Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Colorado Department of Public Health and Environment, Denver, Colorado, USA.
Clin Infect Dis. 2021 Dec 6;73(11):e3836-e3841. doi: 10.1093/cid/ciaa1112.
Little is known about pertussis among pregnant women, a population at increased risk for severe morbidity from respiratory infections such as influenza. We used the Centers for Disease Control and Prevention's Enhanced Pertussis Surveillance (EPS) system to describe pertussis epidemiology among pregnant and nonpregnant women of childbearing age.
Pertussis cases in women aged 18-44 years with cough onset between 1 January 2012 and 31 December 2017 were identified in 7 EPS states. Surveillance data were collected through patient and provider interviews and immunization registries. Bridged-race, intercensal population data and live birth estimates were used as denominators.
We identified 1582 pertussis cases among women aged 18-44 years; 5.1% (76/1499) of patients with a known pregnancy status were pregnant at cough onset. Of the pregnant patients with complete information, 81.7% (49/60) reported onset during the second or third trimester. The median ages of pregnant and nonpregnant patients were 29.0 and 33.0 years, respectively. Most pregnant and nonpregnant patients were White (78.3% vs. 86.4%, respectively; P = .09) and non-Hispanic (72.6% vs. 77.3%, respectively; P = .35). The average annual incidence of pertussis was 7.7/100000 among pregnancy women and 7/3/100000 among nonpregnant women. Compared to nonpregnant patients, more pregnant patients reported whoop (41.9% vs. 31.3%, respectively), posttussive vomiting (58.1% vs. 47.9%, respectively), and apnea (37.3% vs. 29.0%, respectively); however, these differences were not statistically significant (P values > .05 for all). A similar proportion of pregnant and nonpregnant patients reported ever having received Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; 31.6% vs. 32.7%, respectively; P = .84).
Our analysis suggests that incidence of pertussis and clinical characteristics of disease are similar among pregnant and nonpregnant women. Continued monitoring is important to further define pertussis epidemiology in pregnant women.
人们对孕妇百日咳的了解甚少，而孕妇由于呼吸道感染（如流感）而导致严重发病的风险增加。我们使用疾病控制与预防中心的增强型百日咳监测（EPS）系统来描述妊娠和非妊娠育龄妇女中的百日咳流行病学。
在 7 个 EPS 州，我们确定了在 2012 年 1 月 1 日至 2017 年 12 月 31 日期间咳嗽发病的 18-44 岁妇女中的百日咳病例。通过患者和提供者访谈以及免疫登记处收集监测数据。使用桥接种族、人口普查间人口数据和活产估计数作为分母。
我们确定了 1499 名已知妊娠状态的患者中有 5.1%（76/1499）的患者在咳嗽发病时处于妊娠状态。在完整信息的妊娠患者中，81.7%（49/60）报告在第二或第三孕期发病。妊娠和非妊娠患者的中位年龄分别为 29.0 岁和 33.0 岁。大多数妊娠和非妊娠患者为白人（分别为 78.3%和 86.4%；P=.09）和非西班牙裔（分别为 72.6%和 77.3%；P=.35）。妊娠妇女的百日咳年平均发病率为 7.7/100000，而非妊娠妇女的百日咳年平均发病率为 7/3/100000。与非妊娠患者相比，更多的妊娠患者报告有痉挛性咳嗽（分别为 41.9%和 31.3%）、咳嗽后呕吐（分别为 58.1%和 47.9%）和呼吸暂停（分别为 37.3%和 29.0%）；然而，这些差异无统计学意义（所有 P 值均>.05）。妊娠和非妊娠患者报告曾经接受过 Tdap（破伤风类毒素、白喉类毒素和无细胞百日咳疫苗）的比例相似（分别为 31.6%和 32.7%；P=.84）。
我们的分析表明，妊娠和非妊娠妇女中百日咳的发病率和疾病临床特征相似。继续监测对于进一步确定孕妇百日咳的流行病学非常重要。
