Neonatal outcomes after influenza immunization during pregnancy: a randomized controlled trial
Neonatal outcomes after influenza immunization during pregnancy: a randomized controlled trial
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DOI：
10.1503/cmaj.110754
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发表时间：
2012-04-03
影响因子：
14.6
通讯作者：
Zaman, K.
中科院分区：
文献类型：
--
作者：
Steinhoff, Mark C.;Omer, Saad B.;Zaman, K.
背景：关于母亲流感感染对胎儿和新生儿影响的数据有限。我们进行了二次分析的数据从母亲的礼物项目，一项随机研究，旨在测试灭活流感和肺炎球菌疫苗在怀孕期间的有效性。方法：在母亲的礼物项目，340名孕妇在孟加拉国接受灭活流感疫苗或23价肺炎球菌多糖疫苗（对照）。本研究于2004年8月至2005年12月进行。我们在两个时期对母亲流感疫苗接种后的结局进行了二次分析：流感病毒未流行时（2004年9月至2005年1月）和流感病毒流行时（2005年2月至10月）。我们评估了胎龄、平均出生体重和小于胎龄儿的比例。结果：在没有流行性流感病毒的时期，两组母亲和婴儿每100人月的呼吸道疾病伴发热的发病率没有差异（流感疫苗组：3.9;对照组：4.0; p > 0.9）。两组间小于胎龄儿的比例和平均出生体重相似（小于胎龄儿：流感疫苗组29.1%，对照组34.3%;平均出生体重：流感疫苗组3083 g，对照组3053 g）。在流感病毒流行期间，接种流感疫苗的母亲和婴儿中每100人月呼吸道疾病伴发热的发病率大幅降低（流感疫苗：3.7;对照：7.2; p = 0.0003）。在此期间，流感疫苗组中小于胎龄儿的比例低于对照组（25.9% v. 44.8%; p = 0.03）。在此期间，母亲接种流感疫苗的婴儿的平均出生体重高于接种对照疫苗的婴儿（3178 g v. 2978 g; p = 0.02）。在流感病毒流行期间，母亲在怀孕期间接种疫苗与小于胎龄儿的比例降低和平均出生率增加有关重量.这些数据需要证实，但表明预防妊娠期流感感染会影响胎儿宫内发育。
Background: There are limited data about the effect of maternal influenza infection on fetuses and newborns. We performed a secondary analysis of data from the Mother'sGift project, a randomized study designed to test the effectiveness of inactivated influenza and pneumococcal vaccines during pregnancy.Methods: In the Mother'sGift project, 340 pregnant women in Bangladesh received either inactivated influenza vaccine or 23-valent pneumococcal polysaccharide vaccine (control). This study was performed from August 2004 through December 2005. We performed a secondary analysis of outcomes following maternal influenza immunization during two periods: when influenza virus was not circulating (September 2004 through January 2005) and when influenza virus was circulating (February through October 2005). We assessed gestational age, mean birth weight and the proportion of infants who were small for gestational age.Results: During the period with no circulating influenza virus, there were no differences in the incidence of respiratory illness with fever per 100 person-months among mothers and infants in the two groups (influenza vaccine: 3.9; control: 4.0; p > 0.9). The proportion of infants who were small for gestational age and the mean birth weight were similar between groups (small for gestational age: influenza vaccine 29.1%, control 34.3%; mean birth weight: influenza vaccine 3083 g, control 3053 g). During the period with circulating influenza virus, there was a substantial reduction in the incidence per 100 person-months of respiratory illness with fever among the mothers and infants who had received the influenza vaccine (influenza vaccine: 3.7; control: 7.2; p = 0.0003). During this period, the proportion of infants who were small for gestational age was lower in the influenza vaccine group than in the control group (25.9% v. 44.8%; p = 0.03). The mean birth weight was higher among infants whose mothers received the influenza vaccine than among those who received the control vaccine during this period (3178 g v. 2978 g; p = 0.02).Interpretation: During the period with circulating influenza virus, maternal immunization during pregnancy was associated with a lower proportion of infants who were small for gestational age and an increase in mean birth weight. These data need confirmation but suggest that prevention of influenza infection in pregnancy can influence intrauterine growth.