Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory for Health Technology Assessment, National Commission of Health and Family planning, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory for Health Technology Assessment, National Commission of Health and Family planning, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China..
Am J Prev Med. 2020 Aug;59(2):278-287. doi: 10.1016/j.amepre.2020.03.009. Epub 2020 Jun 18.
The study aims to quantitatively assess the immune response to hepatitis B vaccine in infants born preterm or with low birth weight.
In December 2018, a literature search was conducted in 4 databases without date restrictions. The pooled ORs, mean differences, and their corresponding 95% CIs were calculated with random-effects models using the DerSimonian-Laird estimator. The potential risk of bias of each study was assessed using the Newcastle-Ottawa Scale. The stability and publication bias of the pooled estimates were also evaluated. Analyses were completed in 2019.
A total of 27 studies including 22,202 infants were eligible for analysis. The studies found that infants born preterm had significantly poorer immune responses to the hepatitis B vaccine. Preterm infants were 1.36 times more likely to exhibit nonresponse to the hepatitis B vaccine (95% CI=1.12, 1.65, p=0.002) compared with their full-term counterparts. The pooled estimates for preterm birth may be subject to a potential publication bias. However, these results were stable, as suggested by the leave-one-out analysis and fail-safe number. The association between low birth weight and impaired immune response to the hepatitis B vaccine was not statistically significant when birth weight was dichotomized at 2,500 g.
These findings suggest an association between preterm birth and lowered immune responses to hepatitis B vaccine.
本研究旨在定量评估早产儿或低出生体重儿对乙型肝炎疫苗的免疫反应。
2018 年 12 月，在没有时间限制的情况下，对 4 个数据库进行了文献检索。使用随机效应模型和 DerSimonian-Laird 估计值，计算汇总的优势比（OR）、均数差值及其相应的 95%置信区间（CI）。使用 Newcastle-Ottawa 量表评估每项研究的潜在偏倚风险。还评估了汇总估计值的稳定性和发表偏倚。分析于 2019 年完成。
共有 27 项研究，包括 22202 名婴儿符合纳入标准。研究发现，早产儿对乙型肝炎疫苗的免疫反应明显较差。与足月婴儿相比，早产儿对乙型肝炎疫苗无应答的可能性高出 1.36 倍（95%CI=1.12，1.65，p=0.002）。早产的汇总估计值可能存在潜在的发表偏倚。然而，正如缺失值分析和失效安全数所表明的那样，这些结果是稳定的。当出生体重以 2500g 为界分为两分时，低出生体重与乙型肝炎疫苗免疫反应受损之间的关联没有统计学意义。
这些发现表明，早产儿与乙型肝炎疫苗免疫反应降低之间存在关联。
