Englund J, Glezen W P, Piedra P A
Department of Microbiology, Baylor College of Medicine, Houston, TX 77030, USA.
Vaccine. 1998 Aug-Sep;16(14-15):1456-63. doi: 10.1016/s0264-410x(98)00108-x.
The protective effect of maternal antibody against many viral diseases has been recognized. The use of maternal immunization has been considered as a means to augment this protection in the young infant against disease. Advantages of maternal immunization include the fact that young infants are most susceptible to infections but least responsive to vaccines, that pregnant women are accessible to medical care and respond well to vaccines, that IgG antibodies cross the placenta well during the third trimester, and that immunization of the pregnant woman has the potential to benefit both the mother and the infant. Disadvantages include the potential inhibition of an infant's response to active immunization or natural infection and liability issues with pharmaceutical companies and physicians. Immunization of pregnant women with viral vaccines for poliovirus, influenza viruses, and rubella has been described and maternal vaccination with these vaccines has been found to be safe for both the mother and the fetus. An open-label study of post-partum women immunized with the purified fusion protein of RSV (PFP-2, Wyeth-Lederle Pediatrics and Vaccines, Inc., Pearl River, NY) demonstrated that the vaccine was non-reactogenic and immunogenic; RSV-specific antibody was detected in breast milk. Immunization of pregnant women with purified protein or subunit vaccines could be considered against neonatal viral pathogens, such as respiratory syncytial virus, parainfluenza viruses, herpes group viruses, and human immunodeficiency virus. Further studies are needed to define the safety and efficacy of maternal immunization.
母体抗体对多种病毒性疾病的保护作用已得到认可。母体免疫接种已被视为增强幼儿对疾病保护的一种手段。母体免疫接种的优点包括：幼儿最易感染但对疫苗反应最差；孕妇易于获得医疗护理且对疫苗反应良好；IgG抗体在妊娠晚期能很好地穿过胎盘；对孕妇进行免疫接种有可能使母亲和婴儿都受益。缺点包括可能抑制婴儿对主动免疫或自然感染的反应，以及制药公司和医生的责任问题。已有关于用脊髓灰质炎病毒、流感病毒和风疹病毒的病毒疫苗对孕妇进行免疫接种的描述，并且已发现用这些疫苗对孕妇进行接种对母亲和胎儿都是安全的。一项对用呼吸道合胞病毒纯化融合蛋白（PFP - 2，惠氏 - 莱德勒儿科与疫苗公司，纽约州珍珠河）免疫的产后妇女进行的开放标签研究表明，该疫苗无反应原性且具有免疫原性；在母乳中检测到了呼吸道合胞病毒特异性抗体。可以考虑用纯化蛋白或亚单位疫苗对孕妇进行免疫接种，以预防新生儿病毒性病原体，如呼吸道合胞病毒、副流感病毒、疱疹病毒组病毒和人类免疫缺陷病毒。需要进一步研究来确定母体免疫接种的安全性和有效性。
