[英语新闻] 加紧乙肝疫苗在怀孕期间有效

StephenW

加紧乙肝疫苗在怀孕期间有效
Newswise — DALLAS – June 28, 2011 – UT Southwestern Medical Centermaternal-fetal specialists have confirmed a potential new protocol to protectpregnant women who are at risk for hepatitis B, a health problem that affects 2billion people worldwide.
An accelerated hepatitis B vaccination schedule for high-risk pregnant womenwas found effective and well-tolerated. The findings appear in the journal Obstetrics& Gynecology.
While the normal three-shot regimen of hepatitis B vaccine for adults –given over a six-month period – has long been recommended for pregnant women,that schedule often proved unmanageable in the course of a pregnancy.
“It’s difficult to get all three doses in pregnancy, and people tend to getlost to follow-up, especially high-risk populations,” said Dr. JeanneSheffield, associate professor of obstetrics and gynecology at UT Southwesternand lead author of the study.
The research team stepped up the process for pregnant women and used thenormal three-shot dosage given to adults over a 12-week period. That regimen isthe shortest recommended schedule in nonpregnant adults that still offersprotective long-term immunity.
“Now that we’ve shown it’s efficacious in pregnancy, people are interested,”said Dr. Sheffield, who also heads UT Southwestern’s maternal-fetal medicinefellowship program. “We’ve already received a number of requests for ourspecific protocol from physicians who see high-risk patients and are interestedin starting a vaccination program.”
In the U.S.,nearly 1.5 million people live with chronic hepatitis B infection, and it isthe underlying cause of 3,000 deaths per year. The American Collegeof Obstetricians and Gynecologists recommended in 1993 and in 2007 thatpregnant women at risk for hepatitis B should receive vaccination.
Dr. Sheffield said, however, that health care providers seldom offer thehepatitis B vaccine series to reproductive-aged women because of lack ofphysician and patient education, patients’ fear of vaccination and itspurported side effects, and the overall reluctance to vaccinate pregnant women.
Even though the Centers for Disease Control and Prevention reports pregnancyis not a contraindication to hepatitis B vaccine, limited data were availableon its use in pregnancy.
In the current study, conducted at Parkland Memorial Hospital, researchersenrolled high-risk women with a current diagnosis of a sexually transmitteddisease, injection drug use or both, over a six-year period. Of 200 womenenrolled, 168 received all three doses of the vaccine.
Researchers found that race, maternal age, tobacco and alcohol use, andgestational age at first vaccination did not affect seroconversion rates – thedevelopment of antibodies against hepatitis B – using the accelerated schedule.Obesity had a negative influence, however.
The accelerated schedule in pregnancy had seroconversion rates (90 percent)that were comparable to the standard schedule in healthy adults. The study alsoshowed no increase in preterm delivery rates or neonatal intensive careadmissions.
“The vaccine was well-tolerated in our pregnant women, and no seriousadverse events were reported,” Dr. Sheffield said. “Initial concerns about theability of a pregnant woman to mount an effective immune response to a vaccineare largely unfounded. It’s doable.”
Other UT Southwestern obstetrics and gynecology researchers involved in thestudy were Dr. George D. Wendel Jr., professor and senior author; Dr. AshleyHickman, assistant professor; Drs. Jennifer Tang, Kristie Moss and Natalie M.Crawford, all former medical students; and Atoosa Kourosh, candidate for amaster’s degree in public health.
The study was funded by Warren H. Pearse/Wyeth Pharmaceuticals and theWomen’s Health Policy Research Award.
Visit http://www.utsouthwestern.org/obgynto learn more about clinical services in gynecology and obstetrics at UTSouthwestern.
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StephenW

发行时间：2011年6月27日美国东部时间下午01:50
来源：德州大学西南医学中心
Newswise - 达拉斯 - 2011年6月28日 - 德州大学西南医学中心的产妇，胎儿的专家已确认一个潜在的新协议来保护谁在乙肝，健康问题，影响到20亿人的全球风险的孕妇。
为加速乙肝高危孕妇被发现有效的疫苗接种计划和耐受性良好。这一发现刊登在杂志妇产科。
而正常三杆的乙肝成人疫苗疗法 - 超过六个月期限定 - 长期以来一直建议孕妇，计划往往被证明是在怀孕过程中难以管理。
“这是很难得在怀孕三个剂量，人们往往会迷失方向跟进，特别是高危人群，博士说：”珍妮谢菲尔德，副教授，妇产科在德州大学西南和研究的主要作者。
该研究小组加强了对孕妇的过程，并用正常的三杆剂量给予了一项为期12周的时间到成人。该方案是在最短的非妊娠成人建议的时间表仍然提供保护长期免疫力。
“现在，我们已经表明，它在怀孕灵验，人们感兴趣的，博士说：”谢菲尔德，谁也头得克萨斯大学西南的母胎医学研究金方案。 “我们已经收到了我们的医生谁看到高风险患者，并在启动疫苗接种计划感兴趣的特定的协议请求的数量。”
在美国，近1.5亿人生活在慢性乙肝感染，它是每年3000人死亡的根本原因。在妇产科，1993年和2007年的建议，在B型肝炎高危孕妇应接受疫苗接种的美国妇产科学院。
谢菲尔德博士说，不过，卫生保健提供者很少提供乙肝疫苗系列因为医生和病人教育，病人的免疫接种，其本意是副作用的恐惧，总不愿缺乏育龄妇女接种疫苗怀孕女性。
尽管美国疾病控制和预防中心的报告，怀孕是不是对乙肝疫苗的禁忌症，有限的数据是其在孕期使用。
在目前的研究，在帕克兰纪念医院进行，研究人员招收具有的一种性传播疾病，注射毒品或者两者目前诊断高风险的妇女，过了六年的时间。其中200名妇女参加，168接到的所有三个剂量的疫苗。
研究人员发现，种族，产妇年龄，烟草和酒精使用，并在第一次接种孕周不影响血清转换率 - 在对乙肝抗体的开发 - 使用加速时间表。肥胖带来了负面影响，但是。
在妊娠加快进度了血清转换率（90％），这些相比于健康成人标准的时间表。这项研究还没有表现出早产率或新生儿重症监护招生增加。
“该疫苗耐受性良好在我们的孕妇，且无严重不良事件的报道，”博士谢菲尔德说。 “对孕妇有能力进行有效的免疫反应的疫苗的初步问题在很大程度上是没有根据的。这是可行的。“
得克萨斯大学西南其他妇产科研究人员在研究涉及的乔治D.温德尔博士，教授和资深作者小;阿什利希克曼博士，助理教授，博士。唐珍，克里斯蒂Moss和娜塔莉M.克劳福德，所有前医学生和Atoosa Kourosh，对于一个硕士公共卫生研究生。
这项研究是由沃伦H.皮尔斯/惠氏制药和妇女卫生政策研究奖。