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孕期接种疫苗。CAV-AEP 和 SEGO 的共识文件。

Vaccination in pregnancy. Consensus document of the CAV-AEP and the SEGO.

机构信息

Servicio de Pediatría, Hospital Costa del Sol, Asociación Española de Pediatría (CAV-AEP), Marbella, Málaga, Spain.

Centro de Salud de Llanera, Asturias Departamento de Medicina. Universidad de Oviedo. Asociación Española de Pediatría (CAV-AEP), Oviedo, Spain.

出版信息

An Pediatr (Engl Ed). 2024 Apr;100(4):268-274. doi: 10.1016/j.anpede.2024.02.014. Epub 2024 Apr 1.

DOI:10.1016/j.anpede.2024.02.014
PMID:38565447
Abstract

During pregnancy, physiological changes in the immune response make pregnant women more susceptible to serious infection, increasing the risk for the mother as well as the foetus, newborn and infant. All women should be correctly and fully vaccinated as they enter their reproductive years, especially against diseases such as tetanus, hepatitis B, measles, rubella and varicella. In addition to the recommended vaccines, in risk situations, inactivated vaccines could be administered to women who were not correctly vaccinated before, while attenuated vaccines are contraindicated. Despite the fact that vaccination during pregnancy is a very important preventive measure and the existing recommendations from public health authorities, scientific societies and health professionals, the vaccination coverage could clearly be improved, especially against influenza and SARS-CoV-2, so any health professional involved in the care of pregnant women should proactively recommend these vaccines. The Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines, and the Spanish Society of Gynaecology and Obstetrics (SEGO) recommend vaccination against the following diseases during pregnancy: against influenza and COVID-19, in any trimester of pregnancy and during the postpartum period (up to 6 months post birth) in women not vaccinated during pregnancy; against pertussis, with the Tdap vaccine, between weeks 27 and 36 of gestation (in the CAV-AEP recommendations, preferably between weeks 27 and 28); and against RSV, with RSVPreF, between weeks 24 and 36 of gestation, preferably between weeks 32 and 36.

摘要

怀孕期间,免疫反应的生理变化使孕妇更容易受到严重感染,增加了母亲、胎儿、新生儿和婴儿的风险。所有女性在进入生育年龄时都应正确、充分地接种疫苗,尤其是预防破伤风、乙型肝炎、麻疹、风疹和水痘等疾病。除了推荐的疫苗外,在风险情况下,对于之前未正确接种疫苗的女性,可以接种灭活疫苗,而减毒疫苗则是禁忌。尽管怀孕期间接种疫苗是一项非常重要的预防措施,并且公共卫生当局、科学协会和卫生专业人员都有现有的建议,但接种疫苗的覆盖率显然可以提高,尤其是针对流感和 SARS-CoV-2,因此任何参与孕妇护理的卫生专业人员都应积极推荐这些疫苗。西班牙儿科学会 (AEP) 通过其疫苗咨询委员会,以及西班牙妇科学会和产科医师学会 (SEGO) 建议在怀孕期间接种以下疾病的疫苗:针对流感和 COVID-19,在怀孕的任何 trimester 以及产后(产后 6 个月内)期间,对于未在怀孕期间接种疫苗的女性;针对百日咳,使用 Tdap 疫苗,在妊娠第 27 周到 36 周之间(在 CAV-AEP 建议中,最好在第 27 周到 28 周之间);以及针对 RSV,使用 RSVPreF,在妊娠第 24 周到 36 周之间,最好在第 32 周到 36 周之间。

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