The BMJ Today: Flu jabs during pregnancy

As a mother and a doctor, I am often asked medical questions by my non-medical friends. Most of the time this has nothing to do with my specialty (radiology), and I am probably not as helpful as my friends had hoped. Several months ago, a pregnant friend asked me if she should have the “flu jab” being offered to her. Like most, she was aware of the increased risk of influenza infection both for pregnant women and their babies. Happy to help, but too busy (lazy?) to actually do any research, I trawled back through the memory banks for some vague MRCP and medical school knowledge that might help with her decision. My answer wasn’t what she had hoped—I didn’t tell her what to do, I advised with a few pros and cons so that she could decide for herself.

Move forward several months, and I happened to read a recent bmj.com Research paper by Traversa et al: a population based, retrospective cohort study of over 86 000 pregnant women—approximately 7 % of whom were immunised with the MF59 adjuvanted monovalent pandemic A/H1N1 vaccine. T tests, X2, and a propensity score model for multivariate analysis compared multiple maternal, foetal, and neonatal outcomes with those not immunised. They found no increase in the risk of adverse foetal or birth outcomes following vaccination. There was, however, a limited increase in the prevalence of gestational diabetes and pre-eclampsia.

The accompanying Editorial by Fell et al looks at this study and those previously published. The authors agree that the H1N1 safety data is reassuring, but stress the need for “ongoing surveillance of all influenza vaccines given to pregnant women.”

My friend decided to have the vaccination (with little to no help from me) and now has a healthy, happy (noisy) little boy with no adverse outcomes from her vaccine. At least the next time I am asked this question I will be able to give a more confident, robust answer.

On another note, if anyone fancies a foray into radiology, or a quick quiz to test your radiological anatomy skills, take a look at the most recent Endgames; a tricky transverse image from an abdominal ultrasound; or an axial CT of the upper thorax—can you spot the normal variant?

Amy Davis is an associate editor at The BMJ

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