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孕期接种 MenACWY-CRM 疫苗的安全性。

Safety of MenACWY-CRM vaccine exposure during pregnancy.

机构信息

Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, 2(nd) Floor, Pasadena, CA 91101, USA.

Pediatrics and Pediatric Infectious Diseases, Southern California Permanente Medical Group, 25965 S Normandie Ave, Harbor City, CA 90710, USA.

出版信息

Vaccine. 2020 Mar 10;38(12):2683-2690. doi: 10.1016/j.vaccine.2020.02.008. Epub 2020 Feb 10.

Abstract

BACKGROUND

Although the meningococcal conjugate MenACWY-CRM vaccine is not approved for use in pregnant women, unintentional exposure during pregnancy can occur, especially during early pregnancy among women of child-bearing age. This study provides safety information about inadvertent MenACWY-CRM vaccination during pregnancy.

METHODS

The evaluated population consisted of pregnant female members of Kaiser Permanente Southern California who inadvertently received MenACWY-CRM at 11-21 years of age during 09/30/2011-06/30/2013 within 28 days prior to conception or during pregnancy. Chart abstraction was conducted to identify pregnancy and birth outcomes, including spontaneous and induced abortions, preterm births, low weight births, and major congenital malformations (MCMs).

RESULTS

There were 92 women who received MenACWY-CRM during the pregnancy exposure period, mainly during the first trimester (76.1%). Hispanics represented the largest race/ethnicity category (68.5%). Among the known pregnancy outcomes (n = 66; excluding induced abortions and unknown pregnancy outcomes), the prevalence of spontaneous abortions was 18.2% (n = 12). Among live born infants (n = 55; from 54 pregnancies), 14.5% (n = 8) were born preterm (<37 weeks gestation) and 9.1% (n = 5) had a low birthweight (<2500 g). The prevalence rate of MCMs among live born infants (n = 55) was 1.8% (n = 1).

CONCLUSIONS

This study provides baseline prevalence estimates of spontaneous abortions, preterm births, low weight births, and MCMs among women inadvertently exposed to MenACWY-CRM during the pregnancy period. These estimates appear to be comparable with U.S. background prevalence estimates.

摘要

背景

虽然脑膜炎球菌结合疫苗 MenACWY-CRM 未获准用于孕妇,但在妊娠期间仍可能意外接触到该疫苗,尤其是在育龄期妇女的早期妊娠期间。本研究提供了有关妊娠期间意外接种 MenACWY-CRM 的安全性信息。

方法

评估人群包括 Kaiser Permanente Southern California 的妊娠女性成员,她们在 2011 年 9 月 30 日至 2013 年 6 月 30 日期间的 11-21 岁时意外接种了 MenACWY-CRM,接种时间距离受孕或妊娠 28 天内。通过病历摘录来确定妊娠和分娩结局,包括自然流产和人工流产、早产、低体重儿和重大先天畸形(MCM)。

结果

在妊娠暴露期间有 92 名女性接种了 MenACWY-CRM,主要发生在妊娠早期(76.1%)。西班牙裔是最大的种族/民族类别(68.5%)。在已知的妊娠结局中(n=66;不包括人工流产和未知妊娠结局),自然流产的发生率为 18.2%(n=12)。在活产婴儿中(n=55;来自 54 次妊娠),14.5%(n=8)早产(<37 周妊娠),9.1%(n=5)低体重(<2500 克)。活产婴儿中 MCM 的发生率为 1.8%(n=1)。

结论

本研究提供了妊娠期间意外接触 MenACWY-CRM 的女性中自然流产、早产、低体重儿和 MCM 的基线流行率估计值。这些估计值似乎与美国的背景流行率估计值相当。

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