Naleway Allison L, Smith Wendy J, Mullooly John P
Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA.
Epidemiol Rev. 2006;28:47-53. doi: 10.1093/epirev/mxj002. Epub 2006 May 26.
Pregnant women have an increased risk of influenza infection and complications. The Advisory Committee on Immunization Practices currently recommends vaccination for women who are pregnant during influenza season. The authors review the literature concerning influenza vaccine safety, effectiveness, and coverage rates during pregnancy, as well as opportunities to improve vaccination rates during pregnancy. No study has demonstrated an increased risk of maternal complications or adverse fetal outcomes associated with inactivated influenza vaccine. Few studies have examined the effectiveness of vaccination during pregnancy, and the results from these studies are inconsistent, with some showing a protective effect and others showing no effect. Despite the proven safety of vaccination and the possible benefits to women and their infants, reported vaccination rates during pregnancy are generally less than 10%. Mothers frequently cite concerns about vaccine safety as a barrier to vaccination. Lack of adequate information about the risks and benefits of vaccination is reported by both patients and obstetric care providers. Organizational factors such as lack of vaccine storage facilities may also limit vaccination during pregnancy. Effective interventions should target factors pertaining to patients or providers, or they should address organizational or logistic barriers. The Advisory Committee on Immunization Practices currently recommends standing orders programs or reminders for patients and providers as strategies to improve vaccination rates.
孕妇感染流感及出现并发症的风险增加。免疫实践咨询委员会目前建议在流感季节为孕期女性接种疫苗。作者回顾了有关孕期流感疫苗安全性、有效性和接种率的文献，以及提高孕期接种率的机会。尚无研究表明与灭活流感疫苗相关的孕产妇并发症或不良胎儿结局风险增加。很少有研究考察孕期接种疫苗的有效性，这些研究的结果并不一致，一些显示有保护作用，另一些则显示无作用。尽管已证实接种疫苗的安全性以及对女性及其婴儿可能带来的益处，但报道的孕期接种率普遍低于10%。母亲们经常将对疫苗安全性的担忧作为接种疫苗的障碍。患者和产科护理人员都表示缺乏关于接种疫苗风险和益处的充分信息。诸如缺乏疫苗储存设施等组织因素也可能限制孕期接种。有效的干预措施应针对与患者或提供者相关的因素，或者应解决组织或后勤方面的障碍。免疫实践咨询委员会目前建议为患者和提供者制定常备医嘱计划或提醒，作为提高接种率的策略。
