Blanchard-Rohner Geraldine, Meier Sara, Bel Michael, Combescure Christophe, Othenin-Girard Véronique, Swali Rhimou Azbar, Martinez de Tejada Begoña, Siegrist Claire-Anne
From the *Department of Pediatrics, Children's Hospital of Geneva; † Department of Pediatrics and Pathology-Immunology, Center for Vaccinology and Neonatal Immunology,; ‡Laboratory of Virology, Department of Genetics and Laboratory Medicine; §Clinical Research Center; and ¶Department of Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
Pediatr Infect Dis J. 2013 Dec;32(12):1374-80. doi: 10.1097/01.inf.0000437066.40840.c4.
Pregnant women and infants are at higher risk of complications secondary to influenza infection. Immunization during pregnancy facilitates protection of the neonates through passive transfer of maternal antibodies.
This was a cross-sectional study performed during the post-H1N1 pandemic winter season of 2010/2011 in Geneva, Switzerland. We measured antibody titers against the seasonal influenza A H1N1, H3N2 and B 2010/2011 strains by hemagglutination inhibition in the umbilical cord blood of newborns born to vaccinated and nonvaccinated mothers. Seroprotection was defined as a hemagglutination inhibition titer ≥ 40.
A total of 188 women were enrolled, 101 of whom had been vaccinated with a nonadjuvanted influenza vaccine (all during the second or third trimester) and the other 87 had not. Among newborns of vaccinated women, 84-86% showed seroprotective levels depending on the strain. In comparison, seroprotection rates were significantly lower in babies of nonvaccinated women (29-33%, P < 0.001). Adjusting for various confounding factors and applying multivariate regression analysis, vaccination during pregnancy ≥ 2 weeks before delivery increased geometric mean titers in umbilical cord blood 5-17 times and seroprotection rates 5.8-34.4 times, depending on the strain and the interval between vaccination and delivery. Vaccinating pregnant women only 2-4 weeks before delivery was still more effective than no vaccination at all (geometric mean titers increased 6.8-11.1 times and seroprotection rates increased 5.8-34.4 times compared with nonvaccinated women).
Influenza vaccination at any time during the second and third trimester of pregnancy, but at least 15 days before delivery, confers seroprotection to many neonates.
孕妇和婴儿因流感感染继发并发症的风险较高。孕期接种疫苗可通过母体抗体的被动转移促进对新生儿的保护。
这是一项于2010/2011年甲型H1N1流感大流行后的冬季在瑞士日内瓦进行的横断面研究。我们通过血凝抑制试验测定了接种和未接种疫苗的母亲所生新生儿脐带血中针对2010/2011季节性甲型H1N1、H3N2和乙型流感毒株的抗体滴度。血清保护定义为血凝抑制滴度≥40。
共纳入188名女性，其中101名接种了无佐剂流感疫苗（均在孕中期或晚期），另外87名未接种。在接种疫苗女性的新生儿中，84% - 86%根据毒株显示出血清保护水平。相比之下，未接种疫苗女性的婴儿血清保护率显著较低（29% - 33%，P < 0.001）。在调整各种混杂因素并应用多变量回归分析后，分娩前≥2周孕期接种疫苗可使脐带血中的几何平均滴度提高5 - 17倍，血清保护率提高5.8 - 34.4倍（取决于毒株以及接种疫苗与分娩之间的间隔）。在分娩前仅2 - 4周为孕妇接种疫苗仍然比完全不接种更有效（与未接种疫苗的女性相比，几何平均滴度提高6.8 - 11.1倍，血清保护率提高5.8 - 34.4倍）。
在孕期的第二和第三阶段的任何时间接种流感疫苗，但至少在分娩前15天接种，可为许多新生儿提供血清保护。
