Influenza Vaccination Given at Least 2 Weeks Before Delivery to Pregnant Women Facilitates Transmission of Seroprotective Influenza-specific Antibodies to the Newborn
Influenza Vaccination Given at Least 2 Weeks Before Delivery to Pregnant Women Facilitates Transmission of Seroprotective Influenza-specific Antibodies to the Newborn
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DOI：
10.1097/01.inf.0000437066.40840.c4
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发表时间：
2013-12-01
影响因子：
3.6
通讯作者：
Siegrist, Claire-Anne
中科院分区：
文献类型：
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作者：
Blanchard-Rohner, Geraldine;Meier, Sara;Siegrist, Claire-Anne
背景：孕妇和婴儿感染流感后并发症的风险较高。在怀孕期间的免疫接种有利于保护新生儿通过被动转移的母体antibodies.Methods：这是一个横断面研究期间进行的后H1N1流感大流行的冬季季节的2010/2011年在瑞士日内瓦。我们通过血凝抑制法测量了接种疫苗和未接种疫苗母亲所生新生儿脐带血中针对季节性甲型流感H1 N1、H3 N2和B 2010/2011毒株的抗体滴度。血清保护定义为血凝抑制滴度40。结果：共纳入188名妇女，其中101人接种过无佐剂流感疫苗（均在妊娠中期或晚期），其余87人未接种。在接种疫苗的妇女的新生儿中，84-86%显示血清保护水平取决于菌株。相比之下，未接种疫苗妇女的婴儿血清保护率显著较低（29- 33%，P < 0.001）。调整各种混杂因素并应用多变量回归分析，在分娩前2周妊娠期间接种疫苗可使脐带血中的几何平均滴度增加5-17倍，血清保护率增加5.8-34.4倍，这取决于菌株和接种疫苗与分娩之间的间隔。孕妇在分娩前2-4周接种疫苗仍然比完全不接种疫苗更有效（与未接种疫苗的妇女相比，几何平均滴度增加6.8-11.1倍，血清保护率增加5.8-34.4倍）。在怀孕中期和晚期的任何时候接种流感疫苗，但至少在分娩前15天，为许多新生儿提供血清保护。
Background: Pregnant women and infants are at higher risk of complications secondary to influenza infection. Immunization during pregnancy facilitates protection of the neonates through passive transfer of maternal antibodies.Methods: This was a cross-sectional study performed during the post-H1N1 pandemic winter season of 2010/2011 in Geneva, Switzerland. We measured antibody titers against the seasonal influenza A H1N1, H3N2 and B 2010/2011 strains by hemagglutination inhibition in the umbilical cord blood of newborns born to vaccinated and nonvaccinated mothers. Seroprotection was defined as a hemagglutination inhibition titer 40.Results: A total of 188 women were enrolled, 101 of whom had been vaccinated with a nonadjuvanted influenza vaccine (all during the second or third trimester) and the other 87 had not. Among newborns of vaccinated women, 84-86% showed seroprotective levels depending on the strain. In comparison, seroprotection rates were significantly lower in babies of nonvaccinated women (29-33%, P < 0.001). Adjusting for various confounding factors and applying multivariate regression analysis, vaccination during pregnancy 2 weeks before delivery increased geometric mean titers in umbilical cord blood 5-17 times and seroprotection rates 5.8-34.4 times, depending on the strain and the interval between vaccination and delivery. Vaccinating pregnant women only 2-4 weeks before delivery was still more effective than no vaccination at all (geometric mean titers increased 6.8-11.1 times and seroprotection rates increased 5.8-34.4 times compared with nonvaccinated women).Conclusions: Influenza vaccination at any time during the second and third trimester of pregnancy, but at least 15 days before delivery, confers seroprotection to many neonates.