早期卡介苗疫苗接种于低体重婴儿及其对生命第一年生长发育的影响：一项随机对照试验。

Early BCG vaccine to low-birth-weight infants and the effects on growth in the first year of life: a randomised controlled trial.

作者信息

Biering-Sørensen Sofie, Andersen Andreas, Ravn Henrik, Monterio Ivan, Aaby Peter, Benn Christine Stabell

机构信息

Research Center for Vitamins & Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, DK-2300, Copenhagen S, Denmark.

Projécto de Saúde Bandim, INDEPTH Network, Codex 1004, Bissau, Guinea-Bissau.

出版信息

BMC Pediatr. 2015 Sep 28;15:137. doi: 10.1186/s12887-015-0452-2.

DOI:10.1186/s12887-015-0452-2

PMID:26416147

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4587923/

Abstract

BACKGROUND

Randomised trials have shown that early Bacille Calmette-Guérin (BCG) vaccine reduces overall neonatal and infant mortality. However, no study has examined how BCG affects growth. We investigated the effect on infant growth of early BCG vaccine given to low-birth-weight (LBW) infants.

METHODS

Two-thousand three hundred forty-three LBW infants were randomly allocated 1:1 to "early BCG" (intervention group) or "late BCG" (current practice). Furthermore, a subgroup (N = 1717) were included in a two-by-two randomised trial in which they were additionally randomised 1:1 to vitamin A supplementation (VAS) or placebo. Anthropometric measurements were obtained 2, 6, and 12 months after enrolment.

RESULTS

Overall there was no effect of early BCG on growth in the first year of life. The effect of early BCG on weight and mid-upper-arm circumference at 2 months tended to be beneficial among girls but not among boys (interaction between "early BCG" and sex: weight p = 0.03 and MUAC p = 0.04). This beneficial effect among girls was particularly seen among the largest infants weighing 2.0 kg or more at inclusion.

CONCLUSION

Though BCG vaccination is not recommended to be given to LBW infants at birth in Guinea-Bissau, early BCG had no negative effect on infant growth and may have had a beneficial effect for girls.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (NCT00146302).

摘要

背景

随机试验表明，早期接种卡介苗（BCG）可降低新生儿和婴儿的总体死亡率。然而，尚无研究探讨卡介苗如何影响生长发育。我们调查了给低体重（LBW）婴儿接种早期卡介苗对其生长发育的影响。

方法

2343名低体重婴儿被随机分为1:1的“早期卡介苗组”（干预组）或“晚期卡介苗组”（现行做法）。此外，一个亚组（N = 1717）被纳入一项2×2随机试验，在该试验中，他们又被1:1随机分为维生素A补充剂（VAS）组或安慰剂组。在入组后2、6和12个月进行人体测量。

结果

总体而言，早期卡介苗对生命第一年的生长发育没有影响。早期卡介苗对2个月时体重和上臂中部周长的影响在女孩中倾向于有益，但在男孩中并非如此（“早期卡介苗”与性别之间的相互作用：体重p = 0.（此处原文有误，应为0.03），上臂中部周长p = 0.04）。这种对女孩的有益影响在入组时体重2.0 kg或以上的最大婴儿中尤为明显。