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Preterm birth is commonly defined as any birth before 37 weeks completed weeks of gestation. An estimated 15 million infants are born preterm globally, disproportionately affecting low and middle income countries (LMIC). It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. However, in many clinical settings, the information available to calculate completed weeks of gestation varies widely. Accurate dating of the last menstrual period (LMP), as well as access to clinical and ultrasonographic evaluation are important components of gestational age assessment antenatally. This case definition assign levels of confidence to categorisation of births as preterm, utilising assessment modalities which may be available across different settings. These are designed to enable systematic safety evaluation of vaccine clinical trials and post-implementation programmes of immunisations in pregnancy., (Copyright © 2016. Published by Elsevier Ltd.)

Vaccine-preventable diseases (VPDs) account for significant morbidities and mortalities in the United States on an annual basis. Despite generally successful childhood vaccine programs, adults remain underimmunized against a variety of common VPDs. Lack of both physician and patient awareness contribute to this deficiency. All primary care providers, including obstetrician-gynecologists, must address this need in their office practices. Clear and authoritative adult vaccine recommendations are established and easily accessible by the clinician. Pregnancy is not an absolute contraindication to vaccine administration. In fact, certain vaccines are specifically indicated during pregnancy in the interest of the mother and her unborn child. Women frequently identify gynecologists as their sole providers of care, further emphasizing the need for attention to this health maintenance activity. New vaccine initiatives, in particular those focused on early newborn infectious conditions, sexually transmitted diseases, and cancer prevention, will likely place the obstetrician-gynecologist at the forefront of this important clinical issue.

Maternal vaccination is a safe and effective means of preventing infection in pregnant women, their fetuses, and infants after birth. Several vaccines are routinely administered in pregnancy as a valuable part of prenatal care with supporting recommendations from national and international health organizations. Fears concerning vaccine safety in pregnancy are pervasive despite sufficient available safety data to support their use, leading to underutilization of maternal immunization. Despite this hesitancy, the field of maternal vaccination is evolving to include more vaccines in the routine prenatal vaccination schedule, including the new RSV vaccine. This review discusses the currently recommended vaccines in pregnancy, evidence for their use, and an overview of ongoing clinical trials investigating prospective vaccines for pregnant women. [ABSTRACT FROM AUTHOR]

Seasonal influenza imparts disproportionate morbidity and death to pregnant women. Immunization against influenza is the most effective intervention to mitigate the burden of influenza disease during pregnancy; nevertheless, immunization rates remain suboptimal in this patient population. Therefore, there is a clear need for strategies to optimize influenza vaccination among pregnant women. We reviewed potential patient and health care provider barriers to influenza immunization and propose effective strategies for overcoming them. [Copyright &y& Elsevier]

Passive immunization provides temporary protection in a naïve subject who has been exposed to an infectious pathogen when vaccination is unavailable or has not been given before exposure. Despite the recent attention that has been given to adult-directed vaccines, antibody-based therapeutic strategies have received little discussion yet remain an important part of infectious disease containment. This review examines some of the more common clinical situations in which an obstetrician-gynecologist may need to have expertise related to passive immunization. Potential future uses for this modality are presented. [ABSTRACT FROM AUTHOR]

Background: Obstetrician–gynecologists can play a key role in providing appropriate vaccinations to women of childbearing age. Purpose: This study investigated immunization knowledge and practices, and opinions concerning potential barriers to immunization, among obstetrician-gynecologists. Methods: In 2007, surveys were sent to Collaborative Ambulatory Research Network members, a representative sample of practicing Fellows of the American College of Obstetricians and Gynecologists; 394 responded (51.2%). Data analysis was completed in 2008. Results: Most responding obstetrician–gynecologists disagreed that “routine screening for vaccine-preventable diseases falls outside of the routine practice of an ob/gyn.” A majority (78.7%) stock and administer at least some vaccines. Among those who stock vaccines, 91.0% stock the human papillomavirus vaccine, and 66.8% stock the influenza vaccine. All other vaccines were stocked by <30% of practices that stock vaccines. A majority of physicians agreed that financial factors (e.g., inadequate reimbursement) were barriers to vaccine administration. Most were aware that the influenza (89.8%); hepatitis B (64.0%); and tetanus, diptheria, pertussis (58.6%) vaccines are safe to administer during pregnancy, and that the measles, mumps, rubella (97.5%); and varicella (92.9%) vaccines are not. Most (84.5%) were in concordance with recommendations that all pregnant women should receive the influenza vaccine. A majority believed their immunization training was less than adequate and believed their practice would benefit from continuing medical education courses. Conclusions: Immunization is an important part of women''s health care and has been, at least partially, incorporated into obstetrician–gynecologist practice. Financial burdens and knowledge regarding vaccine recommendations remain barriers to vaccine administration. Additional training and professional information may benefit obstetric–gynecologic practice. [Copyright &y& Elsevier]