Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Disease Epidemiology and Control, 615 North Wolfe Street, Baltimore, MD 21205, USA.
University of Washington, Seattle Children's Hospital, 4800 Sand Point Way NE MA 7.234, Seattle, WA 98105, USA.
Vaccine. 2017 Dec 4;35(48 Pt B):6766-6773. doi: 10.1016/j.vaccine.2017.09.074. Epub 2017 Oct 14.
Infants are at greatest risk for pertussis morbidity and mortality. Maternal vaccination during pregnancy has been shown to prevent pertussis in young infants in high- and middle-income countries. However, data on the levels of maternal pertussis antibodies and the efficiency of transplacental transfer in low-income South Asian settings are limited.
To estimate the prevalence of maternal pertussis antibodies and the efficiency of transplacental transfer in rural southern Nepal.
DESIGN/METHODS: Paired maternal-infant blood samples were collected from a subsample of participants in a randomized, controlled trial of maternal influenza immunization (n=291 pairs). Sera were tested by enzyme-linked immunosorbent assays for pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae. Maternal and infant pertussis antibody levels and transplacental transfer efficiency were determined and potential factors associated with both were assessed.
Elevated maternal antibodies to pertussis toxin, suggesting recent pertussis infection, were rarely detected (4%, tested n=305). However, paired maternal-cord sera were highly correlated across all antibodies; transplacental antibody transfer ratios for pertussis toxin were 1.14 (n=291, 95% CI 1.07-1.20); filamentous hemagglutinin 1.10 (n=120, 95% CI: 1.01-1.20); fimbriae 2/3 1.05 (n=120, 95% CI: 0.96-1.15) and pertactin 0.96 (n=289, 95% CI: 0.91-1.00). Older gestational age was associated with increased pertussis toxin and decreased fimbriae 2/3 antibody transport.
A low prevalence of maternal antibody to all four pertussis antigens was noted in Nepal, but transplacental antibody transfer was efficient. No consistent demographic factors were associated with elevated maternal antibody levels or efficiency of transplacental transfer. If an increase in infant pertussis disease burden was detected in this population, maternal immunization could be an effective intervention to prevent disease in early infancy.
婴儿患百日咳的发病率和死亡率最高。在高收入和中等收入国家，母亲在怀孕期间接种疫苗已被证明可以预防婴儿患百日咳。然而，在低收入南亚地区，关于母体百日咳抗体水平和胎盘转移效率的数据有限。
估计尼泊尔南部农村地区母体百日咳抗体的流行率和胎盘转移效率。
设计/方法：从母亲流感免疫接种随机对照试验的亚组参与者中采集了配对的母婴血液样本（n=291 对）。通过酶联免疫吸附试验检测血清中百日咳毒素、丝状血凝素、 pertactin 和菌毛的抗体。确定了母体和婴儿的百日咳抗体水平和胎盘转移效率，并评估了与两者相关的潜在因素。
很少检测到提示近期百日咳感染的母体百日咳毒素抗体升高（4%，检测 n=305）。然而，所有抗体的配对母婴血清均高度相关；百日咳毒素的胎盘抗体转移比为 1.14（n=291，95%置信区间 1.07-1.20）；丝状血凝素 1.10（n=120，95%置信区间：1.01-1.20）；菌毛 2/3 1.05（n=120，95%置信区间：0.96-1.15）和 pertactin 0.96（n=289，95%置信区间：0.91-1.00）。较大的胎龄与增加的百日咳毒素和减少的菌毛 2/3 抗体转运有关。
在尼泊尔，母体对所有四种百日咳抗原的抗体流行率较低，但胎盘抗体转移效率较高。没有一致的人口统计学因素与母体抗体水平升高或胎盘转移效率相关。如果在该人群中发现婴儿百日咳疾病负担增加，那么母体免疫接种可能是预防婴儿早期疾病的有效干预措施。
