Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.
Clin Infect Dis. 2010 Dec 15;51(12):1355-61. doi: 10.1086/657309. Epub 2010 Nov 8.
Infants aged <12 months are at high risk of hospitalization for influenza. Influenza vaccine is recommended for pregnant women and for most children; however, no vaccine is approved for infants aged <6 months. Effective approaches are needed to protect this vulnerable population. Vaccination of women during pregnancy may protect the infant through transfer of antibodies from the mother. Few studies have examined the effectiveness of this strategy, and those studies produced mixed results.
In a matched case-control study, case patients were infants aged <12 months admitted to a large urban hospital in the northeastern United States because of laboratory-confirmed influenza from 2000 to 2009. For each case, we enrolled 1 or 2 control subjects who were infants who tested negative for influenza and matched cases by date of birth and date of hospitalization (within 4 weeks). Vaccine effectiveness was calculated on the basis of matched odds ratios and was adjusted for confounding.
The mothers of 2 (2.2%) of 91 case subjects and 31 (19.9%) of 156 control subjects aged <6 months, and 1 (4.6%) of 22 case subjects and 2 (5.6%) of 36 control subjects aged ≥6 months, had received influenza vaccine during pregnancy. The effectiveness of influenza vaccine given to mothers during pregnancy in preventing hospitalization among their infants, adjusted for potential confounders, was 91.5% (95% confidence interval [CI], 61.7%-98.1%; P = .001) for infants aged <6 months. The unadjusted effectiveness was 90.7% (95% CI, 59.9%-97.8%; P = .001).
Influenza vaccine given to pregnant women is 91.5% effective in preventing hospitalization of their infants for influenza in the first 6 months of life.
<12 个月龄的婴儿因流感住院的风险较高。流感疫苗推荐给孕妇和大多数儿童使用;然而,<6 个月龄的婴儿尚未有批准使用的疫苗。需要采取有效的方法来保护这一脆弱人群。孕妇接种疫苗可能会通过母体抗体的转移来保护婴儿。虽然已有少数研究探讨了这一策略的效果,但研究结果存在差异。
在一项病例对照匹配研究中,病例组为 2000 年至 2009 年间因实验室确诊的流感而入住美国东北部一家大型城市医院的<12 个月龄婴儿。对于每个病例,我们招募了 1 名或 2 名对照婴儿,这些婴儿流感检测为阴性,且通过出生日期和住院日期(4 周内)与病例相匹配。疫苗效果根据匹配优势比计算,并进行了混杂因素调整。
91 例<6 个月龄病例组的 2 名(2.2%)和 156 例对照婴儿的 31 名(19.9%)母亲、22 例<6 个月龄病例组的 1 名(4.6%)和 36 例对照婴儿的 2 名(5.6%)母亲在怀孕期间接种过流感疫苗。调整潜在混杂因素后,母亲在怀孕期间接种流感疫苗对预防其<6 个月龄婴儿住院的效果为 91.5%(95%置信区间,61.7%-98.1%;P=0.001)。未调整的效果为 90.7%(95%置信区间,59.9%-97.8%;P=0.001)。
孕妇接种流感疫苗可有效预防其<6 个月龄婴儿在生命的最初 6 个月因流感住院。