Pneumococcal vaccination during pregnancy for preventing infant infection

摘要: Background Approximately 450,000 children worldwide die of pneumococcal infections each year. The development bacterial resistance to antimicrobials adds the difficulty treatment diseases and emphasizes need for a preventive approach. Newborn vaccination schedules could substantially reduce impact disease in immunized children, but do not have an effect on morbidity mortality infants less than three months age. Pneumococcal during pregnancy may be way preventing first life before vaccine administered infant starts produce protection. Objectives To assess infection. Search methods We searched Cochrane Pregnancy Childbirth Group's Trials Register (31 July 2014) reference lists retrieved studies. Selection criteria Randomized controlled trials pregnant women comparing with placebo or doing nothing, another prevent infections. Data collection analysis Two review authors independently assessed inclusion risk bias, extracted data checked them accuracy. We contacted study additional information. Main results Seven were included, only six (919 participants) contributed data. There was no evidence that reduces neonatal infection (risk ratio (RR) 0.66; 95% confidence interval (CI) 0.30 1.46; two trials, 241 pregnancies, low quality evidence). Although suggest reducing colonization by 16 age (average RR 0.33; CI 0.11 0.98; one trial, 56 pregnancies), there this at 1.13; 0.46 2.78; 146 evidence) seven 0.67, 0.22 2.08; 148 None included reported death as result infection. Neonatal antibody levels geometric mean CI. inconsistent results between studies. Two studies showed significantly higher immunoglobulin G (IgG) cord blood group when compared control all serotypes. In contrast, trial difference group. Maternal also One IgG maternal serum regardless any Another serotype 14, other serotypes. The percentage seroprotection measured delivery 12 post-delivery. At delivery, favored intervention 6 (RR 1.49, 1.31 1.69), 14 1.40, 1.25 1.56) 19 2.29, 1.89 2.76). differences seen post-delivery serotypes 1.06, 1.00 1.12 0.98 1.15, respectively), 1.59, 1.37 1.85). No significant tenderness injection site who received those 3.20; 0.32 31.54; 130 women). The overall is primary outcomes. Most outcomes had wide intervals crossing line effect, most small numbers participants few events which led downgrading imprecision findings. Authors' conclusions There insufficient whether infections.