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Antibody levels in a cohort of pregnant women after the 2009 influenza A(H1N1) pandemic: Waning and association with self‐reported severity and duration of illness

Identifieur interne : 000376 ( Main/Curation ); précédent : 000375; suivant : 000377

Antibody levels in a cohort of pregnant women after the 2009 influenza A(H1N1) pandemic: Waning and association with self‐reported severity and duration of illness

Auteurs : Gro Tunheim ; Ida Laake ; Anna Hayman Robertson ; Kristian Waalen ; Olav Hungnes ; Lisbeth M. N Ss ; Rebecca J. Cox ; Siri Mjaaland ; Lill Trogstad

Source :

RBID : PMC:6379636

Descripteurs français

English descriptors

Abstract

Background

A population‐based pregnancy cohort was established in Norway to study potential effects of exposure to the 2009 influenza pandemic or pandemic vaccination during pregnancy.

Objectives

We studied maternal A(H1N1)pdm09‐specific hemagglutination inhibition (HI)‐titer levels and waning in women with influenza‐like illness (ILI) in pregnancy compared to vaccinated women. Moreover, we studied the association between HI‐titers and self‐reported severity and duration of ILI.

Methods

HI‐titers against the pandemic virus were measured in maternal blood samples obtained at birth, 3‐9 months after exposure, and linked with information about pregnancy, influenza and vaccination from national registries and a cohort questionnaire.

Results

Among 1821 pregnant women included, 43.7% were unvaccinated and 19.3% of these had ILI. HI‐titers were low (geometric mean titer (GMT) 11.3) in the unvaccinated women with ILI. Higher HI‐titers (GMT 37.8) were measured in the vaccinated women. Estimated HI‐titer waning was similar for vaccinated women and women with ILI. Most ILI episodes were moderate and lasted 3‐5 days. Women with ILI reporting specific influenza symptoms such as fever or cough had higher HI‐titers than women without these symptoms. Women who reported being “very ill” or illness duration of >5 days had higher HI‐titers than women reporting less severe illness or illness of shorter duration, respectively.

Conclusions

Antibody waning was similar in vaccinated women and women with ILI. More severe ILI or longer duration of illness was associated with higher HI‐titers. Most unvaccinated pregnant women with ILI had low HI‐titers, probably due to moderate illness and HI‐titer waning between exposure and sampling.


Url:
DOI: 10.1111/irv.12623
PubMed: 30536590
PubMed Central: 6379636

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PMC:6379636

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<term>Adolescent</term>
<term>Adult</term>
<term>Antibodies, Viral (blood)</term>
<term>Cohort Studies</term>
<term>Female</term>
<term>Hemagglutination Inhibition Tests</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Influenza Vaccines (therapeutic use)</term>
<term>Influenza, Human (immunology)</term>
<term>Middle Aged</term>
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<term>Adolescent</term>
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<term>Adulte d'âge moyen</term>
<term>Anticorps antiviraux (sang)</term>
<term>Autorapport</term>
<term>Enquêtes et questionnaires</term>
<term>Enregistrements</term>
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<term>Grossesse</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
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<term>Influenza, Human</term>
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<term>Anticorps antiviraux</term>
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<term>Vaccination</term>
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<term>Adolescent</term>
<term>Adult</term>
<term>Cohort Studies</term>
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<term>Hemagglutination Inhibition Tests</term>
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<term>Influenza A Virus, H1N1 Subtype</term>
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<div type="abstract" xml:lang="en">
<sec id="irv12623-sec-0001">
<title>Background</title>
<p>A population‐based pregnancy cohort was established in Norway to study potential effects of exposure to the 2009 influenza pandemic or pandemic vaccination during pregnancy.</p>
</sec>
<sec id="irv12623-sec-0002">
<title>Objectives</title>
<p>We studied maternal A(H1N1)pdm09‐specific hemagglutination inhibition (
<styled-content style="fixed-case">HI</styled-content>
)‐titer levels and waning in women with influenza‐like illness (
<styled-content style="fixed-case">ILI</styled-content>
) in pregnancy compared to vaccinated women. Moreover, we studied the association between
<styled-content style="fixed-case">HI</styled-content>
‐titers and self‐reported severity and duration of
<styled-content style="fixed-case">ILI</styled-content>
.</p>
</sec>
<sec id="irv12623-sec-0003">
<title>Methods</title>
<p>
<styled-content style="fixed-case">HI</styled-content>
‐titers against the pandemic virus were measured in maternal blood samples obtained at birth, 3‐9 months after exposure, and linked with information about pregnancy, influenza and vaccination from national registries and a cohort questionnaire.</p>
</sec>
<sec id="irv12623-sec-0004">
<title>Results</title>
<p>Among 1821 pregnant women included, 43.7% were unvaccinated and 19.3% of these had
<styled-content style="fixed-case">ILI</styled-content>
.
<styled-content style="fixed-case">HI</styled-content>
‐titers were low (geometric mean titer (
<styled-content style="fixed-case">GMT</styled-content>
) 11.3) in the unvaccinated women with
<styled-content style="fixed-case">ILI</styled-content>
. Higher
<styled-content style="fixed-case">HI</styled-content>
‐titers (
<styled-content style="fixed-case">GMT</styled-content>
37.8) were measured in the vaccinated women. Estimated
<styled-content style="fixed-case">HI</styled-content>
‐titer waning was similar for vaccinated women and women with
<styled-content style="fixed-case">ILI</styled-content>
. Most
<styled-content style="fixed-case">ILI</styled-content>
episodes were moderate and lasted 3‐5 days. Women with
<styled-content style="fixed-case">ILI</styled-content>
reporting specific influenza symptoms such as fever or cough had higher
<styled-content style="fixed-case">HI</styled-content>
‐titers than women without these symptoms. Women who reported being “very ill” or illness duration of >5 days had higher
<styled-content style="fixed-case">HI</styled-content>
‐titers than women reporting less severe illness or illness of shorter duration, respectively.</p>
</sec>
<sec id="irv12623-sec-0005">
<title>Conclusions</title>
<p>Antibody waning was similar in vaccinated women and women with
<styled-content style="fixed-case">ILI</styled-content>
. More severe
<styled-content style="fixed-case">ILI</styled-content>
or longer duration of illness was associated with higher
<styled-content style="fixed-case">HI</styled-content>
‐titers. Most unvaccinated pregnant women with
<styled-content style="fixed-case">ILI</styled-content>
had low
<styled-content style="fixed-case">HI</styled-content>
‐titers, probably due to moderate illness and
<styled-content style="fixed-case">HI</styled-content>
‐titer waning between exposure and sampling.</p>
</sec>
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