Seroprevalence of rubella in the cord blood of pregnant women and congenital rubella incidence in Nha Trang, Vietnam
Seroprevalence of rubella in the cord blood of pregnant women and congenital rubella incidence in Nha Trang, Vietnam
复制标题
DOI：
10.1016/j.vaccine.2013.08.076
复制
发表时间：
2014-02-26
期刊：
影响因子：
5.5
通讯作者：
Moriuchia, Hiroyuki
中科院分区：
文献类型：
--
作者：
Miyakawa, Masami;Yoshino, Hiroshi;Moriuchia, Hiroyuki
为了调查越南妊娠母亲对风疹感染的易感性以及相关因素，并评估在风疹疫苗（RCV）未纳入常规免疫规划情况下先天性风疹感染（CRI）的负担，我们于2009年至2010年在越南芽庄进行了一项前瞻性队列研究。通过酶联免疫吸附测定法对脐带血样本中的风疹特异性免疫球蛋白M和免疫球蛋白G进行了检测。分析了相应的临床流行病学数据，并通过建模估算了全国先天性风疹综合征（CRS）的发病率。我们招募了1988对年龄在17 - 45岁的母亲及其新生儿。没有母亲接种过风疹疫苗。多变量分析显示，17 - 24岁（调整优势比2.5，95%置信区间：1.7 - 3.8）或25 - 34岁（1.4，1.0 - 2.1）的母亲比35 - 45岁的母亲更易感染。总体而言，28.9%（574/1988，95%置信区间：26.9 - 30.9%）的母亲血清呈阴性。每10万活产儿中，CRI发生率为151（95%置信区间：0 - 322）。建模估算越南每年有3788名婴儿（95%置信区间：3283 - 4143）患有CRS，总体CRS发病率为每10万活产儿234例（95%置信区间：207 - 262）。相当比例的育龄妇女在孕期有风疹感染的风险，这可能导致越南流产频率较高或CRS负担较重。及时将风疹疫苗纳入国家免疫规划，并对儿童和育龄妇女进行补种，将减少越南的先天性风疹感染。（C）2013爱思唯尔有限公司。保留所有权利。
To investigate susceptibility to and factors associated with rubella infection among pregnant mothers and to estimate the burden of congenital rubella infection (CRI) in Vietnam where rubella-containing vaccine (RCV) is not included in the routine immunization program, we conducted a prospective cohort study in Nha Trang, Vietnam between 2009 and 2010. Rubella-specific immunoglobulin-M and immunoglobulin-G were investigated in cord blood samples by enzyme immunoassay. Corresponding clinical-epidemiological data were analyzed and the national congenital rubella syndrome (CRS) incidence was estimated using modeling. We enrolled 1988 pairs of mothers aged 17-45 years and their newborn babies. No mothers had received RCV. Multivariate analysis revealed that mothers aged 17-24 (aOR 2.5,95% CI: 1.7-3.8) or 25-34 (1.4, 1.0-2.1) years were more likely to be susceptible than those aged 35-45 years. Overall 28.9% (574/1988,95% CI: 26.9-30.9%) of mothers were seronegative. The CRI rate was 151 (95% CI: 0-322) per 100,000 live births. Modeling estimated that 3788 babies (95% CI: 3283-4143) were born with CRS annually in Vietnam with an overall CRS incidence of 234 (95% CI: 207-262) cases per 100,000 live births. A substantial proportion of women of childbearing age (WCBA) are at risk of rubella infection during pregnancy and this can result in a high frequency of miscarriage or burden of CRS across Vietnam. Prompt introduction of RCV into national immunization program with catch-up vaccination to children and WCBA will reduce CRI in Vietnam. (C) 2013 Elsevier Ltd. All rights reserved.