Rubella, rubeola, and mumps in pregnant women - Susceptibilities and strategies for testing and vaccinating
Rubella, rubeola, and mumps in pregnant women - Susceptibilities and strategies for testing and vaccinating
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DOI：
10.1097/01.aog.0000171110.49973.e3
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发表时间：
2005-08-01
影响因子：
7.2
通讯作者：
Congdon, CL
中科院分区：
文献类型：
--
作者：
Haas, DM;Flowers, CA;Congdon, CL
目的：评估孕妇对风疹、风疹和腮腺炎 (MMR) 的敏感性，并根据风疹免疫状态确定对风疹或腮腺炎不免疫的百分比。第二个目标是评估旨在消除这些病毒敏感性的疫苗接种和检测计划的成本，以确定最佳策略。方法：这是一项针对接受产前护理的妇女的观察性研究。所有女性都测量了 MMR 抗体滴度。通过年龄、妊娠、产次和疫苗加强疫苗的召回来比较病毒敏感性。进行逻辑回归来评估 MMR 免疫的预测因子。对不同筛查和疫苗接种策略的成本进行了比较。结果：总体而言，91 名（9.4%）女性易患风疹，161 名（16.5%）女性易患风疹，159 名（16.3%）女性易患腮腺炎。三百一十七人 (32.6%) 对至少一种病毒敏感，而只有 17 人 (1.7%) 对所有 3 种病毒敏感。在对风疹免疫的女性中，很大一部分对风疹或腮腺炎没有免疫力 (n = 226, 25.6%)。在知道自己接种了加强疫苗的女性中，只有 74.2% 对 MMR 疫苗的所有成分都具有免疫力。接受加强疫苗可以预测对所有 3 种病毒的免疫力。成本分析表明，更广泛的筛查策略更全面、更昂贵。结论：当前的筛查和疫苗计划使许多育龄妇女容易感染风疹、风疹和腮腺炎。也许需要更全面的病毒筛查计划来确保免疫力。
Objective: To estimate rubella, rubeola, and mumps (MMR) susceptibilities in pregnant women and determine the percentage not immune to rubeola or mumps, depending on rubella immunity status. A secondary objective was to assess costs of vaccination and testing programs aimed at eliminating these viral susceptibilities to determine an optimal strategy.Methods: This was an observational study of women presenting for prenatal care. All women had MMR antibody titers measured. Viral susceptibilities were compared by age, gravidity, parity, and recall of vaccine booster. A logistic regression was performed to assess for predictors of MMR immunity. A cost comparison of different screening and vaccination strategies was performed.Results: Overall, 91 (9.4%) women were susceptible to rubella, 161 (16.5%) to rubeola, and 159 (16.3%) to mumps. Three hundred seventeen (32.6%) were susceptible to at least 1 virus, whereas only 17 (1.7%) were susceptible to all 3. Of the women who were immune to rubella, a large percentage were not immune to either rubeola or mumps (n = 226, 25.6%). Only 74.2% of women who knew they had a booster vaccine were immune to all components of the MMR vaccine. Receiving a booster was predictive of immunity to all 3 viruses. A cost analysis demonstrated that broader screening strategies are more comprehensive and more expensive.Conclusion: The current screening and vaccine program has left many reproductive-aged women susceptible to rubella, rubeola, and mumps infections. Perhaps a more comprehensive viral screening program is needed to ensure immunity.