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在哥伦比亚某地区,通过母体疫苗接种成功诱导产生了针对白喉和破伤风的血清转化。

Successful seroconversion against diphtheria and tetanus induced through maternal vaccination in a region of Colombia.

作者信息

Hincapie-Palacio Doracelly, Echeverri Adriana, Hoyos Cristina, Vargas-Restrepo Felipe, Ospina Marta, Buitrago Seti, Ochoa Jesús

机构信息

"Héctor Abad Gómez" National Faculty of Public Health, Universidad of Antioquia, Medellín, Colombia.

Departmental Laboratory of Public Health, The Sectional Secretariat of Health and Social Protection of Antioquia, Medellín, Colombia.

出版信息

Clin Exp Vaccine Res. 2022 Jan;11(1):72-81. doi: 10.7774/cevr.2022.11.1.72. Epub 2022 Jan 31.

Abstract

PURPOSE

This study aims to compare protection against diphtheria and tetanus conferred on the mother and the neonate before and after maternal vaccination against tetanus, diphtheria, and acellular pertussis (Tdap), transfer of antibodies, and the variables that could impact on the protection.

MATERIALS AND METHODS

The study followed a cohort of 200 pregnant women from a region in Colombia, contacted during prenatal control before vaccination and upon delivery. The work determined immunoglobulin G antibodies against diphtheria and tetanus of pregnant women and umbilical cord. The proportion of protection, the geometric mean of the concentration, and the transfer of maternal antibodies were calculated. The protection profile of the pregnant women was explored by using multiple correspondence analysis.

RESULTS

The concentration of antibodies against diphtheria was significant before and after vaccination of the pregnant women (p=0.000) with proportions of 85.0% and 97.5%, respectively, and of 98.6% in the umbilical cord, with significant antibody correlation (Spearman's coefficient=0.668, p=0.01). Sero-protection against tetanus before vaccination was at 71.0%, after at 92.6%, and in the umbilical cord at 95.9%, with significant antibody concentration before and after vaccination (p=0.000) and antibody correlation (Spearman's coefficient=0.936, p=0.01). Sero-protection was higher when the pregnant women were vaccine 8 to 11 weeks before delivery. Unprotected pregnant women were those not vaccinated during pregnancy.

CONCLUSION

The high proportion of protection against diphtheria and tetanus and the placental transfer support the need to promote maternal immunization with Tdap.

摘要

目的

本研究旨在比较孕妇接种破伤风、白喉和无细胞百日咳疫苗(Tdap)前后,母亲和新生儿对白喉和破伤风的免疫保护、抗体转移情况以及可能影响免疫保护的变量。

材料与方法

该研究对哥伦比亚某地区的200名孕妇进行了队列研究,在接种疫苗前的产前检查期间以及分娩时对她们进行了随访。研究测定了孕妇和脐带血中抗白喉和破伤风的免疫球蛋白G抗体。计算了免疫保护比例、抗体浓度几何均值以及母体抗体的转移情况。通过多重对应分析探讨了孕妇的免疫保护情况。

结果

孕妇接种疫苗前后抗白喉抗体浓度均有显著变化(p = 0.000),接种前比例为85.0%,接种后为97.5%,脐带血中为98.6%,抗体相关性显著(斯皮尔曼系数 = 0.668,p = 0.01)。接种疫苗前破伤风血清保护率为71.0%,接种后为92.6%,脐带血中为95.9%,接种前后抗体浓度有显著变化(p = 0.000)且抗体相关性显著(斯皮尔曼系数 = 0.936,p = 0.01)。孕妇在分娩前8至11周接种疫苗时血清保护率更高。未获得免疫保护的孕妇是那些孕期未接种疫苗的人。

结论

对白喉和破伤风的高免疫保护比例以及胎盘转移支持了推广孕妇接种Tdap疫苗的必要性。

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