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PLoS Med:母体产前接种流感疫苗与儿童过敏性和免疫性疾病相关吗?

2022-04-16 小文子 MedSci原创

孕妇接种流感疫苗与出生儿童患过敏性或自身免疫性疾病有关吗?

WHO建议孕妇接种季节性流感疫苗,以保护母体与新生儿免受感染。很少有研究评估母亲接种流感疫苗对6个月以上儿童过敏性疾病和自身免疫性疾病的影响。PLOS MEDICINE杂志的一项研究探索了宫内暴露季节性流感灭活疫苗(IIV)与儿童诊断过敏性和自身免疫性疾病之间的关系。

这项纵向队列研究纳入了106206名母亲在2012年4月至2016年7月之间出生的124760名儿童,并从出生起进行长达5年的随访。随访结束时的平均年龄为3.0岁(标准差为1.3)。母体在怀孕期间接种季节性IIV。结局是根据医院/急诊科记录的诊断为过敏性或自身免疫性疾病,包括哮喘和过敏反应。母亲特征包括产妇年龄、原住民、社会经济状况、体重指数、胎次、医疗条件、妊娠并发症、孕期吸烟和第一次产检的胎龄。

14396名(11.5%)母亲接种了疫苗,2785名(19.4%)在妊娠早期,5558名(38.6%)在妊娠中期,6053名(42.1%)在妊娠晚期。8568名(6.9%)儿童被诊断为过敏性/自身免疫性疾病,分别有913名(6.3%)母体接种疫苗的儿童和7655名(6.9%)母体未接种疫苗的儿童。与母体未接种疫苗的儿童相比,母体接种疫苗的儿童患过敏性或自身免疫性疾病的风险没有差异(aHR=1.02;95%CI,0.95~1.09)。妊娠期特异性分析发现,妊娠晚期接种流感疫苗与哮喘(n=40;aHR=0.70;95%CI,0.50~0.97)和过敏反应(n=36;aHR=0.67;95%CI,0.47~0.95)的诊断呈负相关。

研究表明,孕妇接种流感疫苗与出生儿童患过敏性或自身免疫性疾病无关。虽然在妊娠晚期接种季节性IIV与哮喘和过敏性疾病诊断呈负相关,但仍需要更多的研究来证实这一结果。总的来说,在涉及儿童早期过敏性疾病和自身免疫性疾病,研究结果支持孕期接种季节性流感灭活疫苗的安全性。

原文出处:

Foo D, Sarna M, Pereira G, Moore HC, Regan AK (2022) Prenatal influenza vaccination and allergic and autoimmune diseases in childhood: A longitudinal, population-based linked cohort study. PLoS Med 19(4): e1003963. https://doi.org/10.1371/journal.pmed.1003963.

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    2022-05-29 zutt
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    2022-04-13 qilu_qi
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