Evaluation of a Temporal Association between Vaccination and Subdural Hematoma in Infants - 23/05/19
Abstract |
Objective |
To investigate a temporal association between vaccination and subdural hematoma, the main feature of abusive head trauma.
Study design |
From a prospective population-based survey carried out in 1 administrative district in France between January 2015 and April 2017, including all infants between 11 and 52 weeks old who underwent a first cerebral imaging (computerized tomography scan or magnetic resonance imaging), we conducted a nested case-control study. Vaccine exposure was compared between cases (infants with subdural hematoma) and 2-3 paired controls, without subdural hematoma or any other imaging findings compatible with abusive head trauma. Cases and controls were matched on chronological (±7 days) and gestational (≤33 vs >33 weeks) ages, respectively. Vaccination status was collected in the personal national pediatric health booklet.
Results |
Among the 228 prospectively surveyed infants, 28 had subdural hematoma including 22 with abusive head trauma. The mean chronological age at imaging was 5.3 months among the 28 cases and the 62 controls, who did not differ significantly in median time since last vaccination (1.4 vs 1.3 months, P = .62) or frequency of at least 1 vaccination since birth (86% vs 89%; matched-pairs OR 0.77, 95% CI 0.17-3.86) or within 7 days (0.94, 0.08-6.96), 14 days (0.70, 0.12-2.92), or 21 days (0.48, 0.08-1.98) before cerebral imaging.
Conclusions |
We found no significant temporal association between vaccination and subdural hematoma diagnosis, which must continue to be considered a red flag for abusive head trauma and child abuse.
Le texte complet de cet article est disponible en PDF.Keywords : abusive head trauma, intracranial hemorrhage, subdural hematoma, immunization, epidemiologic
Abbreviations : CT, MRI
Plan
| C.G-L. was supported by the unrestricted educational grant “Prix Véronique Roualet 2018” and has received travel grants from GSK and Pfizer. E.L. has received travel grants from GSK. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors declare no conflicts of interest. |
Vol 209
P. 134 - juin 2019 Retour au numéro
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