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孕妇接种 Tdpa 疫苗后百日咳婴儿的临床影响:免疫成功吗?

Clinical repercussions in pertussis infants post-Tdpa vaccination of pregnant woman: An immunization success?

机构信息

Universidade de Pernambuco, Brazil.

Universitary Hospital Oswaldo Cruz, Universidade de Pernambuco, Brazil.

出版信息

Vaccine. 2021 Apr 28;39(18):2555-2560. doi: 10.1016/j.vaccine.2021.03.069. Epub 2021 Apr 2.

Abstract

INTRODUCTION

In 2014, there was an epidemic of pertussis in Brazil that caused the death of 129 infants. To control the disease amongst infants under 6 months of age, and especially those under 2 months, the Brazilian Ministry of Health introduced Tdap immunization for all pregnant women.

METHODS

This study aimed to describe the morbidity and mortality variables of pertussis cases in 969 infants aged under 6 months, comparing the periods before and after the introduction of Tdap vaccine in pregnant women. Data was extracted from the Information System on Notifiable Diseases (SINAN) including every case of pertussis that occurred in the metropolitan region of Recife-Brazil in infants under 6 months from January 2009 to October 2018. In order to analyze the variables, patients were divided into two groups Pre-Tdap(2009-2014), and Post-Tdap (2016-2018).

RESULTS

There were no significant differences between the age groups and gender distribution in the period compared. In the Post- Tdap group compared with the Pre-Tdap group, the clinical presentation of pertussis in infants differed with more paroxysmal cough, and more vomiting, less apnea, and cyanosis. During this period, there were fewer complications and no deaths occurred.

CONCLUSIONS

Maternal immunization with Tdap decreased disease severity, complication rates, and no deaths occurred in infants under 6 months of age diagnosed with pertussis.

摘要

简介

2014 年,巴西发生百日咳疫情,导致 129 名婴儿死亡。为了控制 6 个月以下婴儿(尤其是 2 个月以下婴儿)的疾病,巴西卫生部为所有孕妇接种 Tdap 疫苗。

方法

本研究旨在描述 969 例 6 个月以下患百日咳婴儿的发病率和死亡率变量,比较 Tdap 疫苗引入孕妇前后的情况。数据取自法定传染病信息系统(SINAN),包括 2009 年 1 月至 2018 年 10 月期间巴西累西腓大都市区 6 个月以下婴儿每例百日咳病例。为了分析变量,将患者分为 Tdap 前组(2009-2014 年)和 Tdap 后组(2016-2018 年)。

结果

在比较期间,两组的年龄组和性别分布没有显著差异。与 Tdap 前组相比,TdaP 后组婴儿百日咳的临床表现为更频繁的阵发性咳嗽、更多的呕吐、更少的呼吸暂停和发绀。在此期间,并发症较少,无死亡病例发生。

结论

Tdap 疫苗对母亲的免疫接种降低了 6 个月以下确诊百日咳婴儿的疾病严重程度、并发症发生率,且无死亡病例发生。

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