{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:09:42Z","timestamp":1785150582473,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare risks of adverse birth outcomes between maternally vaccinated and unvaccinated twin pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multi\u2010jurisdictional data linkage cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All registered births in Queensland (Qld) and Northern Territory (NT), Australia between 1 January 2012 and 31 December 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Twin pregnancies with infants born \u2265\u200920\u2009weeks gestation and weighing \u2265\u2009400\u2009g.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Cox proportional\u2010hazard models to calculate risk, with maternal vaccination status as the time\u2010varying exposure, and national birthweight percentile charts specific for Australian\u2010born twins to accurately reflect risk among small for gestational age (SGA) infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Adverse birth outcomes including preterm birth, stillbirth and SGA infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among our cohort of\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911\u2009435 infants, there was no statistically significant increased risk of preterm births, stillbirths or SGA infants between women who received a maternal influenza or pertussis vaccination and unvaccinated women. We observed a non\u2010significant lower risk of SGA infants among pertussis vaccinated Qld (aHR 0.85, 95% CI 0.70\u20131.03) and NT women (aHR 0.50, 95% CI 0.17\u20131.44), and a lower risk of preterm infants among influenza vaccinated Qld women (aHR 0.93, 95% CI 0.84\u20131.03) and pertussis vaccinated NT women (aHR 0.78, 95% CI 0.44\u20131.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Maternal influenza and pertussis vaccinations did not increase the risk of preterm birth, stillbirth or SGA infants among twin pregnancies. These novel and important findings alleviate safety concerns for a cohort that carries a higher baseline risk of adverse birth outcomes compared to singleton pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70156","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T06:51:07Z","timestamp":1768805467000},"page":"1083-1092","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Risk of Adverse Birth Outcomes Among Twin Pregnancies After Influenza and Pertussis Vaccinations During Pregnancy: A Data Linkage Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2194-9979","authenticated-orcid":false,"given":"Kahlee","family":"Boyle","sequence":"first","affiliation":[{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1671-4952","authenticated-orcid":false,"given":"Sarah","family":"Graham","sequence":"additional","affiliation":[{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Binks","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research Charles Darwin University  Darwin Northern Territory Australia"},{"name":"Women and Kids Theme South Australian Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"McHugh","sequence":"additional","affiliation":[{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.33321\/cdi.2022.46.3"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2020.09.005"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2013.11.014"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.33321\/cdi.2016.40.54"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0950268817002722"},{"key":"e_1_2_12_7_1","volume-title":"History of Immunisation in Australia","author":"National Centre for Immunisation Research and Surveillance","year":"2022"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13548"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.08.046"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.07.048"},{"key":"e_1_2_12_11_1","volume-title":"Multiple Pregnancy: The Management of Twin and Triplet Pregnancies in the Antenatal Period","author":"National Collaborating Centre for Women's and Children's Health (UK)","year":"2011"},{"key":"e_1_2_12_12_1","volume-title":"Australia's Mothers and Babies","author":"Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_12_13_1","volume-title":"AIHW Analysis of National Perinatal Data Collection","author":"Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13227"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010030277"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010015\u20100464\u2010y"},{"key":"e_1_2_12_17_1","volume-title":"Socio\u2010Economic Indexes for Areas (SEIFA) 2011","author":"Australian Bureau of Statistics","year":"2013"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201011\u201049"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20101754.1999.00354.x"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm324"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2018.1540807"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.704254"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040643"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.01.027"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1555705"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23764"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4353"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318160d65d"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201036758\u20106"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318292766b"},{"key":"e_1_2_12_31_1","volume-title":"AIHW Analysis of the National Perinatal Mortality Data Collection and the National Perinatal Data Collection","author":"Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2010.08.005"},{"key":"e_1_2_12_33_1","volume-title":"Australian Immunisation Handbook","author":"Australian Technical Advisory Group on Immunisation (ATAGI)","year":"2022"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/08035250252834003"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101693689"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.18332\/tid\/123845"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00084\u201018"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0197867"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010066367"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70156","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.70156","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70156","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:44:26Z","timestamp":1775709866000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.70156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,18]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/1471-0528.70156"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.70156","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,18]]},"assertion":[{"value":"2024-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}