The Effect of Tetanus-Diphtheria-Acellular-Pertussis Immunization During Pregnancy on Infant Antibody Responses: Individual-Participant Data Meta-Analysis.
The Effect of Tetanus-Diphtheria-Acellular-Pertussis Immunization During Pregnancy on Infant Antibody Responses: Individual-Participant Data Meta-Analysis.
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DOI：
10.3389/fimmu.2021.689394
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发表时间：
2021
影响因子：
7.3
通讯作者：
Sadarangani M
中科院分区：
文献类型：
--
作者：
Abu-Raya B;Maertens K;Munoz FM;Zimmermann P;Curtis N;Halperin SA;Rots N;Barug D;Holder B;Kampmann B;Leuridan E;Sadarangani M
越来越多的人建议在怀孕期间接种破伤风-白喉-无细胞百日咳（Tdap）疫苗。我们确定了妊娠期Tdap免疫对婴儿疫苗应答的影响。对10项研究（n=1884）的个体参与者数据进行荟萃分析，研究妊娠期Tdap免疫后婴儿对常规免疫的抗体应答。使用混合效应模型计算抗原特异性免疫球蛋白G（IgG）水平的几何平均比值（GMR）。使用卡方检验比较血清保护率。Tdap免疫妇女的婴儿抗百日咳毒素IgG显著降低（GMR 0.65; 95%CI 0.57-0.74），丝状血凝素（FHA）（0.68; 0.53-0.87）、perceptin（0.65; 0.58-0.72）和菌毛2/3（FIM 2/3）（0.41; 0.32-0.52）。这些较低水平在FHA（0.72; 0.61-0.84）和FIM 2/3（0.53; 0.29-0.96）加强免疫后持续存在。初次免疫后，Tdap免疫妇女的婴儿白喉血清保护率较低（90% [843/973] vs 98% [566/579]; p<0.001）和由5种肺炎链球菌（SPN）血清型引起的侵袭性肺炎球菌病（IPD）（SPN 5、SPN 6 B、SPN 9 V、SPN 19 A、SPN 23 F），对流感嗜血杆菌B型的血清保护率更高（短期和长期血清保护率分别为86%[471/547] vs 76%[188/247]和62%[337/547] vs 49%（121/247），所有p=0.001）。加强免疫后，白喉和破伤风的血清保护率分别为99%（286/288）和（618/619）的婴儿Tdap免疫的妇女。与未免疫妇女的婴儿相比，妊娠期Tdap免疫妇女的婴儿在免疫后对百日咳、白喉和一些SPN血清型的IgG水平较低。需要加强对婴儿百日咳、白喉和IPD的监测，以确定这些发现的临床意义。CRD42017079171。
Immunization with tetanus-diphtheria-acellular pertussis (Tdap) vaccine in pregnancy is increasingly recommended. We determined the effect of Tdap immunization in pregnancy on infants’ vaccine responses. Individual-participant data meta-analysis of ten studies (n=1884) investigating infants’ antibody response to routine immunizations following Tdap immunization in pregnancy was performed. Geometric mean ratios (GMRs) of antigen-specific immunoglobulin G (IgG) levels were calculated using mixed-effects models. Seroprotection rates were compared using chi-squared tests. Infants of Tdap-immunized women had significantly lower IgG against pertussis toxin (GMR 0.65; 95%CI 0.57-0.74), filamentous haemagglutinin (FHA) (0.68; 0.53-0.87), pertactin (0.65; 0.58-0.72) and fimbria 2/3 (FIM2/3) (0.41; 0.32-0.52) after primary immunization, compared with infants of unimmunized women. These lower levels persisted after booster immunization for FHA (0.72; 0.61-0.84) and FIM2/3 (0.53; 0.29-0.96). After primary immunization, infants of Tdap-immunized women had lower seroprotection rates against diphtheria (90% [843/973] vs 98% [566/579]; p<0.001) and invasive pneumococcal disease (IPD) caused by 5 Streptococcus pneumoniae (SPN) serotypes (SPN5, SPN6B, SPN9V, SPN19A, SPN23F), and higher seroprotection rates against Haemophilus influenzae type b (short-term and long-term seroprotection rates, 86%[471/547] vs 76%[188/247] and 62%[337/547] vs 49%(121/247), respectively, all p=0.001). After booster immunization, seroprotection rates against diphtheria and tetanus were 99% (286/288) and (618/619) in infants of Tdap-immunized women, respectively. Infants of Tdap-immunized women in pregnancy had lower IgG levels against pertussis, diphtheria and some SPN serotypes after their immunization compared with infants of unimmunized women. Enhanced surveillance of pertussis, diphtheria and IPD in infants is needed to determine the clinical significance of these findings. CRD42017079171.
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影响因子：
168.9
作者：
Amirthalingam, Gayatri;Andrews, Nick;Ramsay, Mary
通讯作者：
Ramsay, Mary
DOI：
10.1093/cid/ciw559
发表时间：
2016-12-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Amirthalingam G;Campbell H;Ribeiro S;Fry NK;Ramsay M;Miller E;Andrews N
通讯作者：
Andrews N
影响因子：
5.5
作者：
Barug, Daan;Berbers, Guy A. M.;Rots, Nynke Y.
通讯作者：
Rots, Nynke Y.
影响因子：
3.6
作者：
Maertens, Kirsten;Burbidge, Polly;Leuridan, Elke
通讯作者：
Leuridan, Elke
影响因子：
5.1
作者：
Castagnini, Luis A.;Munoz, Flor M.
通讯作者：
Munoz, Flor M.