Positive rates for rubella antibody in pregnant women and benefit of post-partum vaccination in a Japanese perinatal center
Positive rates for rubella antibody in pregnant women and benefit of post-partum vaccination in a Japanese perinatal center
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DOI：
10.1111/j.1447-0756.2007.00689.x
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发表时间：
2008-04-01
影响因子：
1.6
通讯作者：
Hirahara, Fumiki
中科院分区：
文献类型：
--
作者：
Okuda, Mika;Yamanaka, Michiko;Hirahara, Fumiki
目的：为了解孕妇风疹免疫状况，评价产后风疹疫苗接种效果及不良反应，采用血凝抑制试验和酶联免疫吸附试验分别检测孕早期风疹抗体和IgM抗体水平，并调查围产中心孕妇风疹抗体阳性率;我们建议免疫力差的妇女在产后接种疫苗。结果：在2741例孕妇中，风疹病毒血清学阴性185例（6.7%）。由于日本政府政策的改变而选择退出疫苗接种的人群中，这一比例尤其高（12.4%）。IgM抗体阳性或假阳性30例（1.1%），无先天性风疹综合征（CRS）发生。血清阳性率为93.3%，但这一数字包括那些需要产后接种疫苗的人（558例或20.3%），因为他们的滴度为16倍或更低。145例产后接种风疹疫苗的患者中，未发现严重不良反应，37例血凝抑制抗体滴度≤ 8倍的患者中，有效率为100%。此外，我们需要强调产后风疹疫苗接种在日本的重要性和安全性。
Aim: This study of pregnant women was undertaken to clarify their immune status for rubella and to evaluate the efficacy of, and adverse reaction to, post-partum rubella vaccination.Methods: We determined the levels of both rubella antibody by hemagglutination inhibition test and IgM antibody by enzyme-linked immunosorbent assay in the first gestational trimester and surveyed the positive rates for rubella antibody in pregnant women at our perinatal center; we recommended post-partum vaccination for women with poor immune status. We also evaluated the effectiveness of the vaccine and any adverse reaction.Results: Among 2741 pregnant women, 185 cases (6.7%) were seronegative for rubella virus. This rate was especially high (12.4%) in the population who had opted out of the vaccination because of a change in Japanese government policy. A total of 30 cases (1.1%) were positive or false-positive for IgM antibody, but no congenital rubella syndrome (CRS) developed. The seropositive rate was 93.3% in total, but this figure includes those who required post-partum vaccination (558 cases or 20.3%) because their titers were 16x or lower. Among 145 cases who received post-partum rubella vaccine, no severe adverse reaction was detected, and in all 37 cases with hemagglutination inhibition antibody titers of 8x or lower, the efficacy rate was 100%.Conclusions: It is necessary to appropriately evaluate the CRS risk. Also, we need to emphasize the importance and safety of post-partum rubella vaccination in Japan.