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Full length article| Volume 265, P212-216, October 2021

Pertussis antibody levels in infants and their mothers receiving combined tetanus-diphtheria toxoid and acellular pertussis vaccine during pregnancy in Turkey

  • Author Footnotes
    1 Present address: Ministry of Health, Balikesir Ataturk Training and Research Hospital, Balikesir, Turkey.
    Mine Ozdil
    Correspondence
    Corresponding author at: Bahcelievler Mh, Teknik Lise Cd, Ekin Sk, Ozdil8 Apt. No:79/5, Altieylul/Balikesir, Turkey.
    Footnotes
    1 Present address: Ministry of Health, Balikesir Ataturk Training and Research Hospital, Balikesir, Turkey.
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
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  • Cemile Sonmez
    Affiliations
    General Directorate of Public Health, Department of Microbiology Reference Laboratories and Biological Products, Vaccine Preventable Bacterial Diseases Serology Laboratory, Ankara, Turkey
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  • Murat Tugberk Bakar
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Public Health, Istanbul, Turkey
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  • Ebru Alici Davutoglu
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
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  • Riza Madazli
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
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  • Selcuk Kilic
    Affiliations
    General Directorate of Public Health, Department of Microbiology Reference Laboratories and Biological Products, Vaccine Preventable Bacterial Diseases Serology Laboratory, Ankara, Turkey
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  • Mehmet Vural
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
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  • Yildiz Perk
    Affiliations
    Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
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  • Author Footnotes
    1 Present address: Ministry of Health, Balikesir Ataturk Training and Research Hospital, Balikesir, Turkey.
Published:September 02, 2021DOI:https://doi.org/10.1016/j.ejogrb.2021.08.033

      Highlights

      • Twenty and 71 % of women had anti-PT IgG level >10 IU/ml before and after immunization.
      • Post-vaccination maternal and cord blood antibodies were higher than pre-vaccination.
      • Cord blood anti-PT IgG levels were higher if vaccinated 11 weeks and more before birth.
      • Early third trimester vaccination generated higher maternal and cord blood antibodies.

      Abstract

      Objective

      Pertussis is an important cause of morbidity and mortality in infants under two months of age and these high risk babies are dependent on maternally derived antibodies until completion of their first immunization series. This study aimed to evaluate the vaccine response of late preterm and term newborns as well as their mothers who underwent combined tetanus-diphtheria toxoid and acellular pertussis (Tdap) vaccination during pregnancy.

      Study design

      A total of 70 pregnant women were administered Tdap vaccine (Boostrix®, GSK) between 27 and 33 gestational weeks of pregnancy. The IgG antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) in maternal blood before vaccination and in both maternal and umbilical cord blood after vaccination were evaluated using the in-house ELISA method. The geometric mean concentrations (GMC) and placental transfer ratios of antibodies were measured.

      Results

      Participants’ with a mean age of 29.59 ± 4.70 years received Tdap vaccine at an average 28.6 ± 1.31 gestational weeks. Average pre and post vaccination levels of anti-PT IgG GMCs and anti-FHA IgG GMCs were 8.01 IU/ml vs 39.48 IU/ml (p = 0.001) and 122.24 IU/ml vs 183.97 IU/ml (p < 0.001), respectively. The anti-PT and anti-FHA IgG GMCs of cord blood after vaccination was 25.15 IU/ml and 118.77 IU/ml, respectively (p < 0.001 and p = 0.064). Placental transfer ratios of anti-PT ve anti-FHA IgG antibodies were detected as 0.65 and 0.62, respectively.

      Conclusion

      Immunization of pregnant women with Tdap at the third trimester results in high maternal and infant antibody levels. Maternal immunization during each pregnancy seems to be the best strategy in revealing the highest maternal and infant antibodies and in narrowing the gap between birth and immune system maturation in infants. Pregnant women in our country should also get the Tdap vaccine during pregnancy especially in the early third trimester.

      Keywords

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