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Analysis included 2,982 case children diagnosed with a simple CHD (no other cardiac involvement with or without extracardiac defects) and 4,937 control children without a birth defect with estimated delivery dates during 2006\u20132011. For defects with \u22655 exposed case children, we used logistic regression to estimate propensity score\u2010adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusting for estimated delivery year and season; plurality; and maternal age at delivery, race\/ethnicity, low folate intake, and smoking and alcohol use during B1P3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 124 (4.2%) simple CHD case mothers and 197 (4.0%) control mothers reported influenza vaccination from 1 month before through the third pregnancy month. The aOR for any simple CHD was 0.97 (95% CI: 0.76\u20131.23). Adjusted ORs for specific simple CHDs ranged from 0.62 for hypoplastic left heart syndrome to 2.34 for total anomalous pulmonary venous return (TAPVR). All adjusted CIs included the null except for TAPVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although we cannot fully exclude that exposure misclassification may have masked risks for some CHDs, findings add to existing evidence supporting the safety of inactivated influenza vaccination during pregnancy. The TAPVR result may be due to chance, but it may help inform future studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2114","type":"journal-article","created":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T06:53:42Z","timestamp":1668236022000},"page":"88-95","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Influenza vaccination during pregnancy and risk of selected major structural congenital heart defects, National Birth Defects Prevention Study 2006\u20132011"],"prefix":"10.1002","volume":"115","author":[{"given":"Kristin","family":"Palmsten","sequence":"first","affiliation":[{"name":"HealthPartners Institute  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Suhl","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health, The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin M.","family":"Conway","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health, The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyse O.","family":"Kharbanda","sequence":"additional","affiliation":[{"name":"HealthPartners Institute  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Scholz","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics University of Iowa Hospitals and Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2062-8148","authenticated-orcid":false,"given":"Elizabeth C.","family":"Ailes","sequence":"additional","affiliation":[{"name":"Division of Birth Defects and Infant Disorders National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet D.","family":"Cragan","sequence":"additional","affiliation":[{"name":"Division of Birth Defects and Infant Disorders National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Nestoridi","sequence":"additional","affiliation":[{"name":"Center for Birth Defects Research and Prevention Massachusetts Department of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4355-7557","authenticated-orcid":false,"given":"Eleni A.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Birth Defects Registry New York State Department of Health  Albany New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9442-9737","authenticated-orcid":false,"given":"Stephen M.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Slone Epidemiology Center at Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean G.","family":"Young","sequence":"additional","affiliation":[{"name":"Arkansas Center for Birth Defects Research and Prevention  Little Rock Arkansas USA"},{"name":"Department of Environmental Health Sciences Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Olson","sequence":"additional","affiliation":[{"name":"Immunization Safety Office Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5393-9984","authenticated-orcid":false,"given":"Paul A.","family":"Romitti","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health, The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The National Birth Defects Prevention Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"issue":"5","key":"e_1_2_11_2_1","first-page":"1125","article-title":"ACOG committee opinion number 305, November 2004. 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