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Review Meta Analysis
Immunogenicity of Hepatitis B Vaccine in Preterm or Low Birth Weight Infants: A Meta-Analysis.
- Wei Fan, Miao Zhang, Yi-Min Zhu, and Ying-Jie Zheng.
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory for Health Technology Assessment, National Commission of Health and Family planning, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
- Am J Prev Med. 2020 Aug 1; 59 (2): 278-287.
ContextThe study aims to quantitatively assess the immune response to hepatitis B vaccine in infants born preterm or with low birth weight.Evidence AcquisitionIn December 2018, a literature search was conducted in 4 databases without date restrictions. The pooled ORs, mean differences, and their corresponding 95% CIs were calculated with random-effects models using the DerSimonian-Laird estimator. The potential risk of bias of each study was assessed using the Newcastle-Ottawa Scale. The stability and publication bias of the pooled estimates were also evaluated. Analyses were completed in 2019.Evidence SynthesisA total of 27 studies including 22,202 infants were eligible for analysis. The studies found that infants born preterm had significantly poorer immune responses to the hepatitis B vaccine. Preterm infants were 1.36 times more likely to exhibit nonresponse to the hepatitis B vaccine (95% CI=1.12, 1.65, p=0.002) compared with their full-term counterparts. The pooled estimates for preterm birth may be subject to a potential publication bias. However, these results were stable, as suggested by the leave-one-out analysis and fail-safe number. The association between low birth weight and impaired immune response to the hepatitis B vaccine was not statistically significant when birth weight was dichotomized at 2,500 g.ConclusionsThese findings suggest an association between preterm birth and lowered immune responses to hepatitis B vaccine.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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