Devecioğlu Esra, Gökçay Gülbin, Boran Perran, Eren Tijen, Yılmaz Gonca, Badur Selim
Istanbul University Faculty of Istanbul Medicine, Department of Pediatrics, Istanbul, Turkey.
Istanbul University Institute of Child Health, Social Pediatrics Unit, Istanbul, Turkey.
Mikrobiyol Bul. 2018 Jul;52(3):324-327. doi: 10.5578/mb.67169.
The protection of infants against infections during the first few months of life is provided mainly by maternal antibodies. The presence of maternal antibodies can decrease vaccine efficacy. The waning time of maternal antibodies shows variations therefore seroepidemiological studies are important for the development of vaccination schedules. Some recent studies showed that the maternal measles antibodies may disappear around 3 months of age especially in infants born from mothers who were vaccinated. There are few cross-sectional studies from Turkey evaluating the maternal antibody levels of infants against measles in recent years. The aim of this prospective, multicentre study is to evaluate the seropositivity of measles, rubella, mumps, and varicella in mothers and their infants at 1 and 6 months after birth. The study was carried out at the Social Pediatrics Units of two university hospitals, a private hospital and a state hospital. The exclusion criteria were known impaired immune system or immune deficiency disorder in mother or child, preterm delivery (< 37 gestational week), administration of immunoglobulins or any blood products before admission or during the follow-up period, and history of vaccination or exposure to one of these diseases during the study period. The final analysis encompassed 209 mother-infant pairs. Blood samples were collected 1 month after birth from mothers and 1 and 6 months after birth from their babies. Antibody levels were determined by ELISA (Enzyme-Linked ImmunoSorbent Assay) method. Information on the socio-economic and demographic characteristics of the families were collected by a face-to-face questionnaire. Seropositivity was found as 95.7%, 92.8%, 92.8% and 96.7% for measles, mumps, rubella and varicella (MMRV) respectively. Majority of infants lost maternal antibodies at 6 months of age. Of all 6 month-old infants 25% were seropositive for measles,14.6% for mumps, 23.2% for rubella and 17.1% for varicella. The proportion of seropositive infants born from seropositive mothers was higher than those born from seronegative mothers for all four diseases. This difference was statistically significant only at 1 month of age (p= 0.001). Our study showed that maternal antibodies against MMRV decreased rapidly by 6 months of age therefore necessary measures should be taken to close this gap between the loss of maternal protection and the vaccination of infants for MMRV. As the epidemiology of the diseases changes in time, it is important to carry out such studies with large series in different countries and settings. Important results were determined in our study within this respect.
婴儿在出生后的头几个月对感染的保护主要由母体抗体提供。母体抗体的存在会降低疫苗效力。母体抗体的消退时间存在差异，因此血清流行病学研究对于制定疫苗接种计划很重要。最近的一些研究表明，母体麻疹抗体可能在3个月龄左右消失，尤其是在母亲接种过疫苗的婴儿中。近年来，土耳其很少有横断面研究评估婴儿针对麻疹的母体抗体水平。这项前瞻性多中心研究的目的是评估母亲及其婴儿在出生后1个月和6个月时麻疹、风疹、腮腺炎和水痘的血清阳性率。该研究在两家大学医院、一家私立医院和一家国立医院的社会儿科病房进行。排除标准为已知母亲或儿童免疫系统受损或免疫缺陷疾病、早产（孕周<37周）、入院前或随访期间使用免疫球蛋白或任何血液制品，以及研究期间有疫苗接种史或接触过这些疾病之一。最终分析纳入了209对母婴。在母亲产后1个月以及婴儿产后1个月和6个月采集血样。通过酶联免疫吸附测定（ELISA）法测定抗体水平。通过面对面问卷调查收集家庭的社会经济和人口统计学特征信息。麻疹、腮腺炎、风疹和水痘（MMRV）的血清阳性率分别为95.7%、92.8%、92.8%和96.7%。大多数婴儿在6个月龄时失去了母体抗体。在所有6个月大的婴儿中，25%的婴儿麻疹血清呈阳性，14.6%的婴儿腮腺炎血清呈阳性，23.2%的婴儿风疹血清呈阳性，17.1%的婴儿水痘血清呈阳性。对于所有四种疾病，血清阳性母亲所生血清阳性婴儿的比例高于血清阴性母亲所生婴儿。这种差异仅在1个月龄时具有统计学意义（p=0.001）。我们的研究表明，针对MMRV的母体抗体在6个月龄时迅速下降，因此应采取必要措施来弥合母体保护丧失与婴儿MMRV疫苗接种之间的差距。随着疾病流行病学随时间变化，在不同国家和环境中开展此类大规模研究很重要。在这方面，我们的研究确定了重要结果。
