Abstract
This study examines associations between geographic origin and risk for congenital infections, through a chart review of women from the St. James Town area of Toronto delivering at Wellesley Hospital in 1996. Foreign-born women (n=203) were significantly less likely than Canadian-born women (n=53) to be HBsAg negative (187/193 vs. 48/48; RR=0.97, 95%CI 0.94–0.99). There was no significant difference in rubella seronegativity, but rubella immunity was unacceptably low in both groups (less than 90%). A number of rubella non-immune women had delivered previously in Canada. Procedures must be implemented to ensure completion of hepatitis B immunization series in affected newborns, and rubella immunization in seronegative women prior to discharge. As well, updating immunization status must become a routine part of the immigration medical examination.
Résumé
Cette étude examine les liens entre l’origine géographique et le risque d’infections congénitales à partir de l’examen des dossiers de femmes de St James Town de Toronto ayant accouché à l’hôpital Wellesley en 1996. Les femmes nées à l’étranger (n = 203) avaient une beaucoup plus faible probabilité que les femmes nées au Canada (n = 53) d’être séronégatives à l’antigène de surface de l’hépatite B (187/193 par rapport à 48/48; RR = 0,97, 95 % IC 0,94–0,99). Il n’y avait pas de différence significative dans la séronégativité à la rubéole, mais la faiblesse du taux d’immunité contre la rubéole était inacceptable pour les deux groupes (moins de 90 %). Plusieurs femmes non vaccinées contre la rubéole avaient déjà donné naissance à des enfants au Canada. Des mesures doivent être mises en place pour s’assurer que les nouveau-nés concernés reçoivent toute la série de vaccins contre l’hépatite B, et que toutes les femmes séronégatives soient vaccinées contre la rubéole avant leur sortie de la maternité. La mise à jour des vaccinations doit aussi faire partie intégrante de l’examen médical exigé par les procédures d’immigration.
Footnotes
The first two authors listed should be considered jointly as “first author”. This research was conducted while these authors were completing the requirements of the Family Medicine Residency Program at the Wellesley Central Hospital, University of Toronto
Funded in part by a grant from the Bureau of Reproductive and Child Health, Health Canada
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