Department of Pediatric Infectious Diseases, School of Medicine, Hospital de Niños "Ricardo Gutiérrez," University of Buenos Aires, Argentina.
National Reference Center, Anlis Instituto Nacional de Microbiología Dr. C. Malbran, Buenos Aires, Argentina.
J Pediatric Infect Dis Soc. 2018 Feb 19;7(1):11-17. doi: 10.1093/jpids/piw069.
Morbidity and mortality rates for pertussis in infants are high because disease often occurs before the onset of routine immunization or in those who do not complete a primary immunization series. Pertussis immunization is recommended during pregnancy to achieve antibody levels sufficient to protect young infants. To our knowledge, no previous reports of maternal pertussis immunization results in Latin America exist in the literature.
This study compared pertussis antibody levels in newborns from mothers who received or did not receive a tetanus-diphtheria-acellular pertussis vaccination (TdapV) during pregnancy. Each mother's level of immunoglobulin G antibodies against pertussis toxin (IgG-PT) was measured with a validated, specific enzyme-linked immunosorbent assay (ELISA).
Paired mother and cord serum samples were compared in 105 mothers with and 99 mothers without a TdapV. At birth, the mothers with and those without a TdapV had serum IgG-PT geometric mean concentrations (GMCs) of 35.1 and 9.8 ELISA units (EU)/mL, respectively (P < .0001); cord blood GMCs were 51.3 and 11.6 EU/mL, respectively (P < .0003); and cord blood IgG-PT levels were <5 EU/mL in 2.9% and 16.1% of the cord blood samples, respectively (P < .001). The mothers received their TdapV at a mean (± standard deviation [SD]) of 24.7 ± 4.8 weeks' gestation. Vaccination timing did not affect the IgG-PT GMC at birth. Placental antibody transference efficiencies (measured as the ratio of the cord blood GMC to the maternal GMC) were 1.46 and 1.18 for mothers with and those without a TdapV, respectively. The IgG-PT GMCs were 17.7 EU/mL in 36 infants in their first month of life and 11.6 EU/mL in 32 infants in their second month of life.
Women who received a TdapV during pregnancy had significantly a higher serum/cord IgG-PT concentration at birth than mothers who did not receive a TdapV. Timing of the immunization was not correlated with antibody concentrations. Infants born to immunized mothers had significantly higher antibody levels during their first 2 months of life.
婴儿百日咳的发病率和死亡率很高，因为该病通常在常规免疫接种开始之前发生，或者发生在未完成初级免疫接种系列的人群中。为了使婴幼儿获得足够保护其免受疾病侵袭的抗体水平，推荐孕妇在孕期接种百日咳疫苗。据我们所知，在之前的文献中尚无有关拉丁美洲孕妇接种百日咳疫苗的结果的报告。
本研究比较了在孕期接种和未接种破伤风类毒素、白喉类毒素和无细胞百日咳疫苗（TdapV）的母亲所生新生儿的百日咳抗体水平。使用经验证的特异性酶联免疫吸附测定（ELISA）法检测每位母亲针对百日咳毒素（IgG-PT）的免疫球蛋白 G 抗体（IgG-PT）水平。
在 105 名接受 TdapV 接种的母亲和 99 名未接受 TdapV 接种的母亲中，比较了配对的母亲和脐血血清样本。出生时，接受 TdapV 接种的母亲和未接受 TdapV 接种的母亲的血清 IgG-PT 几何平均浓度（GMC）分别为 35.1 和 9.8 ELISA 单位（EU）/mL（P<0.0001）；脐血 GMC 分别为 51.3 和 11.6 EU/mL（P<0.0003）；分别有 2.9%和 16.1%的脐血样本 IgG-PT 水平<5 EU/mL（P<0.001）。母亲们在妊娠 24.7±4.8 周时平均（±标准差 [SD]）接受了 TdapV 接种。疫苗接种时间对出生时的 IgG-PT GMC 无影响。胎盘抗体转移效率（以脐血 GMC 与母体 GMC 的比值表示）分别为接受 TdapV 接种的母亲和未接受 TdapV 接种的母亲的 1.46 和 1.18。36 名出生后第一个月婴儿的 IgG-PT GMC 为 17.7 EU/mL，32 名出生后第二个月婴儿的 IgG-PT GMC 为 11.6 EU/mL。
在孕期接受 TdapV 接种的母亲，其新生儿在出生时血清/脐血 IgG-PT 浓度明显高于未接受 TdapV 接种的母亲。免疫接种时间与抗体浓度无关。母亲接种疫苗的婴儿在出生后前 2 个月的抗体水平显著升高。
