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土耳其孕期接受破伤风-白喉类毒素和无细胞百日咳疫苗联合接种的婴儿及其母亲的百日咳抗体水平。

Pertussis antibody levels in infants and their mothers receiving combined tetanus-diphtheria toxoid and acellular pertussis vaccine during pregnancy in Turkey.

作者信息

Ozdil Mine, Sonmez Cemile, Tugberk Bakar Murat, Alici Davutoglu Ebru, Madazli Riza, Kilic Selcuk, Vural Mehmet, Perk Yildiz

机构信息

Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey.

General Directorate of Public Health, Department of Microbiology Reference Laboratories and Biological Products, Vaccine Preventable Bacterial Diseases Serology Laboratory, Ankara, Turkey.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Oct;265:212-216. doi: 10.1016/j.ejogrb.2021.08.033. Epub 2021 Sep 2.

Abstract

OBJECTIVE

Pertussis is an important cause of morbidity and mortality in infants under two months of age and these high risk babies are dependent on maternally derived antibodies until completion of their first immunization series. This study aimed to evaluate the vaccine response of late preterm and term newborns as well as their mothers who underwent combined tetanus-diphtheria toxoid and acellular pertussis (Tdap) vaccination during pregnancy.

STUDY DESIGN

A total of 70 pregnant women were administered Tdap vaccine (Boostrix®, GSK) between 27 and 33 gestational weeks of pregnancy. The IgG antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) in maternal blood before vaccination and in both maternal and umbilical cord blood after vaccination were evaluated using the in-house ELISA method. The geometric mean concentrations (GMC) and placental transfer ratios of antibodies were measured.

RESULTS

Participants' with a mean age of 29.59 ± 4.70 years received Tdap vaccine at an average 28.6 ± 1.31 gestational weeks. Average pre and post vaccination levels of anti-PT IgG GMCs and anti-FHA IgG GMCs were 8.01 IU/ml vs 39.48 IU/ml (p = 0.001) and 122.24 IU/ml vs 183.97 IU/ml (p < 0.001), respectively. The anti-PT and anti-FHA IgG GMCs of cord blood after vaccination was 25.15 IU/ml and 118.77 IU/ml, respectively (p < 0.001 and p = 0.064). Placental transfer ratios of anti-PT ve anti-FHA IgG antibodies were detected as 0.65 and 0.62, respectively.

CONCLUSION

Immunization of pregnant women with Tdap at the third trimester results in high maternal and infant antibody levels. Maternal immunization during each pregnancy seems to be the best strategy in revealing the highest maternal and infant antibodies and in narrowing the gap between birth and immune system maturation in infants. Pregnant women in our country should also get the Tdap vaccine during pregnancy especially in the early third trimester.

摘要

目的

百日咳是2个月以下婴儿发病和死亡的重要原因,这些高危婴儿在完成首次免疫接种系列之前依赖母体来源的抗体。本研究旨在评估晚期早产儿和足月儿以及在孕期接受破伤风-白喉类毒素和无细胞百日咳(Tdap)联合疫苗接种的母亲的疫苗反应。

研究设计

共有70名孕妇在妊娠27至33周期间接种了Tdap疫苗(博德rix,葛兰素史克公司)。采用内部酶联免疫吸附测定法评估接种前母体血液以及接种后母体和脐带血中抗百日咳毒素(PT)和丝状血凝素(FHA)的IgG抗体。测量抗体的几何平均浓度(GMC)和胎盘转运率。

结果

平均年龄为29.59±4.70岁的参与者在平均妊娠28.6±1.31周时接种了Tdap疫苗。接种前和接种后抗PT IgG GMCs和抗FHA IgG GMCs的平均水平分别为8.01 IU/ml对39.48 IU/ml(p = 0.001)和122.24 IU/ml对183.97 IU/ml(p < 0.001)。接种后脐带血中抗PT和抗FHA IgG GMCs分别为25.15 IU/ml和118.77 IU/ml(p < 0.001和p = 0.064)。抗PT和抗FHA IgG抗体的胎盘转运率分别检测为0.65和0.62。

结论

孕晚期孕妇接种Tdap可使母体和婴儿抗体水平升高。每次妊娠期间进行母体免疫似乎是产生最高母体和婴儿抗体以及缩小婴儿出生与免疫系统成熟之间差距的最佳策略。我国孕妇在孕期尤其是孕早期也应接种Tdap疫苗。

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