Cleary Brian J, Rice Úna, Eogan Maeve, Metwally Nehad, McAuliffe Fionnuala
Pharmacy Department, Rotunda Hospital, Dublin 1, Ireland; School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Pharmacy Department, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Eur J Obstet Gynecol Reprod Biol. 2014 Jul;178:163-8. doi: 10.1016/j.ejogrb.2014.04.015. Epub 2014 Apr 18.
To describe the uptake of 2009 A/H1N1 influenza vaccination among pregnant women and determine if vaccination was associated with adverse pregnancy outcomes.
A historical cohort study was performed using booking, delivery suite and neonatal unit discharge records from the Coombe Women and Infants University Hospital, Dublin, Ireland. Singleton deliveries to women pregnant before (December 2008-September 2009) and during the pandemic (December 2009-September 2010) were included. Information on vaccination status and type of vaccine was collected on admission to the delivery suite. Logistic regression analyses were used to determine maternal characteristics associated with vaccination. Pregnancy outcomes were compared for vaccinated and unvaccinated women, with adjustment for differing maternal characteristics. Outcomes included vaccination status, preterm birth, size for gestational age, neonatal intensive care admission, congenital anomalies and perinatal death.
Of 6894 women pregnant during the pandemic, 2996 [43.5%] reported vaccination at delivery. In the early weeks of the vaccination programme rates of over 70% were achieved. Of those vaccinated, 246 [8.2%], 1709 [57.0%] and 1034 [34.5%] were vaccinated in the first, second and third trimesters respectively. Vaccination was less likely in younger age groups, those who were not in the professional/manager/employer socioeconomic group, women from Eastern Europe, Africa and Asia/Middle East, those who reported an unplanned pregnancy, women who booked late for antenatal care and recipients of publicly-funded obstetric care. Irish nationality was associated with reporting vaccination. There was no association between vaccination during pregnancy and adverse pregnancy outcomes. Women who were vaccinated were less likely to have a preterm delivery than unvaccinated women.
2009 A/H1N1 influenza vaccination uptake was influenced by maternal sociodemographic factors. High vaccination uptake can be achieved in a pandemic situation. Future public health campaigns should provide clear information on vaccination safety in pregnancy, ensure consistent vaccination recommendations from healthcare professionals and provide easy access to vaccination in order to optimise uptake rates in subgroups of the population who less likely to be vaccinated. There was no association between vaccination and adverse pregnancy outcomes.
描述孕妇接种2009年甲型H1N1流感疫苗的情况，并确定接种疫苗是否与不良妊娠结局相关。
采用爱尔兰都柏林库姆妇女与婴儿大学医院的预约、分娩室和新生儿病房出院记录进行一项历史性队列研究。纳入在大流行前（2008年12月至2009年9月）及大流行期间（2009年12月至2010年9月）怀孕的单胎分娩妇女。在产妇入院分娩室时收集其疫苗接种状况和疫苗类型信息。采用逻辑回归分析确定与疫苗接种相关的产妇特征。对已接种和未接种疫苗的妇女的妊娠结局进行比较，并对不同的产妇特征进行调整。结局包括疫苗接种状况、早产、孕周大小、新生儿重症监护病房入院、先天性异常和围产期死亡。
在大流行期间怀孕的6894名妇女中，2996名（43.5%）在分娩时报告接种了疫苗。在疫苗接种计划的早期几周，接种率达到了70%以上。在接种疫苗的妇女中，分别有246名（8.2%）、1709名（57.0%）和1034名（34.5%）在孕早期、孕中期和孕晚期接种。年龄较小的人群、非专业/管理人员/雇主社会经济群体的人群、来自东欧、非洲和亚洲/中东地区妇女、报告意外怀孕的妇女、产前护理预约较晚的妇女以及接受公共资助产科护理的妇女接种疫苗的可能性较小。爱尔兰国籍与报告接种疫苗相关。孕期接种疫苗与不良妊娠结局之间无关联。接种疫苗的妇女比未接种疫苗的妇女早产的可能性更小。
2009年甲型H1N1流感疫苗的接种情况受产妇社会人口学因素影响。在大流行情况下可实现高接种率。未来的公共卫生运动应提供关于孕期疫苗接种安全性的明确信息，确保医护人员给出一致的疫苗接种建议，并提供便捷的疫苗接种途径，以优化那些接种可能性较小的人群亚组的接种率。疫苗接种与不良妊娠结局之间无关联。
