法国孕妇的新冠病毒疫苗接种率：一项全国性队列研究。
COVID-19 vaccination rates among pregnant women in France: A nationwide cohort study.
作者信息
Bernard Clément, Drouin Jérôme, Le Vu Stéphane, Botton Jérémie, Semenzato Laura, Bertrand Marion, Jabagi Marie-Joelle, Miranda Sara, Dray-Spira Rosemary, Weill Alain, Zureik Mahmoud
机构信息
EPI-PHARE Scientific Interest Group in Epidemiology of Health Products (French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance), France; University Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Anti-infective evasion and Pharmacoepidemiology Unit/Team, CESP, 78180, Montigny le Bretonneux, France.
EPI-PHARE Scientific Interest Group in Epidemiology of Health Products (French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance), France.
出版信息
Vaccine. 2025 Apr 19;53:127070. doi: 10.1016/j.vaccine.2025.127070. Epub 2025 Apr 4.
BACKGROUND
Pregnant women are at an elevated risk for severe COVID-19, but nationwide rates of vaccination and its timing during pregnancy are not well documented in France.
OBJECTIVES
To assess COVID-19 vaccination rates among pregnant women in France, compare them to those of the general population, and analyse factors associated with vaccination status and timing.
METHODS
A nationwide study using the EPI-MERES register, which includes all 1,203,454 pregnant women who delivered between April 2021 and December 2022 in France. Standardization by age and social index was used to compare vaccination rates with those of the general female population. Associations with sociodemographic factors, pregnancy monitoring indicators, and pre-existing comorbidities were measured using multivariable logistic regression.
RESULTS
Overall, 52 % of pregnant women received at least one vaccine dose, with 62.1 % vaccinated before conception and 8.2 %, 20.9 %, and 8.8 % vaccinated in the 1st, 2nd, and 3rd trimester, respectively. Vaccination rates initially lagged behind those of the general population but converged by June 2022, with a six-month lag. Younger and more socially deprived women were less highly vaccinated. Unvaccinated women were more likely to be in their third pregnancy (aOR, 1.21 [1.19-1.22]), had fewer ultrasound scans (aOR, 0.71 [0; 70-0.73]), and less often took folic acid (aOR, 0.73 [0.72-0.74]). Women with comorbidities, such as obesity, diabetes, hypertension, antidepressant use, or chronic respiratory disease, were less likely to be unvaccinated (aORs ranged from 0.69 to 0.89).
CONCLUSIONS
Pregnant women in France were less highly vaccinated than the general population during crucial pandemic periods but eventually reached similar vaccination rates. Socioeconomic status and the level of prenatal care were strongly associated with low vaccine uptake. This should be a focus for future interventions and policy adjustments across all segments of this population.
背景
孕妇感染重症 COVID-19 的风险较高，但法国全国范围内的疫苗接种率及其在孕期的接种时间尚无充分记录。
目的
评估法国孕妇的 COVID-19 疫苗接种率，将其与普通人群的接种率进行比较，并分析与接种状态和接种时间相关的因素。
方法
一项使用 EPI-MERES 登记册的全国性研究，该登记册涵盖了 2021 年 4 月至 2022 年 12 月期间在法国分娩的所有 1,203,454 名孕妇。采用年龄和社会指数标准化方法，将疫苗接种率与普通女性人群的接种率进行比较。使用多变量逻辑回归分析与社会人口学因素、妊娠监测指标和既往合并症的关联。
结果
总体而言，52% 的孕妇接种了至少一剂疫苗，其中 62.1% 在受孕前接种，在孕早期、孕中期和孕晚期接种的比例分别为 8.2%、20.9% 和 8.8%。疫苗接种率最初落后于普通人群，但到 2022 年 6 月趋于一致，滞后六个月。年轻和社会经济地位较低的女性接种率较低。未接种疫苗的女性更有可能是第三次怀孕（调整后比值比，1.21 [1.19 - 1.22]），超声检查次数较少（调整后比值比，0.71 [0.70 - 0.73]），服用叶酸的频率也较低（调整后比值比，0.73 [0.72 - 0.74]）。患有肥胖、糖尿病、高血压、使用抗抑郁药或慢性呼吸道疾病等合并症的女性未接种疫苗的可能性较小（调整后比值比范围为 0.69 至 0.89）。
结论
在关键的疫情期间，法国孕妇的疫苗接种率低于普通人群，但最终达到了相似的接种率。社会经济地位和产前护理水平与疫苗接种率低密切相关。这应成为该人群所有群体未来干预措施和政策调整的重点。
Zotero 插件