Influenza vaccination in pregnancy: vaccine uptake, maternal and healthcare providers’ knowledge and attitudes. A quantitative study

BackgroundInfluenza during pregnancy is a potentially life threatening illness. There are limited data on influenza vaccination uptake and determinants of uptake in Irish obstetric populations.AimTo determine the uptake of influenza vaccination during pregnancy; determinants of vaccination uptake; knowledge, attitudes, and concerns of postnatal women; and knowledge and attitudes of healthcare professionals (HCPs) surrounding vaccination.Design & settingA quantitative study of postnatal women attending the Rotunda Hospital, a tertiary referral maternity hospital in Dublin, Ireland. A separate quantitative study conducted by the North Dublin City GP Training Programme surveyed GPs, pharmacists, and Rotunda Hospital clinical staff.MethodA paper-based survey was distributed to postnatal women. HCPs completed the survey via the online tool Survey Monkey.Results330 patient surveys were disseminated, with a 60.0% response rate. Of 198 responders, 109 (55.1%) were vaccinated against influenza. Non-professionals were less likely to be vaccinated (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] = 0.09 to 0.89). Vaccination in previous pregnancy (aOR 5.2, 95% CI = 1.69 to 15.62) and information from an HCP were strongly associated with vaccination (aOR 12.8, 95% CI = 2.65 to 62.5). There was a 20.2% (n = 1180) response rate among HCPs. More GPs felt that it was their role to discuss vaccination (92.9%; n = 676), and offer to vaccinate women (91.7%; n = 666) than any other HCP.ConclusionProvision of information about the importance of vaccination against influenza and pertussis during pregnancy by HCPs and their consistent recommendations in support of vaccination were key determinants of vaccine uptake during pregnancy. The sociodemographic determinants of a woman’s vaccination status should be addressed in health promotion campaigns. Education of HCPs may address knowledge gaps surrounding vaccination.

Pregnancy Outcomes of Mothers with Detectable CMV-Specific IgM Antibodies: A Three-Year Review in a Large Irish Tertiary Referral Maternity Hospital

A retrospective audit was performed for all obstetric patients who had positive CMV IgM results between January 2012 and December 2014 in the Rotunda Hospital, Ireland. In total, 622 CMV IgM positive tests were performed on samples from 572 patients. Thirty-seven patients had a positive CMV IgM result (5.9%) on the Architect system as part of the initial screening. Three patients were excluded as they were not obstetric patients. Of the 34 pregnant women with CMV IgM positive results on initial screening, 16 (47%) had CMV IgM positivity confirmed on the second platform (VIDAS) and 18 (53%) did not. In the 16 patients with confirmed positive CMV IgM results, four (25%) had acute infection, two (12.5%) had infection of uncertain timing, and ten (62.5%) had infection more than three months prior to sampling as determined by the CMV IgG avidity index. Two of the four neonates of women with low avidity IgG had CMV DNA detected in urine. Both these cases had severe neurological damage and the indication for testing their mothers was because the biparietal diameter (BPD) was less than the 5th centile at the routine 20-week gestation anomaly scan.

Has the Incidence of Molar Pregnancy Changed Over the Last 10 Years?

ABSTRACT A retrospective audit was conducted at the Rotunda hospital, Dublin to assess the incidence of partial molar pregnancies and complete molar pregnancies over a 10-year period from the 1st of January 1997 to 31 of December 2006. Methods Records from the pathology department were accessed for the number of molar pregnancies from 1997 to 2006. Each pathology result was then retrieved to differentiate between complete moles and partial moles. The annual reports published by the hospital were used to obtain the number of deliveries and live births per year. Results The incidence of partial molar pregnancies at the Rotunda Hospital from 1997 to 2006 was 1 in 328 live births. The incidence of complete molar pregnancies from 1997 to 2006 was 1 in 1105 live births. The incidence of a molar pregnancy in the study period was 1:253. Conclusion The incidence of a molar pregnancy was estimated to be 1: 512 in 1993 and was 1: 253 in this study, indicating a significant rise. The incidence of complete and partial molar pregnancies has also doubled. The Rotunda hospital caters to a large proportion of Dublin's noncaucasian population which might account for an increase. But it is still possible that there is an over diagnosis of cases as diagnosis is only by histology and flow cytometry is not routinely performed in all cases.