Maternal Pertussis Immunization and Immunoglobulin G Levels in Early- to Late-Term and Preterm Infants

• Published in: JAMA network open 2024-07, Vol.7 (7), p.e2424608
• Main Authors: Immink, Maarten M, Bekker, Mireille N, de Melker, Hester E, den Hartog, Gerco, Rots, Nynke Y, van Gageldonk, Pieter G M, Groenendaal, Floris, Sanders, Elisabeth A M, van der Maas, Nicoline A T
• Format: Article
• Language: English
• Subjects: Adult; Age; Antibodies; Cohort analysis; Diphtheria-Tetanus-acellular Pertussis Vaccines - administration & dosage; Diphtheria-Tetanus-acellular Pertussis Vaccines - immunology; Female; Gestational Age; Humans; Immunity, Maternally-Acquired - immunology; Immunization; Immunoglobulin G - blood; Immunoglobulin G - immunology; Immunoglobulins; Infant; Infant, Newborn; Infant, Premature - immunology; Infectious Diseases; Male; Netherlands; Newborn babies; Online Only; Original Investigation; Pregnancy; Premature babies; Prospective Studies; Suffocation; Vaccination; Whooping cough; Whooping Cough - immunology; Whooping Cough - prevention & control
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2024.24608

Maternal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination protects newborns against severe pertussis. Data on transplacental antibody transfer on Tdap vaccination before 24 weeks' gestation remain scarce and are particularly relevant for preterm infants to increase the time interval for maternal antibody transfer. To assess noninferiority of anti-pertussis toxin (anti-PT) immunoglobulin G (IgG) antibody levels at age 2 months in early- to late-term infants following Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation compared with 30 0/7 and 33 0/7 weeks' gestation and compared with preterm infants. This prospective, multicenter cohort study included pregnant women aged 18 years or older in birthing centers and hospitals in the Netherlands between August 2019 and November 2021 who received Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation. Women with imminent premature birth were recruited if they had received maternal Tdap vaccination between 20 and 24 weeks' gestation. Blood samples were collected from mothers at delivery, from the umbilical cord, and from infants at age 2 months. Data from infants' blood samples at age 2 months were compared with a reference cohort (recruited between January 2014 and February 2016) of early- to late-term infants of the same age whose mothers had received Tdap vaccination between 30 0/7 and 33 0/7 weeks' gestation. Maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation or 30 0/7 and 33 0/7 weeks' gestation. The primary outcome was the geometric mean concentration (GMC) of anti-PT IgG antibodies in early- to late-term infants (≥37 0/7 weeks' gestation) at age 2 months, comparing maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' vs 30 0/7 and 33 0/7 weeks' gestation (reference cohort). Anti-PT GMC in 2-month-old infants born preterm (