目的 本研究旨在探讨上海市产妇孕期流感疫苗的接种情况，分析影响接种行为的主要人口学特征，评估孕期流感疫苗接种与早产结局之间的潜在关联，为我国流感疫苗接种策略提供实证依据。方法 收集上海市出生医学信息系统中2012年1月1日至2022年12月31日的全部产妇及其新生儿信息，采用多因素logistic回归模型，分析影响孕期女性接种流感疫苗的主要人口学因素，评估孕期接种流感疫苗与早产结局之间的关联性。结果 研究期间共2 209名产妇在孕期接种流感疫苗。多因素logistic回归分析结果显示，产妇户籍、年龄、学历，配偶年龄、学历，流产史及子代出生年份均为孕期接种流感疫苗的影响因素（均P<0.001）。与上海市户籍产妇相比，外省市户籍产妇接种的可能性较低（调整后OR=0.83，95%CI：0.76~0.91）；与<25岁组相比，25~34岁（调整后OR=2.65，95%CI：1.75~4.00）和≥35岁组（调整后OR=3.35，95%CI：2.19~5.14）产妇的接种可能性更高；与配偶年龄<25岁者相比，配偶年龄≥35岁者的产妇更可能接种（调整后OR=2.74，95%CI：1.57~4.78）；与产妇学历为大学以下者相比，大学及以上学历者接种可能性更高（调整后OR=5.63，95%CI：95%CI：4.30~7.38）；配偶学历为大学及以上者相比于大学以下者也更倾向于接种（调整后OR=2.19，95%CI：1.78~2.69）；与无流产史者相比，有流产史者的接种可能性较低（调整后OR=0.76，95%CI：0.70~0.84）；与子代出生于2012—2015年者相比，子代出生于2016—2019年（调整后OR=8.70，95%CI：6.45~11.75）和2020—2022年（调整后OR=54.56，95%CI：40.79~72.97）的产妇孕期接种可能性显著增加。在调整产妇户籍、年龄、学历，配偶年龄、学历、单/多胎妊娠、流产史、妊娠期高血压、妊娠期高血糖、子代出生年份后，与孕期未接种任何疫苗的产妇相比，孕期接种流感疫苗的产妇早产风险显著降低35%（调整后OR=0.65，95%CI：0.53~0.81）。结论 多个社会人口学特征与2012—2022年上海市产妇孕期疫苗接种行为存在显著关联，且孕期接种流感疫苗可能与早产风险降低有关。建议进一步加强科普宣传与服务保障，持续推进疫苗接种工作，切实保障母婴健康。

Objective This study aimed to investigate the influenza vaccination coverage among pregnant women in Shanghai, analyze the main demographic factors influencing vaccination behavior, and further assess the potential association between influenza vaccination during pregnancy and the occurrence of preterm birth, providing empirical evidence for influenza vaccination strategies in China. Methods All the information of the mothers and their newborns from January 1, 2012 to December 31, 2022 in the Shanghai Birth Medical Information System was collected. A multivariate logistic regression model was used to analyze the main demographic factors influencing influenza vaccination among pregnant women and to evaluate the association between influenza vaccination during pregnancy and preterm birth outcomes. Results During the study period, 2209 pregnant women received influenza vaccination. Multivariate logistic regression analysis revealed that maternal residency, age, education, spouse’s age and education, history of miscarriage, and offspring birth year were significant factors influencing influenza vaccination during pregnancy (all P<0.001). Compared with pregnant women registered in Shanghai, those with residency outside Shanghai had a lower likelihood of vaccination (adjusted OR=0.83, 95% CI: 0.76-0.91). Compared to women aged < 25 years, those aged 25-34 years (adjusted OR=2.65, 95% CI: 1.75-4.00) and ≥ 35 years (adjusted OR=3.35, 95% CI: 2.19-5.14) had higher likelihoods of vaccination. Women whose spouses were ≥ 35 years old were more likely to be vaccinated compared with those whose spouses were < 25 years old (adjusted OR=2.74, 95% CI: 1.57-4.78). Women with a college degree or above had a higher likelihood of vaccination than those with less than college education (adjusted OR=5.63, 95% CI: 4.30-7.38), and similarly, women whose spouses had a college degree or above were more likely to be vaccinated compared to those whose spouses had lower education (adjusted OR=2.19, 95% CI: 1.78-2.69). Women with a history of miscarriage were less likely to be vaccinated compared with those without (adjusted OR=0.76, 95% CI: 0.70-0.84). Compared to offspring born between 2012 and 2015, women with offspring born between 2016 and 2019 (adjusted OR=8.70, 95% CI: 6.45-11.75) and between 2020 and 2022 (adjusted OR=54.56, 95% CI: 40.79-72.97) were significantly more likely to receive influenza vaccination during pregnancy. After adjusting for maternal residency, age, education, spouse’s age and education, single/multiple pregnancies, history of miscarriage, gestational hypertension, gestational diabetes, and offspring birth year, influenza vaccination during pregnancy was associated with a 35% reduction in the risk of preterm birth compared to that of no vaccination during pregnancy (adjusted OR=0.65, 95% CI: 0.53-0.81). Conclusions Multiple sociodemographic factors are significantly associated with influenza vaccination behavior among pregnant women in Shanghai between 2012 and 2022, and influenza vaccination during pregnancy may be related to a reduced risk of preterm birth. It is recommended to further strengthen public education and service support, continuously promote vaccination efforts, and effectively safeguard maternal and infant health.