Relationship Between Prepregnancy Anthrax Vaccination and Pregnancy and Birth Outcomes Among US Army Women

摘要

With the advent of the Persian Gulf War, the US Department of Defense determined there was a credible threat of anthrax exposure to its troops from biological weapons and a large-scale vaccination program with anthrax vaccine was started. Substantial concern surrounds the potential health effects of the anthrax vaccine particularly the potential adverse effects on reproductive processes. The objective of this research is to determine whether receipt of anthrax vaccination by reproductive-aged women has an effect on pregnancy rates. A Cohort study was based on information from a computer database of women aged 17 to 44 years who were stationed at Fort Stewart, Ga or Hunter Army Airfield, Ga from January 1999 through March 2000, was conducted. The main outcome measures of this study were pregnancy and birth rates and adverse birth outcomes. Of a total of 4092 women, 3136 received at least 1 dose of the anthrax vaccine. There was a total of 513 pregnancies with 385 following at least 1 dose of anthrax vaccine. The pregnancy rate ratio (before and after adjustment for marital status, race, and age) comparing vaccinated with unvaccinated women was 0.94 (95% confidence interval Cl)(0.8-1.2; P = .60). There were 353 live births and 25 pregnancies lost to follow-up. The birth odds ratio after anthrax vaccination (before and after adjustment for marital status and age) was 0.9 (95% Cl 0.5-1.4; P = .55). After adjusting for age the odds ratio for adverse birth outcome after receiving at least 1 dose of anthrax vaccination was 0.9 (95% Cl 0.4-2.4; P = .88). However this study did not have sufficient power to detect adverse birth outcomes. It is concluded that Anthrax vaccination had no effect on pregnancy and birth rates or adverse birth outcomes.