Vacina difteria, tétano e pertussis acelular (dTpa) na gravidez: prevenção da tosse convulsa no lactente
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v24.i3.8526Palavras-chave:
gravidez, tosse convulsa, vacina pertussis acelularResumo
Introdução: Atualmente observa-se uma reemergência de tosse convulsa em países com elevadas coberturas vacinais, incluindo Portugal. Os lactentes com menos de três meses de idade constituem o grupo mais vulnerável. Novas estratégias vacinais têm sido propostas, entre as quais a vacinação no terceiro trimestre de gravidez. No entanto, a sua implementação é ainda limitada, existindo dúvidas quanto à sua eficácia e segurança.
Objectivo: Rever a evidência quanto à eficácia e segurança da vacina difteria, tétano e pertussis acelular (dTpa) administrada na gravidez na prevenção da tosse convulsa no lactente.
Métodos: Foram pesquisadas normas de orientação clínica (NOC), revisões sistemáticas e estudos originais (EO) na Medline, bases de dados de medicina baseada na evidência e sítios da Direção-Geral da Saúde e Sociedade Portuguesa de Pediatria. Utilizaram-se os termos MeSH pertussis vaccine e pregnancy e foram selecionados artigos publicados entre 01/07/09 e 15/07/2014 nas línguas portuguesa, inglesa e espanhola.
Desenvolvimento: A maioria das NOC recomenda a vacinação de todas as grávidas no terceiro trimestre. Os EO mostram que a dTpa administrada na gravidez é eficaz no aumento da concentração de anticorpos anti-pertussis maternos e do lactente e na diminuição dos casos de doença e de hospitalizações em lactentes. A vacina não parece associar-se a aumento de efeitos adversos materno-fetais ou nas crianças.
Conclusões: A vacinação com dTpa durante o terceiro trimestre de gravidez parece ser segura e eficaz na prevenção da tosse convulsa no lactente.
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Referências
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