Incidence of Influenza-like Illness in Pregnant Women with Autoimmune Disease and Women without Autoimmune Disease Who Do or Do Not Receive an Influenza Vaccination
Bibliographic record
Abstract
Purpose: Pregnant women with autoimmune diseases may be at higher risk of contracting influenza infection during pregnancy. It is unknown if the receipt of influenza vaccination during pregnancy is as protective for infection in these women compared to healthy women. We sought to determine if the incidence of influenza-like illness (ILI) among pregnant women who received an influenza vaccination differs for women with autoimmune diseases compared to healthy pregnant women. Methods: Data were obtained from an ongoing prospective cohort study of pregnancy outcome among women in the U.S. and Canada conducted by the Organization of Teratology Information Specialists (OTIS). We enrolled pregnant women between 2009 and 2012 who had Crohn's disease, psoriasis, psoriatic arthritis, rheumatoid arthritis or ankylosing spondylitis, and healthy women without autoimmune disease. Women were interviewed at multiple standard time points during and after pregnancy; data were collected about receipt of influenza vaccination during pregnancy and dates in gestation, and any subsequent report of physician diagnosis of ILI. Using time varying vaccine exposure during pregnancy and adjusting for calendar months of pregnancy relative to the flu season, we estimated the hazard ratio (HR) and its 95% confidence interval (CI) for ILI in a Cox regression model comparing women who reported receipt of an influenza vaccine some time in pregnancy to women without vaccine during pregnancy and including autoimmune disease status and the interaction between autoimmune disease status and vaccination receipt in the model. Results: There were 1,508 subjects available for analysis: 1,003 women received the influenza vaccine during pregnancy and 505 women did not receive vaccine. Among them 520 women had autoimmune disease and 988 women were without autoimmune disease. Eighteen (3.5%) of the women with autoimmune disease and 55 (5.6%) women without autoimmune disease reported ILI at some time in pregnancy. The adjusted HR for ILI in women vaccinated vs. women not vaccinated was 1.17 (95% CI 0.63, 2.17). The interaction between vaccine exposure and autoimmune disease was not significant (p=0.13). Conclusion: Based on these data, women with autoimmune disease were no more likely to report ILI than healthy women, and there was no evidence of a differential effect of influenza vaccination in risk of ILI among women with autoimmune disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".