Watson Barbara, Civen Rachel, Reynolds Meredith, Heath Karl, Perella Dana, Carbajal Tina, Mascola Laurene, Jumaan Aisha, Zimmerman Laura, James Abike, Quashi Carlene, Schmid Scott
Philadelphia Department of Public Health, 500 South Broad St., Philadelphia, PA 19146, USA.
Public Health Rep. 2007 Jul-Aug;122(4):499-506. doi: 10.1177/003335490712200411.
The purpose of this study was to assess the validity of self-reported history for varicella disease relative to serological evidence of varicella immunity in pregnant women attending antenatal care at clinics located in two diverse geographical locations in the U.S. (Antelope Valley, California, and Philadelphia) with high varicella vaccination coverage.
Pregnant women attending prenatal care appointments who needed blood drawn as part of their routine care were eligible to participate. Self-reported varicella disease history was obtained via questionnaire. Varicella serostatus was determined using a whole-cell enzyme-linked immunosorbent assay to test for varicella zoster virus-specific immunoglobulin G (VZV IgG) antibodies.
Of the 309 study participants from Antelope Valley and the 528 participants from Philadelphia who self-reported having had chickenpox disease, 308 (99.7%; 95% confidence interval [CI]: 98.2, 100) and 517 (97.9%; 95% CI: 96.3, 99.0), respectively, had serological evidence of immunity to varicella. Only 6.8% (95% CI: 3.9, 11.0) and 17.4% (95% CI: 13.1, 22.5) of women who self-reported having a negative or uncertain varicella disease history in Antelope Valley and Philadelphia, respectively, were seronegative for varicella antibodies.
Despite the dramatic changes in the epidemiology of varicella that have occurred since 1995 due to the introduction and subsequent widespread use of the varicella vaccine, self-reported history of varicella continues to be a strong predictor of VZV IgG antibodies in pregnant women. Negative or uncertain history remains poorly predictive of negative serostatus.
本研究旨在评估在美国两个地理位置不同（加利福尼亚州羚羊谷和费城）且水痘疫苗接种率高的诊所接受产前护理的孕妇中，自我报告的水痘病史相对于水痘免疫血清学证据的有效性。
参加产前检查且作为常规护理一部分需要抽血的孕妇有资格参与。通过问卷获取自我报告的水痘病史。使用全细胞酶联免疫吸附试验检测水痘带状疱疹病毒特异性免疫球蛋白G（VZV IgG）抗体来确定水痘血清状态。
在羚羊谷的309名研究参与者和费城的528名自我报告患过水痘的参与者中，分别有308名（99.7%；95%置信区间[CI]：98.2，100）和517名（97.9%；95%CI：96.3，99.0）有水痘免疫的血清学证据。在羚羊谷和费城，分别自我报告水痘病史为阴性或不确定的女性中，只有6.8%（95%CI：3.9，11.0）和17.4%（95%CI：13.1，22.5）的水痘抗体呈血清阴性。
尽管自1995年引入并随后广泛使用水痘疫苗以来，水痘的流行病学发生了巨大变化，但自我报告的水痘病史仍然是孕妇VZV IgG抗体的有力预测指标。阴性或不确定的病史对阴性血清状态的预测性仍然很差。
