第3四半期Tdap予防接種と新生児疹抗体濃度との関連
C Mary Healy1, Marcia A Rench1, Laurie S Swaim2
1Infectious Disease Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
JAMA
|October 11, 2018
まとめ
妊娠中の乳,白喉,非細胞性 pertussis (Tdap) ワクチンによる母親の免疫は,新生児の pertussis トキシン抗体を著しく増加させる. 特に第27週から第30週間のTdapワクチン接種は,新生児の抗体濃度が最も高くなります.
科学分野:
- 免疫学
- 妊婦と胎児の医療
- ワクチン学
背景:
- 乳児の pertussis は生命を脅かす危険性があり,妊娠期間 (27週から36週) の間,乳,弁,および非細胞性 pertussis (Tdap) のワクチンで母親の免疫が必要である.
- 新生児の抗体レベルを最大化するために,妊娠中にTdapワクチン接種の最適なタイミングは未定です.
研究 の 目的:
- 妊娠中にTdapワクチンを接種した母親から生まれた新生児の pertussis toxin抗体濃度を比較する.
- 新生児の抗体のピークレベルを達成するために,母親のTdap免疫のための最適な妊娠年齢を特定する.
主な方法:
- テキサス州ヒューストンの新生児を対象に前向きな観察コホート研究が行われました.
- Tdap免疫と免疫のない母親からの新生児の毒抗体濃度について,帯血のサンプルを分析した.
- 母親のTdapワクチン接種時の妊娠年齢を記録し,分析した.
主要な成果:
- 母親のTdap免疫は,新生児の pertussis toxin抗体 (47. 3 IU/ mL vs. 12. 9 IU/ mL) の幾何学平均濃度 (GMC) が著しく高かった.
- Tdapワクチン接種を受けた母親から生まれた新生児の割合は,抗体濃度が15IU/ mL以上 (86%対37%),30IU/ mL以上 (72%対17%),40IU/ mL以上 (59%対12%) であった.
- 新生児の抗体の最高GMCは,妊娠27週から30週間の間のTdapワクチン接種で観察され,ピークは30週でした.
結論:
- 妊娠3ヶ月間のTdapワクチン接種は,新生児の pertussis toxin抗体濃度を著しく増加させる.
- 新生児にTdapワクチンを早めに投与すると (27週~30週) 新生児の抗体濃度が高くなり,保護が強化される可能性がある.
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