Saitoh Aya, Saitoh Akihiko, Sato Isamu, Shinozaki Tomohiro, Kamiya Hajime, Nagata Satoko
Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Vaccine. 2017 Mar 14;35(12):1645-1651. doi: 10.1016/j.vaccine.2017.01.069. Epub 2017 Feb 17.
Perinatal immunization education is important for improving the immunization outcomes of infants; however, the content of educational materials used at each perinatal period has not been carefully evaluated. We hypothesized that stepwise education offered at different perinatal periods would improve infant immunization status and enhance maternal immunization knowledge.
In this cluster-randomized controlled trial, pregnant women were recruited from nine obstetric sites in Niigata, Japan. The intervention group received a stepwise, interactive education intervention (prenatally, postnatally, and 1month after birth). The control group received a leaflet containing general information on immunization. Infant immunization status was evaluated at 6months of age, and maternal immunization knowledge was evaluated by a written survey after each intervention.
Among 188 study participants, 151 (80.3%) replied to the final post-intervention survey. At 6months of age, the percentage of children who completed three doses of inactivated polio, diphtheria, tetanus toxoid, and acellular pertussis (DTaP-IPV) vaccine was higher in the intervention group than in the control (p=0.04); however, no differences between groups were observed for the Haemophilus influenzae type b (Hib) (p=0.67) or 13-valent pneumococcal conjugate (PCV13) vaccines (p=0.20). The duration to the completion of the third dose of the DTaP-IPV, Hib, and PCV13 vaccines was shorter in the intervention group than in the control (p=0.03, p<0.01, and p<0.01, respectively). Furthermore, maternal knowledge scores exhibited significantly greater improvement in the intervention group over time compared with those of the control group (p=0.02).
Stepwise perinatal immunization education improved immunization schedule adherence for required vaccines and improved maternal immunization knowledge.
围产期免疫教育对于提高婴儿免疫效果很重要；然而，每个围产期使用的教育材料内容尚未得到仔细评估。我们假设在不同围产期提供逐步教育将改善婴儿免疫状况并增强母亲的免疫知识。
在这项整群随机对照试验中，从日本新潟的9个产科地点招募孕妇。干预组接受逐步的互动教育干预（产前、产后和出生后1个月）。对照组收到一份包含免疫一般信息的传单。在婴儿6个月大时评估其免疫状况，并在每次干预后通过书面调查评估母亲的免疫知识。
在188名研究参与者中，151名（80.3%）回复了干预后的最终调查。在6个月大时，干预组完成三剂灭活脊髓灰质炎、白喉、破伤风类毒素和无细胞百日咳（DTaP-IPV）疫苗的儿童百分比高于对照组（p=0.04）；然而，两组之间在B型流感嗜血杆菌（Hib）疫苗（p=0.67）或13价肺炎球菌结合疫苗（PCV13）方面未观察到差异（p=0.20）。干预组完成DTaP-IPV、Hib和PCV13疫苗第三剂的时间比对照组短（分别为p=0.03、p<0.01和p<0.01）。此外，与对照组相比，干预组母亲的知识得分随时间有显著更大的提高（p=0.02）。
围产期逐步免疫教育改善了所需疫苗的免疫接种计划依从性并提高了母亲的免疫知识。
