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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Use of the combined tetanus-diphtheria and pertussis vaccine during pregnancy
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Use of the combined tetanus-diphtheria and pertussis vaccine during pregnancy

机译：破伤风-白喉和百日咳混合疫苗在怀孕期间的使用

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Objective A recent increase in pertussis cases prompted the Advisory Committee on Immunization Practices to recommend administering the perinatal tetanus, diphtheria, and pertussis (Tdap) vaccine during each pregnancy. We sought to describe uptake of Tdap and identify predictors of vaccination in pregnancy. Study Design We conducted a retrospective study of all women delivering at a university hospital between February and June 2013. Demographic, pregnancy, and vaccination data were abstracted from the medical record. The relationship between maternal age, parity, gestational age, race/ethnicity, marital status, prenatal provider/site, insurance, influenza vaccination status, and Tdap vaccine was described by univariate analysis. Independent predictors were identified by multivariable logistic regression. Results In our cohort of 1467 women, 1194 (81.6%) received a Tdap vaccine. After adjusting for potential confounders, 3 factors were found to be independent predictors of receiving the vaccine. Patients were more likely to receive Tdap if they had been vaccinated against influenza during this pregnancy (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.4-2.3). Black women were less likely to receive Tdap when compared with other women (aOR, 0.42; 95% CI, 0.27-0.67). Also, women who delivered preterm were less likely to receive the Tdap vaccine (aOR, 0.33; 95% CI, 0.22-0.48). Conclusion A high overall Tdap vaccination rate was observed following implementation of the Advisory Committee on Immunization Practices guidelines. Black women, however, had significantly lower vaccine uptake than other women. Further research is needed to understand and minimize this disparity. Women who delivered prematurely also had a decreased rate of Tdap vaccination; vaccinating earlier should be considered to better capture this population.
机译：目的近期百日咳病例的增加促使免疫实践咨询委员会建议在每次妊娠期间接种围产期破伤风，白喉和百日咳（Tdap）疫苗。我们试图描述Tdap的摄入量，并确定妊娠疫苗接种的预测因素。研究设计我们对2013年2月至6月之间在大学医院分娩的所有妇女进行了回顾性研究。人口，怀孕和疫苗接种数据均摘自病历。通过单变量分析描述了孕产妇年龄，胎龄，胎龄，种族/民族，婚姻状况，产前提供者/地点，保险，流感疫苗接种状况和Tdap疫苗之间的关系。通过多变量逻辑回归确定独立的预测变量。结果在我们的1467名女性队列中，有1194名（81.6％）接受了Tdap疫苗。在调整了潜在的混杂因素后，发现3个因素是接种疫苗的独立预测因素。如果在此怀孕期间接受过流感疫苗接种，则患者更可能接受Tdap（调整后的优势比[aOR]为1.7; 95％置信区间[CI]为1.4-2.3）。与其他女性相比，黑人女性接受Tdap的可能性较小（aOR为0.42; 95％CI为0.27-0.67）。另外，早产的妇女接受Tdap疫苗的可能性较小（aOR为0.33; 95％CI为0.22-0.48）。结论实施免疫实践咨询委员会指南后，总体Tdap疫苗接种率很高。但是，黑人妇女的疫苗摄入量明显低于其他妇女。需要进一步的研究来理解和最小化这种差异。早产的妇女的Tdap疫苗接种率也降低了;应考虑尽早接种疫苗，以更好地捕获该人群。

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