{"id":35849,"date":"2024-06-24T15:50:13","date_gmt":"2024-06-24T07:50:13","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=35849"},"modified":"2025-02-11T13:40:35","modified_gmt":"2025-02-11T05:40:35","slug":"vaccine-rsv-moi-o-phu-nu-mang-thai-loi-ich-va-nguy-co","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/vaccine-rsv-moi-o-phu-nu-mang-thai-loi-ich-va-nguy-co\/","title":{"rendered":"Vaccine RSV m\u1edbi \u1edf ph\u1ee5 n\u1eef mang thai: l\u1ee3i \u00edch v\u00e0 nguy c\u01a1"},"content":{"rendered":"\n

Virus h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (Respiratory Syncytial Virus \u2013 RSV) g\u00e2y ra nhi\u1ec1u g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt cho nh\u0169 nhi. \u01af\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 1.4 tri\u1ec7u nh\u0169 nhi < 6 th\u00e1ng tu\u1ed5i ph\u1ea3i nh\u1eadp vi\u1ec7n li\u00ean quan \u0111\u1ebfn RSV, trong \u0111\u00f3 c\u00f3 t\u1edbi 45,700 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong [1]<\/sup>. \u1ede Hoa K\u1ef3, RSV l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u khi\u1ebfn nh\u0169 nhi ph\u1ea3i nh\u1eadp vi\u1ec7n, trong \u0111\u00f3 nh\u0169 nhi < 6 th\u00e1ng tu\u1ed5i chi\u1ebfm 2 \u2013 3%. V\u00e0o n\u0103m 2023, C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 (FDA) \u0111\u00e3 ch\u1ea5p thu\u1eadn nirsevimab, m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng c\u00f3 t\u00e1c \u0111\u1ed9ng k\u00e9o d\u00e0i, cho ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u0169 nhi. Kho\u1ea3ng 1 th\u00e1ng sau \u0111\u00f3, FDA ti\u1ebfp t\u1ee5c ch\u1ea5p thu\u1eadn vaccine RSV \u0111\u1ea7u ti\u00ean cho ph\u1ee5 n\u1eef mang thai [2]<\/sup>.<\/p>\n\n\n\n

Vaccine RSV m\u1edbi RSVPreF3 cho m\u1eb9<\/strong><\/h2>\n\n\n\n

M\u1ed9t vaccine ph\u00f2ng ng\u1eeba RSV m\u1edbi \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u cho ch\u1ec9 \u0111\u1ecbnh \u1edf ph\u1ee5 n\u1eef mang thai – RSVPreF3-Mat. Th\u1eed nghi\u1ec7m pha 3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u l\u1ef1c v\u00e0 t\u00ednh an to\u00e0n c\u1ee7a vaccine n\u00e0y \u1edf ph\u1ee5 n\u1eef mang thai v\u1eeba \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 tr\u00ean t\u1ea1p ch\u00ed The New England Journal of Medicine. <\/em>Ph\u1ee5 n\u1eef mang thai tham gia nghi\u00ean c\u1ee9u c\u00f3 \u0111\u1ed9 tu\u1ed5i 18 \u2013 49. T\u1ed5ng c\u1ed9ng c\u00f3 5328 ph\u1ee5 n\u1eef mang thai (v\u1edbi 5233 nh\u0169 nhi) \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean v\u1edbi t\u1ef7 l\u1ec7 2:1 \u0111\u1ec3 \u0111\u01b0\u1ee3c ti\u00eam vaccine ph\u00f2ng ng\u1eeba RSV ho\u1eb7c gi\u1ea3 d\u01b0\u1ee3c trong th\u1eddi gian t\u1eeb t\u1eeb 24 tu\u1ea7n \u2013 34 tu\u1ea7n thai. Ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u l\u00e0 b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi li\u00ean quan \u0111\u1ebfn RSV \u1edf nh\u0169 nhi < 6 th\u00e1ng tu\u1ed5i v\u00e0 t\u00ednh an to\u00e0n \u1edf nh\u0169 nhi < 12 th\u00e1ng tu\u1ed5i.<\/p>\n\n\n\n

K\u1ebft qu\u1ea3 cho th\u1ea5y c\u00f3 l\u1ea7n l\u01b0\u1ee3t 0.46% v\u00e0 1.4% nh\u0169 nhi m\u1eafc b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi li\u00ean quan \u0111\u1ebfn RSV \u1edf nh\u00f3m m\u1eb9 \u0111\u01b0\u1ee3c ph\u00f2ng ng\u1eeba RSV b\u1eb1ng vaccine RSV v\u00e0 gi\u1ea3 d\u01b0\u1ee3c (hi\u1ec7u l\u1ef1c vaccine 65.5%). T\u1ef7 l\u1ec7 nh\u0169 nhi m\u1eafc b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi nghi\u00eam tr\u1ecdng li\u00ean quan \u0111\u1ebfn RSV \u1edf 2 nh\u00f3m RSV vaccine v\u00e0 gi\u1ea3 d\u01b0\u1ee3c l\u1ea7n l\u01b0\u1ee3t l\u00e0 0.23% v\u00e0 0.82% (hi\u1ec7u l\u1ef1c vaccine 69.0%). Nghi\u00ean c\u1ee9u cho th\u1ea5y vaccine ph\u00f2ng ng\u1eeba RSV \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 hi\u1ec7u l\u1ef1c. Tuy nhi\u00ean, t\u1ef7 l\u1ec7 sinh non cao h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m m\u1eb9 \u0111\u01b0\u1ee3c ti\u00eam vaccine RSV h\u01a1n nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c [3]<\/sup>. C\u1ee5 th\u1ec3 l\u00e0 6.8% v\u00e0 4.9%. Ngo\u00e0i ra, t\u1ef7 l\u1ec7 t\u1eed vong \u1edf tr\u1ebb s\u01a1 sinh cao h\u01a1n \u1edf nh\u00f3m m\u1eb9 \u0111\u01b0\u1ee3c ph\u00f2ng ng\u1eeba b\u1eb1ng vaccine RSV so v\u1edbi nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c (0.4% v\u00e0 0.2%), tuy nhi\u00ean, s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a. Do v\u1eady, c\u00f4ng t\u00e1c ph\u00e1t tri\u1ec3n vaccine RSVPreF3-Mat \u0111\u00e3 b\u1ecb ng\u01b0ng.<\/p>\n\n\n\n

Trong d\u00e2n s\u1ed1 nghi\u00ean c\u1ee9u, s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 sinh non gi\u1eefa nh\u00f3m vaccine RSV v\u00e0 gi\u1ea3 d\u01b0\u1ee3c \u0111\u01b0\u1ee3c quan s\u00e1t gi\u1eefa c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp th\u1ea5p \u2013 trung b\u00ecnh v\u00e0 c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp cao. C\u1ee5 th\u1ec3 t\u1ef7 l\u1ec7 sinh non \u1edf qu\u1ed1c gia c\u00f3 thu nh\u1eadp th\u1ea5p \u2013 trung b\u00ecnh cao h\u01a1n so v\u1edbi qu\u1ed1c gia c\u00f3 thu nh\u1eadp cao, tuy nhi\u00ean, s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a. \u0110\u1ed3ng th\u1eddi, s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y gi\u1eef c\u00e1c nh\u00f3m qu\u1ed1c gia v\u1ec1 t\u1ef7 l\u1ec7 sinh non c\u0169ng \u0111\u01b0\u1ee3c quan s\u00e1t trong th\u1eddi k\u1ef3 \u0111\u1eb7c bi\u1ec7t, v\u1edbi s\u1ef1 kh\u00e1c bi\u1ec7t cao nh\u1ea5t \u0111\u01b0\u1ee3c quan s\u00e1t trong giai \u0111o\u1ea1n b\u00f9ng ph\u00e1t c\u1ee7a bi\u1ebfn th\u1ec3 SARS-CoV-2 B.1.617.2 (delta). Tuy nhi\u00ean, m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa sinh non v\u00e0 nhi\u1ec5m SARS-CoV \u1edf ph\u1ee5 n\u1eef mang thai kh\u00f4ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh.<\/p>\n\n\n\n

Si\u00eau \u00e2m trong th\u1eddi k\u1ef3 tam c\u00e1 nguy\u1ec7t \u0111\u1ea7u ti\u00ean l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh x\u00e1c nh\u1ea5t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh tu\u1ed5i thai. C\u00f3 t\u1edbi 45% ph\u1ee5 n\u1eef mang thai trong nghi\u00ean c\u1ee9u kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m x\u00e9t nghi\u00eam n\u00e0y, d\u1eabn \u0111\u1ebfn sinh non. Tuy nhi\u00ean, ph\u00e2n lo\u1ea1i sai tu\u1ed5i thai c\u00f3 kh\u1ea3 n\u0103ng x\u1ea3y ra \u1edf c\u1ea3 2 nh\u00f3m ti\u00eam vaccine RSV v\u00e0 gi\u1ea3 d\u01b0\u1ee3c, do v\u1eady, x\u00e1c \u0111\u1ecbnh sai tu\u1ed5i thai kh\u00f4ng \u0111\u01b0\u1ee3c xem l\u00e0 nguy\u00ean nh\u00e2n cho s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 sinh non gi\u1eefa 2 nh\u00f3m nghi\u00ean c\u1ee9u.<\/p>\n\n\n\n

S\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa vaccine RSVPreF3 v\u00e0 vaccine \u0111\u00e3 \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn<\/strong><\/h2>\n\n\n\n

Vaccine \u0111\u00e3 \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn l\u00e0 vaccine RSV nh\u1ecb gi\u00e1 v\u00e0 RSVPreF3 l\u00e0 vaccine \u0111\u01a1n gi\u00e1, c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m c\u00f2n l\u1ea1i c\u1ee7a 2 vaccine l\u00e0 t\u01b0\u01a1ng t\u1ef1 nhau. Vaccine RSV nh\u1ecb gi\u00e1 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u qua th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha 3, \u1edf ph\u1ee5 n\u1eef mang thai trong th\u1eddi gian t\u1eeb tu\u1ea7n thai 24 \u2013 36. Trong 6 th\u00e1ng \u0111\u1ea7u ti\u00ean sau sinh, hi\u1ec7u l\u1ef1c c\u1ee7a vaccine \u0111\u01b0\u1ee3c quan s\u00e1t l\u00e0 69.4% \u0111\u1ed1i v\u1edbi b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi nghi\u00eam tr\u1ecdng li\u00ean quan \u0111\u1ebfn RSV [4]<\/sup>. T\u1ef7 l\u1ec7 sinh non \u1edf nh\u00f3m vaccine RSV v\u00e0 gi\u1ea3 d\u01b0\u1ee3c l\u1ea7n l\u01b0\u1ee3t l\u00e0 5.7% v\u00e0 4.7% (kh\u00e1c bi\u1ec7t kh\u00f4ng c\u00f3 \u00fd ngh\u0129a). \u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p sinh non \u0111\u1ec1u x\u1ea3y ra mu\u1ed9n (tu\u1ea7n thai 34 – < 37) v\u00e0 x\u1ea3y ra sau 30 ng\u00e0y k\u1ec3 t\u1eeb khi ti\u00eam vaccine. Lo ng\u1ea1i v\u1ec1 v\u1ea5n \u0111\u1ec1 sinh non, FDA khuy\u1ebfn c\u00e1o ch\u1ec9 \u0111\u1ecbnh cho vaccine ph\u00f2ng ng\u1eeba RSV nh\u1ecb gi\u00e1 cho ph\u1ee5 n\u1eef mang thai trong tu\u1ea7n thai 32 \u2013 36 tu\u1ea7n l\u1ebb 6 ng\u00e0y.<\/p>\n\n\n\n

B\u00e0n lu\u1eadn<\/strong><\/h2>\n\n\n\n

B\u1eb1ng ch\u1ee9ng an to\u00e0n c\u1ee7a vaccine RSVPreF3 \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m ch\u1ee9ng qua ph\u00e2n t\u00edch h\u1eadu ki\u1ec3m, tuy nhi\u00ean nh\u00f3m nghi\u00ean c\u1ee9u v\u1eabn ch\u01b0a th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u01a1 ch\u1ebf d\u1eabn \u0111\u1ebfn sinh non \u1edf nh\u00f3m ti\u00eam ph\u00f2ng vaccine RSVPreF3. Tuy nhi\u00ean, k\u1ec3 c\u1ea3 \u0111\u1ed1i v\u1edbi vaccine RSVPreF3 hay vaccine RSV nh\u1ecb gi\u00e1, lu\u00f4n c\u00f3 s\u1ef1 ch\u00eanh l\u1ec7ch v\u1ec1 t\u1ef7 l\u1ec7 sinh non gi\u1eefa nh\u00f3m ph\u00f2ng ng\u1eeba b\u1eb1ng vaccine RSV v\u00e0 gi\u1ea3 d\u01b0\u1ee3c. Do v\u1eady, c\u1ea7n \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 khi ti\u00eam ph\u00f2ng RSV cho ph\u1ee5 n\u1eef mang thai [5]<\/sup>.<\/p>\n\n\n\n

\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h3>\n\n\n\n
    \n
  1. Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022;399:2047-64<\/li>\n\n\n\n
  2. Fleming-Dutra KE, Jones JM, Roper LE, et al. Use of the Pfizer respiratory syncytial virus vaccine during pregnancy for the prevention of respiratory syncytial virus-associated lower respiratory tract disease in infants: recommendations of the Advisory Committee on Immunization Practices \u2014 United States, 2023. MMWR Morb Mortal Wkly Rep 2023;72:1115-22.<\/li>\n\n\n\n
  3. Dieussaert I, Hyung Kim J, Luik S, Seidl C, Pu W, Stegmann JU, Swamy GK, Webster P, Dormitzer PR. RSV Prefusion F Protein-Based Maternal Vaccine – Preterm Birth and Other Outcomes. N Engl J Med. 2024 Mar 14;390(11):1009-1021. doi: 10.1056\/NEJMoa2305478.<\/li>\n\n\n\n
  4. Kampmann B, Radley D, Munjal I. Bivalent prefusion F vaccine in pregnancy to prevent RSV illness in infants. N Engl J Med 2023;389:1053-5<\/li>\n\n\n\n
  5. Rasmussen SA, Jamieson DJ. Maternal RSV Vaccine – Weighing Benefits and Risks. N Engl J Med. 2024 Mar 14;390(11):1050-1051. doi: 10.1056\/NEJMe2401072. PMID: 38477994.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Virus h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (Respiratory Syncytial Virus \u2013 RSV) g\u00e2y ra nhi\u1ec1u g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt cho nh\u0169 nhi. \u01af\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 1.4 tri\u1ec7u nh\u0169 nhi < 6 th\u00e1ng tu\u1ed5i ph\u1ea3i nh\u1eadp vi\u1ec7n li\u00ean quan \u0111\u1ebfn RSV, trong \u0111\u00f3 c\u00f3 t\u1edbi 45,700 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong.<\/p>\n","protected":false},"author":123,"featured_media":35942,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1437],"articles_languages":[1375],"articles_filters":[],"class_list":["post-35849","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/35849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=35849"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/35849\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/35942"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=35849"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=35849"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=35849"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=35849"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=35849"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=35849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}