Hofstra University-Northwell Health System-Staten Island University Hospital, Staten Island, and Rochester General Hospital, Research Institute, Center for Infectious Diseases and Immunology, Rochester, New York.
Obstet Gynecol. 2018 Feb;131(2):364-369. doi: 10.1097/AOG.0000000000002438.
To compare pertussis antibody concentrations in maternal venous serum (at the time of delivery) and umbilical cord arterial serum among women vaccinated with the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine from either 27-30 6/7 weeks of gestation or from 31-35 6/7 weeks of gestation.
We conducted a prospective cohort study of pregnant women divided into two groups based on when Tdap was administered: 27-30 6/7 weeks of gestation and 31-35 6/7 weeks of gestation. Paired maternal and umbilical cord samples were obtained at the time of delivery to determine immunoglobulin G (IgG) concentrations to pertussis toxin and pertactin.
Eighty-eight pregnant women were enrolled. Cord serum pertussis toxin IgG concentrations were approximately twice maternal serum pertussis toxin IgG concentrations (91.6 vs 48.6 enzyme-linked immunoassay [ELISA] units/mL, P<.01) and were significantly correlated (Pearson correlation coefficient=0.85, P<.01). There was no significant difference in maternal serum pertussis toxin IgG concentrations (48.6 vs 48.6 ELISA units/mL, P=.99), cord serum pertussis toxin IgG concentrations (92.1 vs 90.7 ELISA units/mL, P=.95), and cord serum pertactin IgG concentrations (798 vs 730 international units/mL, P=.73) between the two groups. Furthermore, there was no correlation between time from vaccination to delivery and these three parameters. Cord serum pertussis toxin IgG concentrations were greater than 10 ELISA units/mL (ie, in the protective range) in 87% and 97% of those vaccinated from 27-30 6/7 weeks of gestation and from 31-35 6/7 weeks of gestation, respectively (P=.13).
Maternal vaccination against pertussis between 27 and 36 weeks of gestation was associated with a high percentage of newborns with antibody concentrations conferring protection and did not vary by gestational age at vaccination.
比较在妊娠 27-30 6/7 周或 31-35 6/7 周时接受破伤风类毒素、白喉类毒素和无细胞百日咳（Tdap）疫苗接种的孕妇，其脐动脉血清（分娩时）与母静脉血清中的百日咳抗体浓度。
我们对孕妇进行了一项前瞻性队列研究，根据 Tdap 接种时间将孕妇分为两组：27-30 6/7 周和 31-35 6/7 周。分娩时采集配对的母血和脐血样本，以确定针对百日咳毒素和 pertactin 的免疫球蛋白 G（IgG）浓度。
共纳入 88 名孕妇。脐血清百日咳毒素 IgG 浓度约为母血清百日咳毒素 IgG 浓度的两倍（91.6 与 48.6 酶联免疫吸附试验[ELISA]单位/mL，P<.01），且呈显著相关（Pearson 相关系数=0.85，P<.01）。两组间母血清百日咳毒素 IgG 浓度（48.6 与 48.6 ELISA 单位/mL，P=.99）、脐血清百日咳毒素 IgG 浓度（92.1 与 90.7 ELISA 单位/mL，P=.95）和脐血清 pertactin IgG 浓度（798 与 730 国际单位/mL，P=.73）均无显著差异。此外，从疫苗接种到分娩的时间与这三个参数均无相关性。在妊娠 27-30 6/7 周和 31-35 6/7 周接受疫苗接种的孕妇中，分别有 87%和 97%的脐血清百日咳毒素 IgG 浓度大于 10 ELISA 单位/mL（即处于保护范围内）（P=.13）。
妊娠 27 周至 36 周时母亲接种百日咳疫苗与新生儿抗体浓度具有保护作用的比例较高有关，且与疫苗接种时的胎龄无关。
