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Specific antibodies against vaccine-preventable infections: a mother-infant cohort study
Christine Jones1, Louisa Pollock, Sara M Barnett
1Academic Department of Paediatrics, Imperial College London, London, UK.
Insights
Maternal antibody levels against pertussis were low, indicating the UK's new maternal immunization program may be effective. Antibody transfer to infants was reduced in HIV-infected mothers.
Area of Science:
- Immunology and Vaccinology
- Maternal and Child Health
- Infectious Disease Epidemiology
Background:
- Maternal antibodies provide crucial protection to newborns against vaccine-preventable diseases.
- Understanding maternal and neonatal antibody levels is essential for evaluating vaccine program effectiveness and informing public health strategies.
- The impact of maternal HIV infection on antibody transfer to infants requires further investigation.
Purpose of the Study:
- To quantify maternal and neonatal specific antibody levels against pertussis, Haemophilus influenzae type b (Hib), tetanus, and pneumococcus.
- To assess the correlation between maternal and infant antibody levels.
- To investigate the effect of maternal HIV infection on the placental transfer of specific antibodies.
Main Methods:
- A prospective cohort study was conducted in a UK secondary care maternity unit.
- 111 mothers and 109 infants were analyzed for specific antibody levels using commercial ELISAs.
- Protective antibody levels were defined based on established thresholds for pertussis, Hib, and tetanus.
Main Results:
- Only 17% of women had protective antibody levels against pertussis, while 50% and 79% were protected against Hib and tetanus, respectively.
- Strong positive correlations were observed between maternal and infant antibody responses for pertussis, Hib, tetanus, and pneumococcus.
- Placental transfer of specific IgG was significantly reduced in HIV-infected mothers compared to HIV-uninfected mothers.
Conclusions:
- Low baseline pertussis antibody levels in mothers suggest the UK's maternal pertussis immunization program has potential effectiveness.
- The study highlights the importance of maternal vaccination for infant protection.
- Reduced antibody transfer in HIV-infected mothers warrants consideration for targeted interventions.
Objectives:
To determine maternal and neonatal specific antibody levels to selected vaccine-preventable infections (pertussis, Haemophilus influenzae type b (Hib), tetanus and pneumococcus).
Design:
Prospective cohort study.
Setting:
A UK secondary care maternity unit (March 2011-January 2012).
Participants:
Mothers and infants within 72 h of delivery were eligible. Unwell individuals, mothers less than 18 years of age, and infants born at less than 36 weeks gestation, or weighing less than 2500 g, were excluded. HIV-infected mothers were included. 112 mother-infant pairs were recruited. Samples from 111 mothers and 109 infants (108 pairs) were available for analysis.
Outcome Measures:
Specific antibody levels were determined using standard commercial ELISAs. Specific antibody to pertussis antigens (PT and FHA) of >50 IU/ml, defined as 'positive' by the test manufacturer, were interpreted as protective. Antitetanus antibody titres >0.1 IU/ml and anti-Hib antibody titres >1 mg/l were regarded as protective.
Results:
Only 17% (19/111) of women exhibited a protective antibody response against pertussis. 50% (56/111) of women had levels of antibody protective against Hib and 79% (88/111) against tetanus. There was a strong positive correlation between maternal-specific and infant-specific antibodies' responses against pertussis (rs=0.71, p<0.001), Hib (rs=0.80, p<0.001), tetanus (rs=0.90, p<0.001) and pneumococcal capsular polysaccharide (rs=0.85, p<0.001). Only 30% (33/109) and 42% (46/109) of infants showed a protective antibody response to pertussis and Hib, respectively. Placental transfer (infant:mother ratio) of specific IgG to pertussis, Hib, pneumococcus and tetanus was significantly reduced from HIV-infected mothers to their HIV-exposed, uninfected infants (n=12 pairs) compared with HIV-uninfected mothers with HIV-unexposed infants (n=96 pairs) by 58% (<0.001), 61% (<0.001), 28% (p=0.034) and 32% (p=0.035), respectively.
Conclusions:
Low baseline antibody levels against pertussis in this cohort suggest the recently implemented UK maternal pertussis immunisation programme has potential to be effective.
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