妊娠期能否接种H1N1疫苗?暂未见其对宝宝的不利影响
  • 纳入出生日期在2009年11月至2010年10月的儿童,其中30%的母亲接种过H1N1流感疫苗,随访其至5岁;
  • 利用倾向性评分匹配的方式分析,发现疫苗接种与儿童上/下呼吸道感染、中耳炎、感染性疾病、肿瘤、感觉障碍、儿童期慢性病、死亡等风险均不存在统计学关联;
  • 疫苗接种与哮喘风险增高以及胃肠道感染风险的降低存在微弱关联;
  • 这种关联的存在可能是由于一些未被观测到的混杂因素的存在;
  • 暂未发现妊娠期接种H1N1疫苗对后代的有害影响。
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小笋干儿
2009年H1N1流感流行期间,曾推广过流感疫苗接种,其在妊娠期女性中亦有接种。本文研究当时接种疫苗的女性其后代儿童期的健康效应。结果并未发现疫苗接种与儿童不良健康效应之间的关联,证明了疫苗的长期安全性。
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Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy: retrospective cohort study

2009年接种H1N1流感疫苗的孕妇其后代儿童的健康状况:回顾性队列研究

10.1136/bmj.l4151

2019-07-10, Article

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OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood.
PARTICIPANTS: All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes.
MAIN OUTCOME MEASURES:: Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding.
RESULTS: Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups.
CONCLUSIONS: No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.

First Authors:
Laura K Walsh

Correspondence Authors:
Deshayne B Fell

All Authors:
Laura K Walsh,Jessy Donelle,Linda Dodds,Steven Hawken,Kumanan Wilson,Eric I Benchimol,Pranesh Chakraborty,Astrid Guttmann,Jeffrey C Kwong,Noni E MacDonald,Justin R Ortiz,Ann E Sprague,Karina A Top,Mark C Walker,Shi Wu Wen,Deshayne B Fell

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