GrippeCanadaV4, Main, Exploration, bibRecord, 000026

Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.

Identifieur interne : 000026 ( Main/Exploration ); précédent : 000025; suivant : 000027

Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.

Auteurs : Laura K. Walsh [Canada] ; Jessy Donelle [Canada] ; Linda Dodds [Canada] ; Steven Hawken [Canada] ; Kumanan Wilson [Canada] ; Eric I. Benchimol [Canada] ; Pranesh Chakraborty [Canada] ; Astrid Guttmann [Canada] ; Jeffrey C. Kwong [Canada] ; Noni E. Macdonald [Canada] ; Justin R. Ortiz [États-Unis] ; Ann E. Sprague [Canada] ; Karina A. Top [Canada] ; Mark C. Walker [Canada] ; Shi Wu Wen [Canada] ; Deshayne B. Fell [Canada]

Source :

BMJ (Clinical research ed.) [ 1756-1833 ] ; 2019.

RBID : pubmed:31292120

Descripteurs français

English descriptors

KwdEn :
- Adult (MeSH), Asthma (epidemiology), Child Health (MeSH), Child, Preschool (MeSH), Female (MeSH), Gastrointestinal Diseases (epidemiology), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Infections (epidemiology), Influenza A Virus, H1N1 Subtype (MeSH), Influenza Vaccines (adverse effects), Influenza, Human (prevention & control), Ontario (epidemiology), Pandemics (prevention & control), Pregnancy (MeSH), Pregnancy Complications, Infectious (prevention & control), Prenatal Exposure Delayed Effects (MeSH), Propensity Score (MeSH), Registries (MeSH), Retrospective Studies (MeSH), Young Adult (MeSH).
MESH :
- chemical , adverse effects : Influenza Vaccines.
- geographic , epidemiology : Ontario.
- epidemiology : Asthma, Gastrointestinal Diseases, Infections.
- prevention & control : Influenza, Human, Pandemics, Pregnancy Complications, Infectious.
- Adult, Child Health, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Influenza A Virus, H1N1 Subtype, Pregnancy, Prenatal Exposure Delayed Effects, Propensity Score, Registries, Retrospective Studies, Young Adult.

Abstract

OBJECTIVE

To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.

DESIGN

Retrospective cohort study.

SETTING

Population based birth registry linked with health administrative databases in the province of Ontario, Canada.

PARTICIPANTS

All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.

MAIN OUTCOME MEASURES

Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.

RESULTS

Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.

CONCLUSIONS

No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.

DOI: 10.1136/bmj.l4151
PubMed: 31292120
PubMed Central: PMC6614795

Affiliations:

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<author><name sortKey="Wen, Shi Wu" sort="Wen, Shi Wu" uniqKey="Wen S" first="Shi Wu" last="Wen">Shi Wu Wen</name>
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<author><name sortKey="Chakraborty, Pranesh" sort="Chakraborty, Pranesh" uniqKey="Chakraborty P" first="Pranesh" last="Chakraborty">Pranesh Chakraborty</name>
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<country xml:lang="fr">Canada</country>
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<author><name sortKey="Guttmann, Astrid" sort="Guttmann, Astrid" uniqKey="Guttmann A" first="Astrid" last="Guttmann">Astrid Guttmann</name>
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</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Hospital for Sick Children, Toronto, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kwong, Jeffrey C" sort="Kwong, Jeffrey C" uniqKey="Kwong J" first="Jeffrey C" last="Kwong">Jeffrey C. Kwong</name>
<affiliation wicri:level="1"><nlm:affiliation>ICES, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>ICES, Toronto, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Public Health Ontario, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Public Health Ontario, Toronto, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:affiliation>Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Family and Community Medicine, University of Toronto, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Macdonald, Noni E" sort="Macdonald, Noni E" uniqKey="Macdonald N" first="Noni E" last="Macdonald">Noni E. Macdonald</name>
<affiliation wicri:level="1"><nlm:affiliation>Dalhousie University, Halifax, NS, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Dalhousie University, Halifax, NS</wicri:regionArea>
<wicri:noRegion>NS</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ortiz, Justin R" sort="Ortiz, Justin R" uniqKey="Ortiz J" first="Justin R" last="Ortiz">Justin R. Ortiz</name>
<affiliation wicri:level="2"><nlm:affiliation>University of Maryland School of Medicine, Baltimore, MD, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Maryland School of Medicine, Baltimore, MD</wicri:regionArea>
<placeName><region type="state">Maryland</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sprague, Ann E" sort="Sprague, Ann E" uniqKey="Sprague A" first="Ann E" last="Sprague">Ann E. Sprague</name>
<affiliation wicri:level="1"><nlm:affiliation>Better Outcomes Registry & Network, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Better Outcomes Registry & Network, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Ottawa, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Top, Karina A" sort="Top, Karina A" uniqKey="Top K" first="Karina A" last="Top">Karina A. Top</name>
<affiliation wicri:level="1"><nlm:affiliation>Dalhousie University, Halifax, NS, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Dalhousie University, Halifax, NS</wicri:regionArea>
<wicri:noRegion>NS</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Walker, Mark C" sort="Walker, Mark C" uniqKey="Walker M" first="Mark C" last="Walker">Mark C. Walker</name>
<affiliation wicri:level="1"><nlm:affiliation>Better Outcomes Registry & Network, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Better Outcomes Registry & Network, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Ottawa, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Ottawa Hospital Research Institute, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Wen, Shi Wu" sort="Wen, Shi Wu" uniqKey="Wen S" first="Shi Wu" last="Wen">Shi Wu Wen</name>
<affiliation wicri:level="1"><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Ottawa, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Ottawa Hospital Research Institute, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fell, Deshayne B" sort="Fell, Deshayne B" uniqKey="Fell D" first="Deshayne B" last="Fell">Deshayne B. Fell</name>
<affiliation wicri:level="1"><nlm:affiliation>University of Ottawa, Ottawa, ON, Canada dfell@cheo.on.ca.</nlm:affiliation>
<country wicri:rule="url">Canada</country>
<wicri:regionArea>University of Ottawa, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>ICES, Toronto, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>ICES, Toronto, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON</wicri:regionArea>
<wicri:noRegion>ON</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">BMJ (Clinical research ed.)</title>
<idno type="eISSN">1756-1833</idno>
<imprint><date when="2019" type="published">2019</date>
</imprint>
</series>
</biblStruct>
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</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Asthma (epidemiology)</term>
<term>Child Health (MeSH)</term>
<term>Child, Preschool (MeSH)</term>
<term>Female (MeSH)</term>
<term>Gastrointestinal Diseases (epidemiology)</term>
<term>Humans (MeSH)</term>
<term>Infant (MeSH)</term>
<term>Infant, Newborn (MeSH)</term>
<term>Infections (epidemiology)</term>
<term>Influenza A Virus, H1N1 Subtype (MeSH)</term>
<term>Influenza Vaccines (adverse effects)</term>
<term>Influenza, Human (prevention & control)</term>
<term>Ontario (epidemiology)</term>
<term>Pandemics (prevention & control)</term>
<term>Pregnancy (MeSH)</term>
<term>Pregnancy Complications, Infectious (prevention & control)</term>
<term>Prenatal Exposure Delayed Effects (MeSH)</term>
<term>Propensity Score (MeSH)</term>
<term>Registries (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Asthme (épidémiologie)</term>
<term>Complications infectieuses de la grossesse (prévention et contrôle)</term>
<term>Effets différés de l'exposition prénatale à des facteurs de risque (MeSH)</term>
<term>Enfant d'âge préscolaire (MeSH)</term>
<term>Enregistrements (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (prévention et contrôle)</term>
<term>Grossesse (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Maladies gastro-intestinales (épidémiologie)</term>
<term>Nourrisson (MeSH)</term>
<term>Nouveau-né (MeSH)</term>
<term>Ontario (épidémiologie)</term>
<term>Pandémies (prévention et contrôle)</term>
<term>Santé de l'enfant (MeSH)</term>
<term>Score de propension (MeSH)</term>
<term>Sous-type H1N1 du virus de la grippe A (MeSH)</term>
<term>Vaccins antigrippaux (effets indésirables)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Influenza Vaccines</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ontario</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Vaccins antigrippaux</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Asthma</term>
<term>Gastrointestinal Diseases</term>
<term>Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term>
<term>Pandemics</term>
<term>Pregnancy Complications, Infectious</term>
</keywords>
<keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Complications infectieuses de la grossesse</term>
<term>Grippe humaine</term>
<term>Pandémies</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Asthme</term>
<term>Maladies gastro-intestinales</term>
<term>Ontario</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Child Health</term>
<term>Child, Preschool</term>
<term>Female</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant, Newborn</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Pregnancy</term>
<term>Prenatal Exposure Delayed Effects</term>
<term>Propensity Score</term>
<term>Registries</term>
<term>Retrospective Studies</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Effets différés de l'exposition prénatale à des facteurs de risque</term>
<term>Enfant d'âge préscolaire</term>
<term>Enregistrements</term>
<term>Femelle</term>
<term>Grossesse</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Nourrisson</term>
<term>Nouveau-né</term>
<term>Santé de l'enfant</term>
<term>Score de propension</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Études rétrospectives</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN</b>
</p>
<p>Retrospective cohort study.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>Population based birth registry linked with health administrative databases in the province of Ontario, Canada.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b>
</p>
<p>All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b>
</p>
<p>Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31292120</PMID>
<DateCompleted><Year>2019</Year>
<Month>07</Month>
<Day>16</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>02</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1756-1833</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>366</Volume>
<PubDate><Year>2019</Year>
<Month>07</Month>
<Day>10</Day>
</PubDate>
</JournalIssue>
<Title>BMJ (Clinical research ed.)</Title>
<ISOAbbreviation>BMJ</ISOAbbreviation>
</Journal>
<ArticleTitle>Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.</ArticleTitle>
<Pagination><MedlinePgn>l4151</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1136/bmj.l4151</ELocationID>
<Abstract><AbstractText Label="OBJECTIVE">To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.</AbstractText>
<AbstractText Label="DESIGN">Retrospective cohort study.</AbstractText>
<AbstractText Label="SETTING">Population based birth registry linked with health administrative databases in the province of Ontario, Canada.</AbstractText>
<AbstractText Label="PARTICIPANTS">All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.</AbstractText>
<AbstractText Label="MAIN OUTCOME MEASURES">Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.</AbstractText>
<AbstractText Label="RESULTS">Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.</AbstractText>
<AbstractText Label="CONCLUSIONS">No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.</AbstractText>
<CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Walsh</LastName>
<ForeName>Laura K</ForeName>
<Initials>LK</Initials>
<AffiliationInfo><Affiliation>Better Outcomes Registry & Network, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Donelle</LastName>
<ForeName>Jessy</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dodds</LastName>
<ForeName>Linda</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Dalhousie University, Halifax, NS, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hawken</LastName>
<ForeName>Steven</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wilson</LastName>
<ForeName>Kumanan</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Benchimol</LastName>
<ForeName>Eric I</ForeName>
<Initials>EI</Initials>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chakraborty</LastName>
<ForeName>Pranesh</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Guttmann</LastName>
<ForeName>Astrid</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Hospital for Sick Children, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kwong</LastName>
<ForeName>Jeffrey C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Public Health Ontario, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>MacDonald</LastName>
<ForeName>Noni E</ForeName>
<Initials>NE</Initials>
<AffiliationInfo><Affiliation>Dalhousie University, Halifax, NS, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ortiz</LastName>
<ForeName>Justin R</ForeName>
<Initials>JR</Initials>
<AffiliationInfo><Affiliation>University of Maryland School of Medicine, Baltimore, MD, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sprague</LastName>
<ForeName>Ann E</ForeName>
<Initials>AE</Initials>
<AffiliationInfo><Affiliation>Better Outcomes Registry & Network, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Top</LastName>
<ForeName>Karina A</ForeName>
<Initials>KA</Initials>
<AffiliationInfo><Affiliation>Dalhousie University, Halifax, NS, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Walker</LastName>
<ForeName>Mark C</ForeName>
<Initials>MC</Initials>
<AffiliationInfo><Affiliation>Better Outcomes Registry & Network, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wen</LastName>
<ForeName>Shi Wu</ForeName>
<Initials>SW</Initials>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Ottawa Hospital Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fell</LastName>
<ForeName>Deshayne B</ForeName>
<Initials>DB</Initials>
<Identifier Source="ORCID">0000-0002-5548-3228</Identifier>
<AffiliationInfo><Affiliation>University of Ottawa, Ottawa, ON, Canada dfell@cheo.on.ca.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>ICES, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><Agency>CIHR</Agency>
<Country>Canada</Country>
</Grant>
</GrantList>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2019</Year>
<Month>07</Month>
<Day>10</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>BMJ</MedlineTA>
<NlmUniqueID>8900488</NlmUniqueID>
<ISSNLinking>0959-8138</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001249" MajorTopicYN="N">Asthma</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000067576" MajorTopicYN="Y">Child Health</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005767" MajorTopicYN="N">Gastrointestinal Diseases</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
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<CoiStatement>Competing interests: All authors have completed and submitted the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: support for the work as described above; KAT has received grants from GlaxoSmithKline and personal fees and non-financial support from Pfizer, both of which were unrelated to the submitted work; no other relationships or activities that could appear to have influenced the submitted work.</CoiStatement>
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   |texte=   Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.
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Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.

Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study.

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