Universidade de Pernambuco, Pós-Graduação em Ciências da Saúde, Recife, PE, Brazil.
Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil.
J Pediatr (Rio J). 2021 Sep-Oct;97(5):500-507. doi: 10.1016/j.jped.2020.10.018. Epub 2021 Jan 16.
To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness.
This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date.
Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; -34% a 60%).
Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.
评估纯母乳喂养和母亲接种疫苗在减少类百日咳疾病方面的保护作用。
这是一项在 2016 年 7 月至 2018 年 7 月期间在累西腓百日咳监测医院进行的病例对照研究。病例包括 6 个月以下有百日咳症状（类百日咳疾病）的儿童。对照组包括 6 个月以下的儿童，居住在累西腓大都市区，没有类百日咳疾病的诊断，与相同的医院和出生日期相匹配。
共纳入 73 例病例和 194 例对照组。类百日咳疾病的诊断主要是临床诊断（97.2%）。主要症状中，阵发性咳嗽在 95.89%的病例中观察到，呕吐在 53.4%的病例中观察到。有 29 例住院病例，无死亡病例。在 73 例病例中，有 47 例的母亲在怀孕期间接种了百日咳疫苗，而 194 例对照组中有 144 例母亲接种了疫苗。母乳喂养的保护作用为 74%（95%CI；38%，89%）。6 个月以下纯母乳喂养且母亲在怀孕期间接种了百日咳疫苗的儿童患类百日咳疾病的风险降低 5 倍，保护率为 79%（95%CI；31%，94%）。6 个月以下儿童母亲接种百日咳疫苗对类百日咳疾病的有效性较低（27%），且无统计学意义（95%CI；-34%至 60%）。
纯母乳喂养可保护 6 个月以下儿童免受类百日咳疾病的侵害，并且当与母亲接种疫苗结合使用时，可能会增强保护作用。应鼓励这些策略，因为它们还可以预防类百日咳疾病。
