Çocuk/Adolesan Gebelikler ve İnfluenza Enfeksiyonları

Year 2014, Volume: 12 Issue: 1, 31 - 36, 01.06.2014

Ahmet Gülen Mustafa Hacımustafaoğlu

Abstract

Bu yazıda ülkemizde çocuk/adolesan gebeliklere genel bakış ile influenzanın klinik, bulaşma özelliklerinden ayrıca korunma ve tedavisinden bahsedilmesi amaçlanmıştır. Dünya Sağlık Örgütü DSÖ , 10-19 yaş grubunu ergen adolesan , olarak kabul eder. Türkiye’de 15-19 yaş arası evli çocuk/adolesan oranı %9,3 bildirilmiştir. Türkiye’de doğumların %9’u 15-19 yaşında olup, 15-19 yaş çocuk sahibi olma oranı ise 40/1000’dir. Çocuk/adolesan gebeliklerde doğum öncesi bakım, normal gebeliklere göre daha yetersiz olup doğum sonrası bebekte komplikasyon oranları da daha yüksek bulunmuştur. Çocuk/adolesan gebelerdeki influenza enfeksiyonları normal gebelerden esas olarak farklılık göstermez, ancak daha ağır hastalığa, daha fazla hastaneye yatışa ve daha yüksek oranda ölüme yol açar. Gebelerde influenza enfeksiyonu gebe annenin yanı sıra embriyo veya fetüsü ayrıca doğum sonrası yenidoğan bebeği de olumsuz etkileyebilir. Gebelikte influenza enfeksiyonunun embriyo ve fetüse etkileri iyi çalışılmamıştır. Aslında influenza virüsünün transplasental geçişi nadirdir, ancak doğum defektlerine yol açabilir. Gebede influenza enfeksiyonunun klinik bulguları ve tanısı diğer genel toplumda görülenlere benzerdir. Gebeye eğer endikasyon varsa influenzanın hem A, hem B profilaksi ve tedavisinde oseltamivir ve zanamivir verilir.Ancak aşılama influenza enfeksiyonundan korunmada tercih edilen en önemli korunma yoludur. Gebeye inaktif influenza aşısının gebe ve fetüs için artmış bir risk oluşturmadığı ve güvenli olduğu kabul edilir. Gebedeki grip aşılaması bir risk grubu olarak gebeyi, fetüsü ve ilk 6 aya kadar yenidoğan bebeği grip ve komplikasyonlarından koruyabilir. Ancak ülkemizde gebelerde aşılanma oranının %10’un altında olduğu tahmin edilmektedir

Keywords

Çocuk, adolesan, influenza, enfeksiyon

Childhood/Adolescent Pregnancies and Influenza Infections

Abstract

In this article, we aimed to review child/adolescent pregnancies in general, and the clinical and epidemiological features including prevention and management of influenza in these patients in our country. World Health Organization WHO defines the children between 10-19 years as adolescents. In Turkey, the rate of marriage in adolescent children aged between 15-19 years is 9.3%. Of the births, 9% are in ages between 15-19 years and the rate of birth in ages between 15- 19 years is 40/1000. The pre-birth health care of child/adolescent pregnancies is inadequate and the birth complications are higher than the normal pregnancies. The influenza infections in child/adolescent pregnancies are not different from the influenza infectionsin normal pregnancies, however it causes more severe diseases, higher rates of hospitalizations and higher mortality in pregnant women. During the pregnancy, influenza can affect mother, embryo or fetus as well as the newborn baby after the delivery. In pregnancy, the effects of influenza on embryo and fetus have not so far been extensively investigated. Transplasental viral transmission of the influenza is rare however it may cause birth defects. The clinical findings and diagnostic approaches in pregnancy are similar to normal population. Chemoprophylaxis or chemotherapy oseltamivir or zanamivir can be given to pregnant women when they are indicated for both influenza A or B. Vaccination is the preferred way of preventing influenza in pregnancy. Inactive influenza vaccine is safe and effective in every stage of pregnancy. Vaccination in pregnancy can prevent the mother, the fetus and the newborn baby up to 6 months from the complication of influenza. In Turkey the estimated vaccination rate in pregnancy is very low, which is less than 10%

Keywords

Child, ­adolescent, ­influenza, ­infection

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