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Published on: August 7, 2017
Antimeasles antibodies in preterm infants during early infancy in Turkey
Tamer Gunes1, Esad Koklu, Mehmet Adnan Ozturk
1Division of Neonatology, Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, Turkey. trgunes@erciyes.edu.tr
Insights
Maternal measles antibodies in premature infants are lower and wane faster than in full-term infants. This suggests current infant immunization schedules may need adjustment for preterm babies, particularly those born to vaccinated mothers.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Maternal antibodies provide crucial passive immunity to infants.
- Premature infants may have different antibody transfer and decay rates compared to full-term infants.
- Understanding antibody levels in premature infants is vital for optimizing vaccination strategies.
Purpose of the Study:
- To quantify maternally derived measles antibodies in premature infants at birth.
- To assess seropositivity rates of measles antibodies in early infancy among premature infants.
- To investigate the influence of gestational age and maternal immunity status on infant antibody levels.
Main Methods:
- A prospective longitudinal study involving 65 premature and 24 full-term infants and their mothers.
- Infants categorized by gestational age (<33, 33-37, >37 weeks) and maternal immunization status (natural or vaccine-induced).
- Maternal and infant blood samples collected at birth, with infant follow-up at 2, 4, and 6 months.
Main Results:
- 20.3% of mothers were seronegative for measles antibodies; 24.2% of infants in the <33 weeks group were seronegative at birth.
- Infants born to naturally immunized mothers had higher antibody levels than those born to vaccinated mothers.
- Infant antibody levels decreased rapidly with age; gestational age, birth weight, and maternal immunity significantly impacted antibody levels post-birth.
Conclusions:
- Current measles vaccination recommendations at 9 months may not be optimal for all premature infants.
- Premature infants, especially those with vaccination-induced maternal immunity, may require earlier or modified immunization schedules.
- Further research is needed to refine infant immunization timing based on gestational age and maternal immune status.
Aim:
To measure maternally derived measles antibodies in sera of premature infants at birth and seropositivity rates in early infancy in a rural area of central Turkey.
Methods:
65 premature and 24 full-term infants born in Erciyes University Hospital and their mothers were recruited to a longitudinal, prospective study. The infants were divided into three groups by gestational age: group A, <33 weeks; group B, 33-37 weeks; group C, >37 weeks. For specific analyses, the groups were subdivided into groups Al, B1 and C1 (infants of naturally immunised mothers) and A2, B2 and C2 (infants of vaccinated mothers). Blood samples were obtained from mothers and infants after delivery. The infants were re-evaluated at 2, 4 and 6 months of age.
Results:
Of 25 mothers, 20.3% were seronegative for measles antibodies. Twenty of the mothers had not been vaccinated. The percentages of seronegative infants at birth were 24.2% (n=8), 12.5% (n=4) and 0% (n=0) in groups A, B and C, respectively. No infants were seronegative at birth in Al, B1 or C1. Mean levels of antimeasles antibodies in all naturally immunised mothers were significantly higher than in vaccinated mothers. Antibody levels in all infants decreased rapidly with increasing age. Gestational age at birth [beta=0.179, t=3.359, 95% confidence interval (CI) 0.0001-0.0001, p<0.05], birthweight (beta=0.637, t=9.691, 95% CI 0.057-0.086, p<0.05) and maternal naturally immunised status (beta=0.168, t=2.825, 95% CI 0.002-0.014, p<0.05) were significantly associated with antibody levels after birth. In all groups of naturally immunised mothers, the percentages of seronegative infants were significantly lower than in vaccinated mothers at birth and at 2, 4 and 6 months of age.
Conclusion:
The current recommendation to immunise all infants at 9 months of age might require revision for premature infants, especially those whose mothers have vaccination-induced immunity.
