Evidence map›Paper›PMID 41549545›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2026

The Risk of Adverse Birth Outcomes Among Twin Pregnancies After Influenza and Pertussis Vaccinations During Pregnancy: A Data Linkage Study.

Kahlee Boyle, Sarah Graham, Michael Binks, Lisa McHugh

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Article in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Kahlee BoyleSchool of Public Health, University of Queensland, Brisbane, Queensland, Australia.ORCID https://orcid.org/0009-0003-2194-9979
Sarah GrahamSchool of Public Health, University of Queensland, Brisbane, Queensland, Australia.ORCID https://orcid.org/0009-0008-1671-4952
Michael BinksMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Lisa McHughSchool of Public Health, University of Queensland, Brisbane, Queensland, Australia.

Funding

National Health and Medical Research Council
6 · The paper itself

Abstract

objectiveTo compare risks of adverse birth outcomes between maternally vaccinated and unvaccinated twin pregnancies.

designMulti-jurisdictional data linkage cohort study.

settingAll registered births in Queensland (Qld) and Northern Territory (NT), Australia between 1 January 2012 and 31 December 2017. POPULATION: Twin pregnancies with infants born ≥ 20 weeks gestation and weighing ≥ 400 g.

methodsWe used Cox proportional-hazard models to calculate risk, with maternal vaccination status as the time-varying exposure, and national birthweight percentile charts specific for Australian-born twins to accurately reflect risk among small for gestational age (SGA) infants.

main outcome measuresAdverse birth outcomes including preterm birth, stillbirth and SGA infants.

resultsAmong our cohort of n = 11 435 infants, there was no statistically significant increased risk of preterm births, stillbirths or SGA infants between women who received a maternal influenza or pertussis vaccination and unvaccinated women. We observed a non-significant lower risk of SGA infants among pertussis vaccinated Qld (aHR 0.85, 95% CI 0.70-1.03) and NT women (aHR 0.50, 95% CI 0.17-1.44), and a lower risk of preterm infants among influenza vaccinated Qld women (aHR 0.93, 95% CI 0.84-1.03) and pertussis vaccinated NT women (aHR 0.78, 95% CI 0.44-1.38).

conclusionMaternal influenza and pertussis vaccinations did not increase the risk of preterm birth, stillbirth or SGA infants among twin pregnancies. These novel and important findings alleviate safety concerns for a cohort that carries a higher baseline risk of adverse birth outcomes compared to singleton pregnancies.

Indexed as

Influenza, HumanInfluenza VaccinesPertussis VaccinePregnancy Complications, InfectiousPregnancy, TwinPremature BirthVaccinationAdultCohort StudiesFemaleHumansInfant, NewbornInfant, Small for Gestational AgeNorthern TerritoryPregnancyPregnancy OutcomeInfluenza VaccinesPertussis Vaccineinfluenzamaternal vaccinationmultiple pregnancypertussissafetytwins

Identifiers

PMID41549545
PMCPMC12972857

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.