产后接种疫苗活动对日本女性风疹血清阴性率的影响。

Effects of campaign for postpartum vaccination on seronegative rate against rubella among Japanese women.

作者信息

Yamada Takahiro, Mochizuki Junko, Hanaoka Masachi, Hashimoto Eriko, Ohkuchi Akihide, Ito Mika, Kubo Takahiko, Nakai Akihito, Saito Shigeru, Unno Nobuya, Matsubara Shigeki, Minakami Hisanori

机构信息

Department of Obstetrics, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo 060-8638, Japan.

出版信息

BMC Infect Dis. 2014 Mar 21;14:152. doi: 10.1186/1471-2334-14-152.

DOI:10.1186/1471-2334-14-152

PMID:24650141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3994452/

Abstract

BACKGROUND

Japan experienced two rubella outbreaks in the past decade (2004 and 2012-2013), resulting in 10 and 20 infants with congenital rubella syndrome (CRS), respectively. This study was performed to determine whether the seronegative rate was lower in multiparous women than in primiparous women in Japan.

METHODS

Hemagglutination inhibition (HI) test results during pregnancy were analyzed retrospectively in 11048 primiparous and 9315 multiparous women who gave birth at six hospitals in northern Japan in the 5-year study period (January 2008 through December 2012). Women with HI titer < 1:8 were defined as susceptible to rubella.

RESULTS

The seronegative rate was significantly lower in multiparous than primiparous women aged 30 - 31 years (2.3% [22/967] vs. 4.5% [66/1454], P = 0.0036), 36 - 37 years (3.4% [55/1601] vs. 5.7% [79/1389], P = 0.0030), and overall women (3.8% [350/9315] aged 34.7 ± 5.2 vs. 5.4% [597/11048] for 33.2 ± 5.9, P < 0.001). The susceptible fraction size did not differ largely according to hospital, ranging from 3.5% to 6.3%. Those for each year did not change markedly; 4.5% [150/3369], 5.2% [221/4268], 4.4% [195/4412], 4.6% [186/4056], and 4.6% [195/4258] for 2008, 2009, 2010, 2011, and 2012, respectively. Those for teenagers were consistently high: 22.7% [5/22], 20.7% [6/29], 20.6% [7/34], 13.0% [3/23], and 23.5% [4/17] for 2008, 2009, 2010, 2011, and 2012, respectively.

CONCLUSIONS

The seronegative rate was significantly lower in multiparous than primiparous women. However, Japanese rubella vaccination programs were insufficient to eliminate CRS.

摘要

背景

日本在过去十年（2004年以及2012 - 2013年）经历了两次风疹疫情，分别导致10例和20例先天性风疹综合征（CRS）患儿。本研究旨在确定在日本经产妇的血清阴性率是否低于初产妇。

方法

回顾性分析了在5年研究期间（2008年1月至2012年12月）于日本北部6家医院分娩的11048例初产妇和9315例经产妇孕期的血凝抑制（HI）试验结果。HI效价<1:8的女性被定义为对风疹易感。

结果

30 - 31岁经产妇的血清阴性率显著低于初产妇（2.3% [22/967] 对比 4.5% [66/1454]，P = 0.0036），36 - 37岁时也是如此（3.4% [55/1601] 对比 5.7% [79/1389]，P = 0.0030），总体女性中也是经产妇更低（经产妇为3.8% [350/9315]，年龄34.7 ± 5.2岁；初产妇为5.4% [597/11048]，年龄33.2 ± 5.9岁，P < 0.001）。不同医院的易感比例差异不大，范围在3.5%至6.3%之间。每年的易感比例变化不明显；2008年、2009年、2010年、2011年和2012年分别为4.5% [150/3369]、5.2% [221/4268]、4.4% [195/4412]、4.6% [186/4056] 和 4.6% [195/4258]。青少年的易感比例一直较高：2008年、2009年、2010年、2011年和2012年分别为22.7% [5/22]、20.7% [6/29]、20.6% [7/34]、13.0% [3/23] 和 23.5% [4/17]。