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Clin Gastroenterol Hepatol:孕期接受生物疗法是否影响宝宝出生后对疫苗的反应?

2018-01-29 林巧楠 环球医学网

炎症性肠病(IBD)通常在育龄女性中发病,而使用免疫调节剂对于生育、妊娠、婴儿结局的影响是临床医生和患者共同关注的部分。2018年1月,发表在《Clin Gastroenterol Hepatol》的一项由美国科学家进行的研究,考察了IBD孕妇接受生物疗法是否影响婴儿对疫苗的应答。

炎症性肠病IBD)通常在育龄女性中发病,而使用免疫调节剂对于生育、妊娠、婴儿结局的影响是临床医生和患者共同关注的部分。2018年1月,发表在《Clin Gastroenterol Hepatol》的一项由美国科学家进行的研究,考察了IBD孕妇接受生物疗法是否影响婴儿对疫苗的应答。

背景和目的:在IBD女性患者中,使用免疫调节剂或生物疗法与妊娠期不良事件或新生儿不良结局不相关。研究者考察了患者在妊娠期使用这些药物是否会影响新生儿对疫苗的血清应答。

方法:2007年~2016年,研究者从记录美国多个中心确诊为IBD并接受治疗的妊娠女性结局的系统(IBD妊娠和新生儿结局注册系统)中收集数据。从至少7个月月龄的婴儿中收集血清样本,并分析流感嗜血杆菌B(蛋白-多聚糖结合物)或破伤风毒素(纯灭活的蛋白抗原)的抗体滴度;2013年7月~2016年10月,母亲完成关于婴儿疫苗接种和结局的调查。测定33例婴儿的脐带血样本中的生物制剂浓度。比较母亲使用生物疗法(怀孕至分娩期间任何时候使用英夫利昔单抗、阿达木单抗、赛妥珠单抗、戈利木单抗、那他珠单抗、维多珠单抗,或优特克单抗—单药或与一种免疫调节剂联合)与未使用生物疗法的婴儿对疫苗应答的差异。

结果:共179例女性完成疫苗调查(26例未暴露于生物制剂,153例暴露于生物制剂)。研究者发现,暴露于生物疗法的母亲(42例,71%)与未暴露的母亲(8例,50%)相比,其婴儿抗HiB保护性抗体滴度无显着差异(P=0.41)。研究者发现,暴露于生物疗法的母亲(80%)与未暴露的母亲(75%)相比,其婴儿的破伤风菌疫苗保护性抗体滴度无显着差异(P=0.66)。脐带血中英夫利昔单抗浓度在HiB(P=0.30)或破伤风菌疫苗抗体滴度足够和不足(P = 0.93)的婴儿之间无显着差异。7/40例母亲暴露于生物疗法的婴儿接种轮状病毒疫苗,应答较轻微。

结论:年龄≥7个月的婴儿基于抗体滴度接种抗HiB和破伤风菌疫苗似乎不受子宫内暴露于生物疗法的影响。

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    2018-12-10 许安
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    2018-01-31 gwc384
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    2018-01-29 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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根据斯坦福大学医学院的研究人员的研究,即使在无糖尿病的母亲身上,妊娠早期血糖升高也会增加婴儿患先天性心脏病的风险。

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