Myers Helen I, Spracklen Cassandra N, Ryckman Kelli K, Murray Jeffrey C
University of Iowa Carver College of Medicine, Iowa City, IA, USA; University of Iowa College of Public Health, Iowa City, IA, USA.
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Vaccine. 2015 May 11;33(20):2316-21. doi: 10.1016/j.vaccine.2015.03.053. Epub 2015 Mar 31.
Infants are at high risk of developing chronic, life-threatening disease as a result of hepatitis B virus infection. Universal vaccination of infants against hepatitis B virus, before discharge from the hospital after delivery is recommended as a measure to eradicate infection and associated mortality and morbidity. The purpose of this study was to determine rates of perinatal hepatitis B vaccine (Hep B) administration at a tertiary care center in Iowa and to assess the impact of maternal factors on Hep B uptake.
Data concerning mother-infant pairs that received care at one institution from 1/2009 to 4/1/2013 were extracted from the system's electronic medical record. Characteristics of study participants were compared using chi-square tests. Multivariate logistic regression was used to assess the association between each factor and vaccination status, controlling for other characteristics.
Of 5663 mother-infant pairs, 5175 (91.4%) infants received Hep B within 7 days after delivery. The majority of those not vaccinated had a medical indication to delay vaccination. Single women were significantly more likely to have an infant not vaccinated, after adjustment for all other factors. Women of minority groups were significantly less likely to have an infant who lacked Hep B at hospital discharge than Caucasian women.
Significant improvements have occurred in Hep B rates in the state and region. Infants of single mothers may be at the greatest risk for lacking vaccination at hospital discharge.
由于感染乙肝病毒,婴儿患慢性、危及生命疾病的风险很高。建议在婴儿出生后出院前普遍接种乙肝疫苗,作为根除感染及相关死亡率和发病率的一项措施。本研究的目的是确定爱荷华州一家三级医疗中心围产期乙肝疫苗(Hep B)的接种率,并评估母亲因素对乙肝疫苗接种情况的影响。
从该系统的电子病历中提取2009年1月至2013年4月1日期间在一家机构接受护理的母婴对的数据。使用卡方检验比较研究参与者的特征。采用多因素逻辑回归分析评估每个因素与疫苗接种状况之间的关联,并对其他特征进行控制。
在5663对母婴中,5175名(91.4%)婴儿在出生后7天内接种了乙肝疫苗。大多数未接种疫苗的婴儿有医学指征延迟接种。在对所有其他因素进行调整后,单身女性的婴儿未接种疫苗的可能性显著更高。少数群体的女性在出院时婴儿未接种乙肝疫苗的可能性明显低于白人女性。
该州和该地区的乙肝疫苗接种率有了显著提高。单身母亲的婴儿在出院时未接种疫苗的风险可能最大。