Weerasekera Deepal S, Fernanado Sirimalee, Weerasekera Manjula M
Faculty of Medical Sciences, University of Sri Jayawardenepura, Nugegoda.
Ceylon Med J. 2003 Jun;48(2):51-3.
To determine the susceptibility to rubella infection in early pregnancy and the incidence of seropositivity of cord blood for rubella specific IgM among the newborn babies at Colombo South Teaching Hospital.
1000 cord blood samples and 500 maternal blood samples from pregnant women before the 16th week of gestation were taken from the labour room and the antenatal clinic of the University Unit, Colombo South Teaching Hospital during the period of February 1999 to February 2001. These samples were tested for rubella specific IgM and IgG antibodies by ELISA. A detailed questionnaire was filled during the time of sampling.
Of the 500 antenatal blood samples 82% were positive for rubella specific IgG. 373(75%) women gave a history of vaccination against rubella before their present pregnancy. Among the vaccinated 2(0.5%) were negative for IgG antibodies by ELISA. Out of 127 unvaccinated women 12(9%) gave a history of past infection with rubella and of this 3(25%) were seronegative for rubella specific IgG. 18% of pregnant women at 16 weeks of gestation were at risk of giving birth to a baby with congenital rubella syndrome. Among the tested 1000 cord blood samples three were seropositive (0.3%) for rubella specific IgM.
A significant proportion of pregnant women were susceptible to rubella infection in the studied population. The present strategy of selective rubella vaccination should be reconsidered if we are to get closer to eliminating rubella syndrome in Sri Lanka.
确定科伦坡南部教学医院早孕妇女对风疹感染的易感性以及新生儿脐带血风疹特异性IgM血清阳性率。
1999年2月至2001年2月期间,从科伦坡南部教学医院大学部产房和产前诊所采集了1000份脐带血样本和500份妊娠16周前孕妇的母血样本。通过酶联免疫吸附测定法(ELISA)检测这些样本中的风疹特异性IgM和IgG抗体。采样时填写了一份详细问卷。
500份产前血样本中,82%风疹特异性IgG呈阳性。373名(75%)妇女有本次妊娠前接种风疹疫苗的病史。在接种过疫苗的妇女中,2名(0.5%)ELISA检测IgG抗体呈阴性。在127名未接种疫苗的妇女中,12名(9%)有既往风疹感染史,其中3名(25%)风疹特异性IgG血清学阴性。妊娠16周时18%的孕妇有生出先天性风疹综合征患儿的风险。在检测的1000份脐带血样本中,3份风疹特异性IgM血清阳性(0.3%)。
在研究人群中,相当比例的孕妇对风疹感染易感。如果我们要在斯里兰卡更接近消除风疹综合征,应重新考虑目前的选择性风疹疫苗接种策略。