Maternal immunization with tetanus–diphtheria–pertussis vaccine: effect on maternal and neonatal serum antibody levels

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 4; pp. 334.e1 - 334.e5
• Main Authors: Gall, Stanley A., MD, Myers, John, PhD, Pichichero, Michael, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2011; Elsevier
• Subjects: acellular pertussis antigens vaccine increased neonatal protection; Adhesins, Bacterial - immunology; Antibodies - blood; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Bacterial Outer Membrane Proteins - immunology; Biological and medical sciences; Diphtheria Antitoxin - blood; Diphtheria-Tetanus-Pertussis Vaccine; Ent and stomatologic bacterial diseases; Female; Fimbriae Proteins - immunology; Gynecology. Andrology. Obstetrics; Human bacterial diseases; Humans; Infant, Newborn - blood; Infectious diseases; maternal tetanus; Medical sciences; Obstetrics and Gynecology; Pertussis Toxin - immunology; Pregnancy; reduced diphtheria; Tetanus Antitoxin - blood; Virulence Factors, Bordetella - immunology; acellular pertussis antigens vaccine increased neonatal protection; maternal tetanus; reduced diphtheria; Human; Immunization; Neonatal; Respiratory disease; Antibody; Gynecology; Vaccination; Vaccine; Diphtheria; Obstetrics; Whooping cough; Infection; Prevention; Immunoprophylaxis; Newborn; Mother; Bacteriosis; Serum; Tetanus
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.11.024

Objective We sought to determine whether tetanus–diphtheria–pertussis vaccination (Tdap) in pregnancy provides newborns antibodies against pertussis when compared to mothers who did not receive Tdap. Study Design Paired maternal and umbilical cord blood samples were collected at the time of delivery and the serum stored at –86°C. For each paired sample of maternal and cord blood, the medical chart and vaccine history was reviewed to determine whether Tdap was received or not. Results Newborns born from mothers who received Tdap during pregnancy had significantly higher concentrations of diphtheria antitoxin ( P < .001), tetanus antitoxin ( P = .004), and antibodies to pertussis toxin ( P < .001), filamentous hemagglutinin ( P = .002), pertactin ( P < .001), and fimbriae 2/3 ( P < .001) when compared to newborns from mothers who did not receive Tdap. There was a significant increase in the odds that newborns from mothers who received Tdap during pregnancy have antibodies that may provide protection against diphtheria ( P = .0141), pertussis toxin ( P < .0001), and fimbriae 2/3 ( P = .0146). Conclusion Administering Tdap during pregnancy increases antibody titers against diphtheria and pertussis antigens. Maternal Tdap may prevent neonatal pertussis infection.