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孕妇和新生儿百日咳、白喉和破伤风抗体血清阳性率,作为在日本社会中引入孕前或产前 DTaP 疫苗接种的初步数据。

Pertussis, diphtheria, and tetanus antibodies seroprevalence in pregnant women and neonates, as a preliminary data for introduction of preconception or prenatal DTaP vaccination among Japanese society.

机构信息

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan; Perinatal and Women's Medicine, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan.

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.

出版信息

Vaccine. 2022 Nov 22;40(49):7122-7129. doi: 10.1016/j.vaccine.2022.09.092. Epub 2022 Oct 28.

Abstract

An increasing number of countries have been introducing acellular pertussis vaccination during pregnancy for the prevention of neonatal pertussis. In response to the fact that infantile pertussis cases of 0-5 months age groups remained unchanged despite the universal vaccination program, prenatal pertussis vaccination has been a rising issue in Japan. Hence, we investigated the seroprevalence of pertussis, diphtheria, and tetanus antibodies in Japanese pregnant women and neonates, and evaluated the necessity of diphtheria-tetanus-acellular pertussis (DTaP) vaccination during the preconception or prenatal period. Maternal PT-IgG (EIA) and FHA-IgG (EIA) for the first trimester, within 1 week after delivery, and cord blood were collected, along with colostrum pertussis-IgA (ELISA), diphtheria-IgG (EIA), tetanus-IgG (EIA), and blood samples from the first trimester. The maternal seroprevalence of PT-IgG and FHA-IgG was 69 % and 75 %, respectively. All tested participants were positive for diphtheria-IgG and tetanus-IgG (100 %). First trimester PT-IgG/FHA-IgG antibody titers were significantly associated with cord blood PT-IgG/FHA-IgG titers (P < 0.001). We found that pertussis seroprevalence among pregnant Japanese women was approximately 70 %. The antibody seropositivity rate of pertussis was lower than that of diphtheria and tetanus. Fetal acquired passive immunity against pertussis is higher when the level of maternal antibody in the first trimester is sufficient. At least 30 % of study population did not reach to the threshold value to provide sufficient pertussis immunity for the neonates and themselves. The acellular pertussis vaccine (DTaP) approved in Japan lacks safety information for pregnancy, hence, a solution for prompt administration of prenatal acellular pertussis vaccination might be introducing DTaP in the preconception period.

摘要

越来越多的国家开始在孕期为预防新生儿百日咳而引入无细胞百日咳疫苗。由于尽管实行了普遍疫苗接种计划,0-5 月龄婴儿百日咳病例仍未减少,因此产前百日咳疫苗接种在日本成为一个日益严重的问题。因此,我们调查了日本孕妇和新生儿的百日咳、白喉和破伤风抗体血清阳性率,并评估了在孕前或孕期接种白喉-破伤风-无细胞百日咳(DTaP)疫苗的必要性。采集了孕妇孕早期、产后 1 周内和脐血的 PT-IgG(EIA)和 FHA-IgG(EIA),以及初乳中的百日咳-IgA(ELISA)、白喉-IgG(EIA)、破伤风-IgG(EIA)和孕早期的血液样本。PT-IgG 和 FHA-IgG 的母体血清阳性率分别为 69%和 75%。所有检测参与者的白喉 IgG 和破伤风 IgG 均为阳性(100%)。孕早期的 PT-IgG/FHA-IgG 抗体滴度与脐血的 PT-IgG/FHA-IgG 滴度显著相关(P<0.001)。我们发现,日本孕妇的百日咳血清阳性率约为 70%。百日咳抗体的血清阳性率低于白喉和破伤风。当孕早期母体抗体水平足够时,胎儿获得针对百日咳的被动免疫力更高。至少 30%的研究人群未达到为新生儿和自身提供足够百日咳免疫力的阈值。日本批准的无细胞百日咳疫苗(DTaP)缺乏对妊娠的安全性信息,因此,引入 DTaP 进行产前无细胞百日咳疫苗接种可能是一个解决方案。

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