非常低出生体重婴儿的流感免疫:流行病学和长期结果
Marie-Theres Dammann1, Hannah Kraft1, Guido Stichtenoth1
1Department of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, Germany.
Vaccines
|January 24, 2025
概括
在出生时体重非常低的婴儿 (VLBWI) 中,流感免疫没有改善肺功能或神经发育. 大多数VLBWIs仍然没有接种疫苗,这凸显了对这一高风险群体需要专门的流感疫苗接种指南的需要.
科学领域:
- 新生儿科学 新生儿科学
- 儿科肺病学 儿科肺病学
- 儿科神经学 儿科神经学
背景情况:
- 非常低出生体重婴儿 (VLBWIs) 面临严重流感并发症的风险增加,包括肺炎,脑炎和死亡.
- 有限的数据存在于VLBWIs的流感免疫的有效性和结果.
研究的目的:
- 提供有关德国VLBWIs流感免疫率的流行病学数据.
- 调查一种假设,即流感免疫保护VLBWIs免受神经发育障碍,并在学龄保持肺功能.
主要方法:
- 在德国新生儿网络 (GNN) 中,对2009年至2015年间出生的VLBWI进行了基于人口的观察性研究.
- 6年的随访包括肺功能和神经发育测试.
- 单变量和多变量分析比较了免疫和非免疫VLBWIs之间的结果.
主要成果:
- 26% (871/3358) 的VLBWI在6岁之前接种了流感疫苗.
- 接种疫苗的婴儿有较低的妊娠年龄和更高的支气管肺功能障碍 (BPD) 发病率.
- 早期免疫没有显示出安全问题,并降低了支气管炎的风险 (OR:0.2;95% CI:0.1-0.6),但88%的人在第一季没有免疫接种.
结论:
- 流感疫苗接种与学龄期改善的肺功能 (FEV1,FVC) 或神经认知结果 (IQ,SDQ) 无关.
- 在德国,只有25%的6岁VLBWIs被免疫,在早产婴儿 (<28周) 和患有BPD的婴儿中,这一比例更高.
- 基于证据的流感疫苗接种指导方针对于这个脆弱的人群至关重要.
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