years, we identified pertussis in 925 (49; 5.3% hospitalised) and influenza in 2850 (1092; 38.3% hospitalised) women during pregnancy. Cases of pertussis were similarly distributed by trimester (32% 3rd) whereas 46% of influenza cases were in the 3rd trimester. Younger age, previous birth, and being overseas‐born were associated with both pertussis and influenza, whereas identifying as Aboriginal or Torres Strait Islander, hypertension or diabetes before and during pregnancy, and a number of other factors were only associated with influenza. Both pertussis and influenza in pregnancy were associated with increased risk of preterm birth (pertussis: aHR = 1.30, 95% CI 1.01–1.68; influenza: aHR = 1.56, 95% CI 1.36–1.79) and these increased risks were greater when infections in the period within 2 weeks of birth were considered (pertussis: aHR = 2.36, 95% CI 1.26–4.41; influenza: aHR = 2.29, 95% CI 1.78–2.96).ConclusionsMaternal pertussis and influenza infections close to the time of birth were associated with adverse birth outcomes. These findings highlight the benefits of vaccination during pregnancy.

中文翻译：

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妊娠期诊断为百日咳和流感后的出生结局：一项基于人群的回顾性研究


目的不良分娩结局和妊娠期孕妇流感的严重程度有据可查，但关于百日咳的信息有限。设计在 2001-2016 年期间收集了基于人群的联系数据。地点澳大利亚新南威尔士州人口或样本共 1 453 037 例单胎出生。方法采用 Cox 回归估计妊娠期百日咳或流感与协变量调整后出生结局之间的关联。主要结局指标不良出生结局 （早产和低出生体重）。结果在 16 年内的 1 453 037 例单胎分娩中，我们发现 925 例（49 例;5.3% 住院）患有百日咳，2850 例（1092 例;38.3% 住院）妊娠期妇女患有流感。百日咳病例按妊娠期分布相似 （32% 3rd），而 46% 的流感病例分布在妊娠晚期。年龄较小、既往出生和在海外出生与百日咳和流感有关，而被认定为原住民或托雷斯海峡岛民、怀孕前和怀孕期间的高血压或糖尿病以及许多其他因素仅与流感有关。妊娠期百日咳和流感均与早产风险增加相关（百日咳：aHR = 1.30,95% CI 1.01-1.68;流感：aHR = 1.56,95% CI 1.36-1.79），当考虑出生后 2 周内感染时，这些风险增加更大（百日咳：aHR = 2.36,95% CI 1.26-4.41;流感：aHR = 2.29， 95% CI 1.78–2.96）。结论接近出生时间的母体百日咳和流感感染与不良出生结局相关。这些发现突出了怀孕期间接种疫苗的好处。