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Maternal Immune Activation

Published: 2019
SYNOPSIS

Pregnant women are a WHO priority group for influenza vaccination, but evidence from observational studies in pregnancy is subject, among others, to the healthy-vaccinee bias, overestimating the vaccine effectiveness and safety. An USA survey adds new evidence that documents this bias. Therefore, it is essential to assess vaccine effectiveness and safety with RCTs. Cochrane reviews identified one RCT with “low risk of bias”, in a medium-income country, with NNV 55 for mothers. Its data show an excess of local adverse effects, and a tendency to harm for serious adverse events, with uncertain or very limited protection against influenza.

TITLE

Influenza Vaccination for All Pregnant Women? So Far Less Biased Evidence Does Not Favor It

Pregnant women are a WHO priority group for influenza vaccination, but evidence from observational studies in pregnancy is subject, among others, to the healthy-vaccinee bias, overestimating the vaccine effectiveness and safety. A U.S. survey adds new evidence that documents this bias. Therefore, it is essential to assess vaccine effectiveness and safety with RCTs. Cochrane reviews identified one RCT with “low risk of bias”, in a medium-income country, with NNV 55 for mothers. Its data show an excess of local adverse effects, and a tendency to harm for serious adverse events, with uncertain or very limited protection against influenza.

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Published: 2018
SYNOPSIS

Two prenatal exposures—stress and maternal immune dysregulation—are associated with autism, probably in combination with other genetic and environmental risk factors.

TITLE

Prenatal stress, maternal immune dysregulation, and their association with autism spectrum disorders

Citation

Beversdorf DQ, Stevens HE, Jones KL. Current Psychiatry Reports. 2018;20:76.

 

Summary

Prenatal stress and disruption of a pregnant woman’s immune response (“maternal immune activation”) are two environmental factors associated with the increased incidence of autism spectrum disorder (ASD). However, the fact that, in many cases, these prenatal exposures do not result in ASD suggests an “interaction with multiple other risks.” Some evidence points to greater susceptibility to prenatal stress and maternal immune dysregulation in male offspring.

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