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Risk Markers for Pertussis Among Infants <4 Months of Age: Understanding the Hispanic Disparity

Kathleen Winter, Kathleen Harriman

    The Pediatric Infectious Disease Journal
    |August 5, 2017
    PubMed

    Insights

    Hispanic infants face higher pertussis risks. Factors like maternal parity and teenage mothers increase infant pertussis risk across all ethnicities, with prematurity and Medicaid insurance being key for Hispanic infants.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Epidemiology

    Background:

    • Hispanic infants exhibit a higher risk of pertussis compared to other racial/ethnic groups.
    • Household members are the primary source of Bordetella pertussis infection for infants.
    • Maternal parity, as a proxy for household size, is investigated for its role in ethnic disparities.

    Purpose of the Study:

    • To identify risk markers for pertussis in both Hispanic and non-Hispanic infants.
    • To evaluate the contribution of maternal parity to the observed ethnic disparities in pertussis risk.

    Main Methods:

    • A case-control study design was employed, evaluating infants born in California between 2013-2014.
    • Cases included infants diagnosed with pertussis before four months of age; controls were infants surviving to at least four months without pertussis.
    • Bivariate comparisons and multivariate logistic regression models were utilized to determine risk factors.

    Main Results:

    • Increased maternal parity demonstrated a dose-response association with a higher risk of pertussis.
    • Infants born to teenage mothers were at increased risk, an independent factor across all ethnic groups.
    • Preterm birth and Medicaid insurance emerged as independent risk markers specifically for Hispanic infants.

    Conclusions:

    • Infants with older siblings or born to younger mothers are at elevated pertussis risk, irrespective of race/ethnicity.
    • Prematurity and Medicaid insurance are significant independent risk markers for pertussis among Hispanic infants.
    • Ensuring timely Tdap immunization for pregnant women, starting at 27 weeks gestation, is crucial.
    Abstract

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