Tetanus and diphtheria immunity among term and preterm infant-mother pairs in Turkey, a country where maternal and neonatal tetanus have recently been eliminated

• Published in: European journal of pediatrics 2015-03, Vol.174 (3), p.339-344
• Main Authors: Erener-Ercan, Tugba, Aslan, Mustafa, Vural, Mehmet, Erginoz, Ethem, Kocazeybek, Bekir, Ercan, Gokmen, Turkgeldi, Lale Wetherilt, Perk, Yildiz
• Format: Article
• Language: English
• Subjects: Adult; Antibodies; Antibodies, Bacterial - blood; Diphtheria; Diphtheria - immunology; Female; Fetal Blood - immunology; Gynecology; Humans; Immunity, Maternally-Acquired - immunology; Infant, Newborn; Infant, Premature - immunology; Male; Medicine; Medicine & Public Health; Mortality; Mothers; Newborn babies; Obstetrics; Original Article; Pediatrics; Pregnancy; Premature babies; Term Birth - immunology; Tetanus; Tetanus - immunology; Turkey; Vaccination; Vaccines; Whooping cough; Womens health
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-014-2400-9

The aim of our study was to investigate the anti-tetanus and anti-diphtheria antibody titres and the placental transfer of these antibodies in a group of vaccinated and unvaccinated mothers and their term or preterm offsprings. Anti-tetanus and anti-diphtheria toxoid IgG antibodies were measured quantitatively by ELISA in 91 infant-mother pairs. Protective concentrations of anti-tetanus and anti-diphtheria were found in 58.3 and 50 % of mothers in the unvaccinated group and 94.5 and 85.5 % of the mothers in the vaccinated group. Protective concentrations were found in 63.9 and 50 % of cord samples, respectively, in the unvaccinated group and in 96.4 and 85.5 % of cord samples, respectively, in the vaccinated group ( p  = 0.0001). There were no differences in the maternal and cord geometric mean concentrations (GMCs) of anti-toxoid antibodies between those who received two doses or one dose of Td. The GMCs of maternal and cord anti-tetanus and anti-diphtheria were statistically similar between preterm and term groups. Placental transfer ratios (TR) for anti-tetanus and anti-diphtheria were 175 and 150 %, respectively, in the preterm group and 213 and 178 %, respectively, in the term group. There was a strong correlation between maternal and cord anti-toxoid antibody levels. Maternal vaccination was the only predictor of having protective concentrations of anti-toxoid antibodies in cord blood. Conclusions : Vaccinating pregnant women with at least one dose of Td would confer protection for both the term and preterm infant-mother pairs. Therefore, health personnel caring for pregnant women have the responsibility to emphasize the importance of Td vaccination to avoid missed immunization opportunities.