Evidence map›Paper›PMID 41961837›Full record

Trial reportPloS one2026

Risk factors for spontaneous abortion following hepatitis E vaccination during and shortly before pregnancy: Further analysis from a cluster-randomized trial.

Asma Binte Aziz, Faisal Ahmmed, Kassa Haile, Kelvin Kering, Susanne Dudman, Cathinka Halle Julin, Joakim Øverbø, Ashraful Islam Khan, Afroza Akter, Beatrice Atieno Ongadi and 22 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Asma Binte AzizInternational Vaccine Institute, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-0203-5744
Faisal AhmmedInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Kassa HaileArmauer Hansen Research Institute, Addis Ababa, Ethiopia.
Kelvin KeringKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Susanne DudmanInstitute of Clinical Medicine, University of Oslo, Norway.ORCID https://orcid.org/0000-0001-5047-4982
Cathinka Halle JulinOslo University Hospital, Oslo, Norway.
Joakim ØverbøOslo University Hospital, Oslo, Norway.
Ashraful Islam KhanInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Afroza AkterInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Beatrice Atieno OngadiKenya Medical Research Institute (KEMRI), Nairobi, Kenya.ORCID https://orcid.org/0000-0001-6687-6927
Benjamin NgugiKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Cecilia Kathure MbaeKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Edlawit MesfinArmauer Hansen Research Institute, Addis Ababa, Ethiopia.
Fahima ChowdhuryInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Farhana KhanamInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Joo-Young Esther LeeInternational Vaccine Institute, Seoul, Republic of Korea.
Justin ImResearch Investment for Global Health Technology (RIGHT) Foundation, Seoul, Republic of Korea.
Martin Mwebia BundiKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Md Golam FirojInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Md Taufiqul IslamInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Moses MwangiKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Natasha Y RickettInternational Vaccine Institute, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0002-3172-1877
Sadia Isfat AraInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.ORCID https://orcid.org/0000-0002-7983-087X
Meseret Gebre BehuteInternational Vaccine Institute, Seoul, Republic of Korea.
Se Eun ParkInternational Vaccine Institute, Seoul, Republic of Korea.
Suneth AgampodiInternational Vaccine Institute, Seoul, Republic of Korea.
Samuel KariukiKenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Suman KanungoICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.ORCID https://orcid.org/0000-0003-4441-4443
Deok Ryun KimInternational Vaccine Institute, Seoul, Republic of Korea.
Firdausi QadriInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Khalequ ZamanInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
John D ClemensInternational Vaccine Institute, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA recent randomized trial of Hepatitis E Vaccine (HEV239) found an elevated risk of spontaneous abortion (SAB) in women given HEV239 during or within ninety days before pregnancy. Here we present additional analyses to better understand this risk.

methodsWe investigated whether maternal risk profiles of SAB or gestational age at SAB differed between women receiving HEV239 versus control Hepatitis B vaccine (HBV). We also assessed whether HEV239-vaccinated women who experienced SABs had distinct short-term adverse reactions compared to HEV239-vaccinated women who had live births, exploring potential inflammatory mechanisms. Finally, we assessed maternal exposure to HEV239 in narrowly defined pre-last menstrual period (LMP) windows to more precisely demarcate pre-LMP at which HEV-239 vaccination was associated with an elevated risk of SAB. Chi-square tests and Mann-Whitney U tests were performed for bivariate comparisons. Poisson models were used for multivariable analyses.

findingsBaseline maternal risk factors for SAB (age, body mass index, parity, and histories of SAB, hypertension, or diabetes) were similar between the SABs in HEV239 and HBV groups. Median gestational age at SAB was comparable (10.5 weeks [IQR 10-13] for HEV239 vs. 11 weeks [IQR 9-12.2] for HBV, p = 0.783). No increased short-term adverse events (pain: 9% vs. 9%; fever: 2% vs. 1%) were observed among HEV239 recipients who experienced SABs compared to those who did not. An elevated risk of SAB was observed in HEV239 recipients vaccinated 31-60 days pre-LMP (Relative Risk 4.3 [95% CI 1.3-19.3], p = 0.026).

interpretationOur analyses did not uncover associations pointing to a biological mechanism underlying the original observation of an increased SAB rate connected to HEV239 vaccination shortly before or during pregnancy. Targeted studies such as placental examinations and genetic testing are needed to investigate potential mechanisms.

Indexed as

Abortion, SpontaneousHepatitis EHepatitis E virusVaccinationViral Hepatitis VaccinesAdultFemaleGestational AgeHumansPregnancyRisk FactorsViral Hepatitis Vaccines

Identifiers

PMID41961837
PMCPMC13068265

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Registered trials

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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.