{"doi":"10.1101/2020.08.24.20180455","title":"Asynchronous influenza vaccination and adverse maternal-child health outcomes in the Brazilian semiarid, 2013 to 2018: the INFLUEN-SA Study","abstract":"Abstract Recent models indicate seasonal influenza transmission in Brazil begins annually in the semiarid state of Ceará (pop. 8.8M)—before vaccine campaigns begin. To assess the extent and maternal-child health consequences of this misalignment, we tracked severe acute respiratory infections (SARI), influenza, and influenza immunizations from 2013-2018. Of 3,297 SARI cases, 145 (4%) occurred in pregnancy. Vaccine coverage was >80%; however, campaigns often occurred during or after peak influenza. Birth weights nadired and prematurity increased 30-40 weeks following peak influenza, by a magnitude of 40g and 10.7% to 15.5%, respectively. We identified 61 babies of mothers with gestational SARI; they weighed 10% less at birth (P = 0·019) and were more often premature (OR: 2.944; 95% CI: 1.100 – 7.879) relative to controls (n=122). Mistiming of influenza vaccination adversely impacts pregnancy and birth outcomes in Ceará, with critical implications for influenza transmission dynamics nationally.","journal":"medRxiv","year":2020,"id":130824,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9031,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":583627,"name":"Saionara Cristina Francisco","orcid":"0000-0002-9655-6294","position":1,"is_corresponding":false},{"id":584052,"name":"Thaisy B.R. Lima","orcid":null,"position":2,"is_corresponding":false},{"id":584053,"name":"Vânia A.F. Viana","orcid":null,"position":3,"is_corresponding":false},{"id":584054,"name":"Jaqueline S.V. Burgoa","orcid":null,"position":4,"is_corresponding":false},{"id":443371,"name":"Alberto M. Soares","orcid":"0000-0002-3359-6109","position":5,"is_corresponding":false},{"id":584055,"name":"Álvaro M. Leite","orcid":null,"position":6,"is_corresponding":false},{"id":584056,"name":"Simone A. Herron","orcid":null,"position":7,"is_corresponding":false},{"id":584057,"name":"Hunter L. Newland","orcid":null,"position":8,"is_corresponding":false},{"id":583628,"name":"Kunaal S. Sarnaik","orcid":"0009-0004-7410-1688","position":9,"is_corresponding":false},{"id":583629,"name":"Gabriel F. Hanson","orcid":"0009-0003-0202-062X","position":10,"is_corresponding":false},{"id":59389,"name":"Jason A. Papin","orcid":"0000-0002-2769-5805","position":11,"is_corresponding":false},{"id":258574,"name":"Sean R. Moore","orcid":"0000-0003-1150-6632","position":12,"is_corresponding":false},{"id":289248,"name":"Aldo Â. M. Lima","orcid":"0000-0002-0299-1747","position":13,"is_corresponding":false},{"id":443368,"name":"José Q.S. Filho","orcid":"0000-0002-9619-4553","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-18T23:15:56.698770Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}