The effect of timing of maternal tetanus, diphtheria, and acellular pertussis (Tdap) immunization during pregnancy on newborn pertussis antibody levels - A prospective study
The effect of timing of maternal tetanus, diphtheria, and acellular pertussis (Tdap) immunization during pregnancy on newborn pertussis antibody levels - A prospective study
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DOI：
10.1016/j.vaccine.2014.08.038
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发表时间：
2014-10-07
期刊：
影响因子：
5.5
通讯作者：
Bamberger, Ellen
中科院分区：
文献类型：
--
作者：
Abu Raya, Bahaa;Srugo, Isaac;Bamberger, Ellen
背景：疾病控制和预防中心建议在怀孕期间接种Tdap，目的：探讨孕期母体Tdap免疫是否存在对新生儿产生最高浓度的百日咳特异性抗体的优选期。方法：本前瞻性研究测定了61例妊娠20周后接种Tdap的孕妇配对脐带血清中的百日咳特异性抗体。结果：孕周27-30(+6)周(n=21)的新生儿脐带血清中免疫球蛋白G(Ig G)和百日咳毒素(PT)的几何平均浓度(GMC)高于31-36周(n=30)和GT；36周(n=7)，46.04国际单位/毫升(95%CI，24.29-87.30)对8.69IU/mL(95%CI，3.66-20.63)和21.12IU/mL(95%CI，7.93-56.22)，p<；0.02。免疫后27~30(+6)周的新生儿脐带血清中抗丝状血凝素(FHA)的GMCs高于31~36周和36周，分别为225.86 IU/mL(95%CI，182.34~279.76)和178.31 IU/mL(95%CI，134.59~237.03)和138.03 IU/mL(95%CI，97.61~195.16)，p<；结论：孕周在27~30周(+6周)的孕妇接种Tdap后，脐血中抗PT和FHA的抗体水平最高，而孕周在31周以上的孕妇接种Tdap的孕妇血清中抗PT和FHA的抗体水平最高。应该进行进一步的研究来重申这些发现，以促进最佳的百日咳控制政策。(C)2014爱思唯尔有限公司。保留所有权利。
Background: The Centers for Disease Control and Prevention recommend Tdap immunization during pregnancy, preferably at 27-36 weeks.Aim: To ascertain whether there is a preferential period of maternal Tdap immunization during pregnancy that provides the highest concentration of pertussis-specific antibodies to the newborn.Methods: This prospective study measured pertussis-specific antibodies in paired maternal-cord sera of women immunized with Tdap after the 20th week of their pregnancy (n = 61).Results: The geometric mean concentrations (GMCs) of Immunoglobulin G (IgG) to pertussis toxin (PT) were higher in the newborns' cord sera when women were immunized at 27-30(+6) weeks (n = 21) compared with 31-36 weeks (n = 30) and >36 weeks (n = 7), 46.04 international units/milliliter (IU/mL) (95% CI, 24.29-87.30) vs. 8.69 IU/mL (95% CI, 3.66-20.63) and 21.12 IU/mL (95% CI, 7.93-56.22), p < 0.02, respectively. The umbilical cord GMCs of IgG to filamentous hemagglutinin (FHA) were higher in the newborns' cord sera when women were immunized at 27-30(+6) weeks compared with 31-36 weeks and >36 weeks, 225.86 IU/mL (95% Cl, 182.34-279.76) vs. 178.31 IU/mL (95% CI, 134.59-237.03) and 138.03 IU/mL (95% CI, 97.61-195.16), p < 0.02, respectively.Conclusions: Immunization of pregnant women with Tdap between 27-30(+6) weeks was associated with the highest umbilical cord GMCs of IgG to PT and FHA compared with immunization beyond 31 weeks gestation. Further research should be conducted to reaffirm these finding in order to promote an optimal pertussis controlling policy. (C) 2014 Elsevier Ltd. All rights reserved.