The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
PLoS One. 2018 Jun 14;13(6):e0197867. doi: 10.1371/journal.pone.0197867. eCollection 2018.
Maternal immunization is an effective strategy to protect pregnant women and their infants from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. A midwife delivered immunization program for pregnant women at the Women's and Children's Hospital in South Australia commenced in April 2015. Monitoring the uptake of the current funded vaccine programs for pregnant women is limited. The study aimed to estimate maternal vaccine uptake and assess factors associated with influenza and pertussis vaccine uptake among pregnant women.
This prospective study was undertaken between November 2014 and July 2016 at the Women's and Children's Hospital. Following consent, demographic details and vaccination history for South Australian pregnant women who attended the antenatal clinic were collected. A standardised self-reported survey was completed during pregnancy with a follow up telephone interview at 8-10 weeks post-delivery.
205 women consented and completed the self-reported survey. Of the 180 pregnant women who completed the study, 76% and 81% received maternal influenza and pertussis vaccines respectively. The adjusted odds of women receiving maternal vaccines during pregnancy were significantly higher for women delivering after the implementation of the midwife delivered program compared with women who delivered babies prior to the program for both pertussis vaccination (AOR 21.17, 95% CI 6.14-72.95; p<0.001) and influenza vaccination (AOR 5.95, 95% CI 2.13-16.61, p<0.001). Women receiving a recommendation from a health care provider and first time mothers were significantly more likely to receive influenza vaccination during pregnancy.
High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care. A midwife delivered maternal immunization program is a promising approach to improve maternal vaccine uptake by pregnant women.
母体免疫是保护孕妇及其婴儿免受疫苗可预防疾病的有效策略。尽管澳大利亚建议对孕妇进行流感和最近百日咳疫苗接种,但这些疫苗的接种率仍不理想。南澳大利亚妇女儿童医院于 2015 年 4 月开始为孕妇提供助产士接种疫苗计划。对当前为孕妇提供的免疫接种计划的接种率进行监测受到限制。本研究旨在估计孕妇的疫苗接种率,并评估与孕妇流感和百日咳疫苗接种率相关的因素。
这项前瞻性研究于 2014 年 11 月至 2016 年 7 月在妇女儿童医院进行。征得同意后,收集了在产前诊所就诊的南澳大利亚孕妇的人口统计学详细信息和疫苗接种史。在怀孕期间完成了一份标准化的自我报告调查,并在分娩后 8-10 周进行了后续电话访谈。
有 205 名妇女同意并完成了自我报告调查。在完成研究的 180 名孕妇中,分别有 76%和 81%的孕妇接受了母亲流感和百日咳疫苗。与在该计划实施前分娩的孕妇相比,在该计划实施后分娩的孕妇接受母亲疫苗的调整后的几率明显更高,这在百日咳疫苗接种(AOR 21.17,95%CI 6.14-72.95;p<0.001)和流感疫苗接种(AOR 5.95,95%CI 2.13-16.61,p<0.001)中均如此。接受医疗保健提供者建议的妇女和初产妇在怀孕期间更有可能接种流感疫苗。
通过医疗保健提供者的建议以及将产妇免疫作为标准产前保健的一部分,可以实现孕妇对流感和百日咳疫苗的高接种率。由助产士提供的产妇免疫接种计划是提高孕妇疫苗接种率的一种很有前途的方法。