Munoz Flor M
Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USA.
Pediatr Ann. 2013 Aug;42(8):153-8. doi: 10.3928/00904481-20130723-09.
The immunization of women during pregnancy can protect both the mother and her infant against serious infectious diseases. The prevention of infection through maternal immunization reduces the risk of exposure to the baby, results in higher concentrations of transplacentally transferred pathogen-specific maternal antibodies to the newborn, and provides protection to the infant during a period of vulnerability. The benefits of vaccinating pregnant women outweigh any theoretic risk when there is a risk of exposure to an infectious disease that threatens the mother or the newborn's health. Toxoids and inactivated virus or bacterial vaccines are safe and cause no harm to the mother or fetus. Live vaccines, viral or bacterial, are contraindicated during pregnancy as a precaution because of the theoretic risk of infection of the fetus. However, there has been no evidence to date of direct fetal injury after the administration of live viral vaccines to pregnant women. The administration of immune globulin preparations to pregnant women results in no known risks to the fetus. In the United States, vaccines recommended in pregnancy include the seasonal influenza vaccine, tetanus toxoid, and the pertussis vaccine as a combined tetanus-diphtheria toxoid and acellular pertussis vaccine (Tdap). Pregnant women who travel or who have unavoidable exposures to vaccine-preventable diseases should be immunized. Breast-feeding is not a contraindication to the vaccination of mothers with inactivated and most live vaccines. Women who are not immune to rubella should be immunized after delivery. Similarly, the influenza and Tdap vaccinations may be administered postpartum in women who were not vaccinated during pregnancy.
孕期女性接种疫苗可保护母亲及其婴儿免受严重传染病侵害。通过母体免疫预防感染可降低婴儿接触感染的风险，使经胎盘转移至新生儿的病原体特异性母体抗体浓度更高，并在婴儿易受感染期间为其提供保护。当存在接触威胁母亲或新生儿健康的传染病风险时，给孕妇接种疫苗的益处超过任何理论风险。类毒素以及灭活病毒或细菌疫苗是安全的，不会对母亲或胎儿造成伤害。出于预防目的，孕期禁忌接种活病毒或活细菌疫苗，因为存在胎儿感染的理论风险。然而，迄今为止尚无证据表明孕妇接种活病毒疫苗后会直接导致胎儿损伤。给孕妇注射免疫球蛋白制剂对胎儿无已知风险。在美国，孕期推荐接种的疫苗包括季节性流感疫苗、破伤风类毒素以及作为破伤风-白喉类毒素和无细胞百日咳疫苗（Tdap）联合制剂的百日咳疫苗。出行或不可避免接触可通过疫苗预防疾病的孕妇应接种疫苗。母乳喂养并非母亲接种灭活疫苗和大多数活疫苗的禁忌。未感染风疹的女性应在产后接种疫苗。同样，孕期未接种流感和Tdap疫苗的女性可在产后接种。
