第三个月的Tdap免疫接种与新生儿咳抗体度之间的关联
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
概括
孕妇在怀孕期间接种破伤风,白喉和非细胞性咳 (Tdap) 疫苗可以显著增加新生儿的咳毒素抗体. 在新生儿中,Tdap疫苗接种在第3个月的早期,特别是在第27至30周之间,产生最高的抗体度.
科学领域:
- 免疫学
- 产妇和胎儿医学
- 疫苗学
背景情况:
- 婴儿百日咳是危及生命的疾病,需要在怀孕期间 (第27至第36周) 用疹,白喉和非细胞性百日咳 (Tdap) 疫苗免疫母亲.
- 在怀孕期间进行Tdap疫苗接种以最大限度地提高新生儿抗体水平的最佳时间仍未确定.
研究的目的:
- 为了比较怀孕期间接种Tdap疫苗的新生儿与未接种Tdap疫苗的新生儿的咳毒素抗体度.
- 确定母体Tdap免疫的最佳妊娠年龄,以达到新生儿抗体水平的峰值.
主要方法:
- 在德克萨斯州休斯顿进行了一项前性观察队列研究.
- 从Tdap免疫和未免疫母亲的新生儿中分析了带毒素抗体度的样本.
- 记录和分析了母体Tdap疫苗接种时的妊娠年龄.
主要成果:
- 孕产妇的Tdap免疫与新生儿咳毒素抗体的几何平均度 (GMCs) 显著增加 (47. 3 IU/ mL对比12. 9 IU/ mL).
- 接种Tdap疫苗的新生儿中,更多的新生儿的抗体度为15IU/ ml或更高 (86%对37%),30IU/ ml或更高 (72%对17%),40IU/ ml或更高 (59%对12%).
- 当孕妇在怀孕27周到30周之间接种Tdap疫苗时,观察到新生儿抗体的GMC最高,在30周达到峰值.
结论:
- 孕妇在第三个月内接种Tdap疫苗会显著增加新生儿咳抗体度.
- 在孕期第三季度 (27-30) 早期给予Tdap疫苗,与新生儿的抗体水平较高有关,可能提供更强的保护.
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