From the Centers for Disease Control and Prevention, Atlanta, Georgia; and the American College of Obstetricians and Gynecologists, Washington, DC.
Obstet Gynecol. 2011 Nov;118(5):1074-1080. doi: 10.1097/AOG.0b013e3182329681.
To assess knowledge, attitudes, and practices of obstetrician-gynecologists (ob-gyns) regarding vaccination of pregnant women during the 2009 H1N1 pandemic.
From February to July 2010, a self-administered mail survey was conducted among a random sample of American College of Obstetricians and Gynecologists (the College) members involved in obstetric care. To assess predictors of routinely offering influenza vaccination, adjusted prevalence ratios and 95% confidence intervals (CIs) were calculated from survey data.
Among 3,096 survey recipients, 1,310 (42.3%) responded to the survey, of whom 873 were eligible for participation. The majority of ob-gyns reported routinely offering both seasonal and 2009 H1N1 influenza vaccination to their pregnant patients (77.6% and 85.6%, respectively) during the 2009-2010 season; 21.1% and 13.3% referred patients to other specialists. Reported reasons for not offering vaccination included inadequate reimbursement, storage limitations, or belief that vaccine should be administered by another provider. Seasonal and 2009 H1N1 influenza vaccination during the first trimester was not recommended by 10.6% and 9.6% of ob-gyns, respectively. Predictors of routinely offering 2009 H1N1 influenza vaccine included: considering primary care and preventive medicine a very important part of practice (adjusted prevalence ratio 1.2, CI 1.01-1.4); observing serious conditions attributed to influenza-like illness (adjusted prevalence ratio 1.1, CI 1.02-1.1); personally receiving 2009 H1N1 influenza vaccination (adjusted prevalence ratio 1.2, CI 1.1-1.4); and practicing in multispecialty group (adjusted prevalence ratio 1.1, CI 1.1-1.2). Physicians in solo practice were less likely to routinely offer influenza vaccine (adjusted prevalence ratio 0.8, CI 0.7-0.9).
Although most ob-gyns routinely offered influenza vaccination to pregnant patients, vaccination coverage rates may be improved by addressing logistic and financial challenges of vaccine providers.
评估妇产科医生（ob-gyns）在 2009 年 H1N1 大流行期间对孕妇接种疫苗的知识、态度和实践情况。
2010 年 2 月至 7 月，对参与产科护理的美国妇产科学院（the College）成员进行了随机样本的自我管理邮件调查。为了评估常规提供流感疫苗接种的预测因素，从调查数据中计算了调整后的流行率比和 95%置信区间（CI）。
在 3096 名调查对象中，有 1310 名（42.3%）对调查做出了回应，其中 873 名符合参与条件。大多数 ob-gyns 报告在 2009-2010 季节中，常规向孕妇提供季节性和 2009 年 H1N1 流感疫苗（分别为 77.6%和 85.6%）；21.1%和 13.3%的人将患者转介给其他专家。不提供疫苗接种的原因包括报销不足、储存限制或认为疫苗应由其他提供者接种。10.6%和 9.6%的 ob-gyns 分别不建议在妊娠早期接种季节性和 2009 年 H1N1 流感疫苗。常规提供 2009 年 H1N1 流感疫苗的预测因素包括：认为初级保健和预防医学是实践的重要组成部分（调整后的流行率比 1.2，CI 1.01-1.4）；观察到与流感样疾病有关的严重情况（调整后的流行率比 1.1，CI 1.02-1.1）；本人接种了 2009 年 H1N1 流感疫苗（调整后的流行率比 1.2，CI 1.1-1.4）；并在多专科小组中执业（调整后的流行率比 1.1，CI 1.1-1.2）。个体执业的医生不太可能常规提供流感疫苗（调整后的流行率比 0.8，CI 0.7-0.9）。
尽管大多数 ob-gyns 常规为孕妇提供流感疫苗接种，但通过解决疫苗提供者的后勤和财务挑战，可以提高疫苗接种率。
