Optimizing benefits of influenza virus vaccination during pregnancy: potential behavioral risk factors and interventions.
Optimizing benefits of influenza virus vaccination during pregnancy: potential behavioral risk factors and interventions.
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DOI：
10.1016/j.vaccine.2014.03.075
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发表时间：
2014-05-23
期刊：
影响因子：
5.5
通讯作者：
Christian, Lisa M.
中科院分区：
文献类型：
--
作者：
Christian, Lisa M.
关键词：
孕妇和婴儿因流感而出现并发症、住院和死亡的风险很高。众所周知，在怀孕期间接种流感疫苗可以降低妇女的总体发病率和疾病严重程度。母体免疫还通过胎盘转移和母乳为婴儿提供抗体保护。然而，与普通人群一样，在孕妇接种疫苗后，相对较高比例的孕妇及其婴儿没有达到针对流感病毒的保护性抗体水平。行为因素，特别是母亲的体重和压力暴露，可能会影响最初的母亲抗体反应，随着时间的推移(即，在怀孕期间)抗体水平的维持，以及经胎盘向胎儿转移抗体的效率。相反，包括急性运动和减压在内的行为干预可以增强接种疫苗后的免疫保护。这种行为干预在怀孕期间特别有吸引力，因为它们是安全和非侵入性的。查明疫苗反应不佳的个人风险因素并采用适当的干预措施是实现个性化保健的重要步骤。
Pregnant women and infants are at high risk for complications, hospitalization, and death due to influenza. It is well-established that influenza vaccination during pregnancy reduces rates and severity of illness in women overall. Maternal vaccination also confers antibody protection to infants via both transplacental transfer and breast milk. However, as in the general population, a relatively high proportion of pregnant women and their infants do not achieve protective antibody levels against influenza virus following maternal vaccination. Behavioral factors, particularly maternal weight and stress exposure, may affect initial maternal antibody responses, maintenance of antibody levels over time (i.e., across pregnancy), as well as the efficiency of transplacental antibody transfer to the fetus. Conversely, behavioral interventions including acute exercise and stress reduction can enhance immune protection following vaccination. Such behavioral interventions are particularly appealing in pregnancy because they are safe and non-invasive. The identification of individual risk factors for poor responses to vaccines and the application of appropriate interventions represent important steps towards personalized health care.
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