Pneumococcal vaccination during pregnancy for preventing infant infection

Chaithongwongwatthana S, Yamasmit W, Limpongsanurak S, Lumbiganon P, DeSimone JA, Baxter JK, Tolosa JE

Published Online:

November 9, 2011

Not enough evidence to support the use of pneumococcal vaccination during pregnancy for preventing infant infections.

Although the incidence of invasive pneumococcal disease is variable across the world, mortality rate is high in children who get this infection. Newborn vaccination schedules could reduce the impact of pneumococcal disease in immunized children, but have no effect on the morbidity and mortality of infants less than three months of age. Maternal pneumococcal immunization during pregnancy may be a method of preventing pneumococcal disease during the infant's first months of life. The review of trials found there was not enough information to say whether pneumococcal vaccination during pregnancy led to fewer infant infections.

Abstract (click to read)

Background:

Each year at least one million children worldwide die of pneumococcal infections. The development of bacterial resistance to antimicrobials adds to the difficulty of treatment of diseases and emphasizes the need for a preventive approach. Newborn vaccination schedules could substantially reduce the impact of pneumococcal disease in immunized children, but does not have an effect on the morbidity and mortality of infants less than three months of age. Pneumococcal vaccination during pregnancy may be a way of preventing pneumococcal disease during the first months of life before the pneumococcal vaccine administered to the infant starts to produce protection.

Objectives:

To assess the effect of pneumococcal vaccination during pregnancy for preventing infant infection.

Search strategy:

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2004), CENTRAL (The Cochrane Library, Issue 2, 2004), MEDLINE (January 1966 to June 2004), EMBASE (January 1985 to June 2004), and reference lists of articles. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 6 July 2011 and added the results to the awaiting classification section.

Selection criteria:

Randomized controlled trials in pregnant women comparing pneumococcal vaccine with placebo or doing nothing or with another vaccine to prevent infant infections.

Data collection and analysis:

Two authors independently assessed methodological quality and extracted data using a data collection form. Study authors were contacted for additional information.

Main results:

Three trials (280 participants) were included. There was no evidence that pneumococcal vaccination during pregnancy reduces the risk of neonatal infection (one trial, 149 pregnancies, relative risk (RR) 0.51; 95% confidence interval (CI) 0.18 to 1.41). Although the data suggest an effect in reducing pneumococcal colonisation in infants by 16 months of age (one trial, 56 pregnancies, RR 0.33; 95% CI 0.11 to 0.98), there was no evidence of this effect in infants at two months of age (RR 0.28; 95% CI 0.02 to 5.11) or by seven months of age (RR 0.32; 95% CI 0.08 to 1.29).

Authors' conclusions:

There is insufficient evidence to support whether pneumococcal vaccination during pregnancy could reduce infant infections.

[Note: The eight citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

This record should be cited as:

Chaithongwongwatthana S, Yamasmit W, Limpongsanurak S, Lumbiganon P, DeSimone JA, Baxter JK, Tolosa JE. Pneumococcal vaccination during pregnancy for preventing infant infection. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004903. DOI: 10.1002/14651858.CD004903.pub2

Assessed as up to date:

November 1, 2005

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Primary Review Group:

Pregnancy and Childbirth Group

Health topics:

Infectious disease > Neonatal infections > Other interventions

Neonatal care > Neonatal infections > Other interventions

Pregnancy & childbirth > Infection during pregnancy > Other infections

Infectious disease > Other infections during pregnancy

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Pneumococcal vaccination during pregnancy for preventing infant infection

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