Kent Alison, Ladhani Shamez N, Andrews Nick J, Matheson Mary, England Anna, Miller Elizabeth, Heath Paul T
Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's, University of London, London, United Kingdom;
Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's, University of London, London, United Kingdom; Immunisation, Hepatitis, and Blood Safety Department, Public Health England, Colindale, London, United Kingdom;
Pediatrics. 2016 Jul;138(1). doi: 10.1542/peds.2015-3854. Epub 2016 Jun 2.
Maternal antenatal pertussis-containing vaccination is recommended for the prevention of neonatal pertussis, but the ability of maternal vaccination to protect premature infants is unknown. We hypothesized that that infants born prematurely to antenatally vaccinated women would have higher pertussis antibody concentrations than those born to unvaccinated women.
Mothers had been offered a combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine from 28 weeks' gestation as part of their routine antenatal care. Premature infants of vaccinated and unvaccinated mothers enrolled in a randomized controlled trial of pneumococcal conjugate vaccine schedules had antibody concentrations (pertussis toxin, filamentous hemoagglutinin [FHA], and fimbriae 2 and 3) measured at 2 months (before primary vaccination), 5 months (1 month after primary vaccination), and 12 months of age.
Mothers of 31 (19%) of 160 premature infants had received combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine in pregnancy. Compared with infants of unvaccinated mothers, those born to vaccinated mothers had significantly higher antibody concentrations at 2 months for all measured vaccine antigens (P < .001). The number of days between maternal vaccination and delivery and immunoglobulin G concentration at 2 months of age was positively correlated for pertussis toxin (P = .011) and FHA (P = .001). After primary immunization, infants of vaccinated mothers had significantly lower antibody concentrations for FHA (P = .003) compared with infants of unvaccinated mothers; these differences had resolved by 12 months of age.
Maternal vaccination administered early in the third trimester may provide protection for infants born prematurely.
推荐孕妇进行含百日咳成分的产前疫苗接种以预防新生儿百日咳，但孕妇接种疫苗对早产儿的保护能力尚不清楚。我们推测，产前接种疫苗的孕妇所生的早产儿，其百日咳抗体浓度会高于未接种疫苗的孕妇所生的婴儿。
作为常规产前护理的一部分，从妊娠28周起为母亲们提供破伤风、白喉、5组分无细胞百日咳、灭活脊髓灰质炎联合疫苗。参与肺炎球菌结合疫苗接种程序随机对照试验的接种和未接种疫苗母亲的早产儿，在2个月（初次接种前）、5个月（初次接种后1个月）和12个月龄时测量抗体浓度（百日咳毒素、丝状血凝素[FHA]以及菌毛2和菌毛3）。
160名早产儿中，31名（19%）的母亲在孕期接受了破伤风、白喉、5组分无细胞百日咳、灭活脊髓灰质炎联合疫苗。与未接种疫苗母亲的婴儿相比，接种疫苗母亲所生婴儿在2个月时，所有测量的疫苗抗原的抗体浓度均显著更高（P < .001）。母亲接种疫苗与分娩之间的天数与2个月龄时的免疫球蛋白G浓度，对于百日咳毒素（P = .011）和FHA（P = .001）呈正相关。初次免疫后，与未接种疫苗母亲的婴儿相比，接种疫苗母亲的婴儿FHA抗体浓度显著更低（P = .003）；这些差异在12个月龄时已消失。
在妊娠晚期早期进行的孕妇疫苗接种可能为早产儿提供保护。
