Department of Paediatrics, Division of Neonatology, VU University Medical Center, Amsterdam.
Pediatr Infect Dis J. 2010 Sep;29(9):801-5. doi: 10.1097/inf.0b013e3181dc4f77.
Maternal antibodies, transported through the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. The aim of this study was to measure the concentration of antibodies against several vaccine-preventable diseases in paired maternal and cord blood serum samples in preterm and term infants and to assess placental transfer ratios and infant antibody concentrations against vaccine-preventable diseases.
Antibody concentrations specific against pertussis proteins (pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae), diphtheria and tetanus toxins, and antibody concentrations specific against polysaccharides from Haemophilus influenzae type b and Neisseria meningitidis serogroup C were measured in cord blood samples from preterm (<32 weeks and 1500 g) and term infants and maternal serum samples, using a fluorescent bead-based multiplex immunoassay.
A total of 96 preterm and 42 term infants and their mothers were included in the study. Placental transfer ratios of antibodies against all vaccine antigens were significantly lower in preterm infants (medians varied from 0.26 to 0.86) compared with term infants (medians, 0.74-1.89; all antibodies P < 0.05). Furthermore, polysaccharide-vaccine-specific antibodies showed lower transplacental transport ratios than protein-vaccine-specific antibodies. Maternal concentrations are the most important determinants of infant antibody concentrations against vaccine-preventable diseases.
Preterm infants benefit to a lesser extent from maternal antibodies against vaccine-preventable diseases than term infants, posing them at higher risk for infectious diseases in the first months of life.
母体抗体在怀孕期间通过胎盘转运,有助于保护婴儿在生命的头几个月免受传染病的侵害。本研究旨在测量早产儿和足月儿的配对母血和脐血血清样本中针对多种可通过疫苗预防的疾病的抗体浓度,并评估针对可通过疫苗预防的疾病的胎盘转运率和婴儿抗体浓度。
使用荧光珠基多重免疫分析法测量脐血样本中针对百日咳蛋白(百日咳毒素、丝状血凝素、 pertactin 和菌毛)、白喉和破伤风毒素以及针对 b 型流感嗜血杆菌和 C 群脑膜炎奈瑟菌多糖的特异性抗体浓度,以及母血清样本中的特异性抗体浓度。
本研究共纳入了 96 名早产儿和 42 名足月儿及其母亲。与足月儿(中位数为 0.74-1.89;所有抗体 P < 0.05)相比,早产儿针对所有疫苗抗原的抗体胎盘转运率明显较低(中位数为 0.26-0.86)。此外,多糖疫苗特异性抗体的胎盘转运率低于蛋白疫苗特异性抗体。母体浓度是婴儿针对可通过疫苗预防的疾病的抗体浓度的最重要决定因素。
与足月儿相比,早产儿从针对可通过疫苗预防的疾病的母体抗体中获益较少,使他们在生命的头几个月面临更高的传染病风险。