{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T05:38:32Z","timestamp":1772861912147,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2008,5,21]],"date-time":"2008-05-21T00:00:00Z","timestamp":1211328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND:<\/jats:bold> Women serving in the US military have some unique occupational exposures, including exposure to vaccinations that are rarely required in civilian professions. When vaccinations are inadvertently given during pregnancy, such exposures raise special concerns. These analyses address health outcomes, particularly preterm births and birth defects, among infants who appear to have been exposed to maternal smallpox vaccination in pregnancy. <jats:bold>METHODS:<\/jats:bold> This retrospective cohort study included 31,420 infants born to active\u2010duty military women during 2003\u20132004. We used Department of Defense databases to define maternal vaccination and infant health outcomes. Multivariable regression models were developed to describe associations between maternal smallpox vaccination and preterm births and birth defects in liveborn infants. <jats:bold>RESULTS:<\/jats:bold> There were 7,735 infants identified as born to women ever vaccinated against smallpox, and 672 infants born to women vaccinated in the first trimester of pregnancy. In multivariable modeling, maternal smallpox vaccination in pregnancy was not associated with preterm or extreme preterm delivery. Maternal smallpox vaccination in the first trimester of pregnancy was not significantly associated with overall birth defects (OR 1.40; 95% CI: 0.94, 2.07), or any of seven specific defects individually modeled. <jats:bold>CONCLUSIONS:<\/jats:bold> Results may be reassuring that smallpox vaccine, when inadvertently administered to pregnant women, is not associated with preterm delivery or birth defects in liveborn infants. Birth Defects Research (Part A) 2008. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20470","type":"journal-article","created":{"date-parts":[[2008,5,21]],"date-time":"2008-05-21T18:37:50Z","timestamp":1211395070000},"page":"533-539","source":"Crossref","is-referenced-by-count":23,"title":["Evaluation of preterm births and birth defects in liveborn infants of US military women who received smallpox vaccine"],"prefix":"10.1002","volume":"82","author":[{"given":"Margaret A. K.","family":"Ryan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gia R.","family":"Gumbs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ava Marie S.","family":"Conlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carter J.","family":"Sevick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel G.","family":"Jacobson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine J.","family":"Snell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina N.","family":"Spooner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler C.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Department of Defense Birth and Infant Health Registry Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,7,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10033"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.80.10.1218"},{"key":"e_1_2_6_4_1","volume-title":"Population representation in the military services","author":"Assistant Secretary of Defense for Health Affairs (ASD\/HA)","year":"1999"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.S3.957"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2005.09.009"},{"key":"e_1_2_6_7_1","first-page":"46","article-title":"The tiny victims of Desert Storm","author":"Briggs J","year":"1995","journal-title":"Life"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0860"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.10117"},{"key":"e_1_2_6_10_1","first-page":"386","article-title":"Women with smallpox vaccine exposure during pregnancy reported to the National Smallpox Vaccine in Pregnancy Registry\u2014United States, 2003","volume":"52","author":"Centers for Disease Control and Prevention (CDC)","year":"2003","journal-title":"MMWR"},{"issue":"4","key":"e_1_2_6_11_1","first-page":"1","article-title":"Smallpox vaccination and adverse reactions. Guidance for clinicians","volume":"52","author":"Cono J","year":"2003","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10111"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199706053362306"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2006.1817"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1001\/jama.1984.03350070021017","article-title":"Vietnam veterans' risks for fathering babies with birth defects","volume":"252","author":"Erickson JD","year":"1984","journal-title":"JAMA"},{"key":"e_1_2_6_16_1","series-title":"Smallpox and its eradication. History of International Health","author":"Fenner F","year":"1988"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(77)90662-7"},{"key":"e_1_2_6_18_1","volume-title":"TERIS. Teratogenic Effects of Drugs: A Resource for Clinicians","author":"Friedman JM","year":"2000"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00583.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(66)91202-5"},{"key":"e_1_2_6_21_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1542\/peds.3.4.456","article-title":"The effect of smallpox vaccination during pregnancy on the incidence of congenital malformations","volume":"3","author":"Greenberg M","year":"1949","journal-title":"Pediatrics"},{"key":"e_1_2_6_22_1","first-page":"10","article-title":"Evidence for the viral etiology of congenital defects","volume":"17","author":"Hanshaw JB","year":"1978","journal-title":"Major Probl Clin Pediatr"},{"key":"e_1_2_6_23_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1542\/peds.50.1.150","article-title":"A complicated case of congenital vaccinia","volume":"50","author":"Harley JD","year":"1972","journal-title":"Pediatrics"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000199528.28234.73"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198302243080804"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0274(200010)38:4<447::AID-AJIM11>3.0.CO;2-J"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/73.1.13"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050500224810"},{"key":"e_1_2_6_29_1","first-page":"3","article-title":"Legacy of worry","volume":"1","author":"Moehringer J","year":"1995","journal-title":"Los Angeles Times"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.019"},{"key":"e_1_2_6_31_1","first-page":"223","article-title":"Smallpox vaccination during pregnancy","volume":"46","author":"Naderi S","year":"1975","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.07.014"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1207.051531"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-006-9077-8"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2007.02.022"},{"issue":"10","key":"e_1_2_6_36_1","first-page":"1","article-title":"Vaccinia (smallpox) vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001","volume":"50","author":"Rotz LD","year":"2001","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1081"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1086\/524744"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(02)00092-0"},{"key":"e_1_2_6_40_1","volume-title":"Reproductive Effects of Chemical, Physical, and Biological Agents","author":"Scalli AR","year":"1995"},{"key":"e_1_2_6_41_1","volume-title":"Guidelines for Conducting Birth Defects Surveillance","author":"Sever LE","year":"2004"},{"key":"e_1_2_6_42_1","volume-title":"Catalog of Teratogenic Agents","author":"Shepard TH","year":"1995"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2005.09.033"},{"key":"e_1_2_6_44_1","volume-title":"Declaration regarding administration of smallpox countermeasures. Billing Code 4150\u201324","author":"US Department of Health and Human Services (HHS)","year":"2003"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.4161\/hv.2.2.2589"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-006-0122-y"},{"issue":"7","key":"e_1_2_6_47_1","first-page":"1","article-title":"Recommendations for using smallpox vaccine in a pre\u2010event vaccination program. Supplemental recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC)","volume":"52","author":"Wharton M","year":"2003","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm283"}],"container-title":["Birth Defects Research Part A: Clinical and Molecular Teratology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdra.20470","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdra.20470","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T20:51:11Z","timestamp":1699995071000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdra.20470"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7]]},"references-count":47,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.1002\/bdra.20470"],"URL":"https:\/\/doi.org\/10.1002\/bdra.20470","archive":["Portico"],"relation":{},"ISSN":["1542-0752","1542-0760"],"issn-type":[{"value":"1542-0752","type":"print"},{"value":"1542-0760","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7]]}}}