217078 Administrating Tdap during Pregnancy Increases a Newborn's Protection against Pertussis, Diphtheria and Tetanus

Wednesday, November 10, 2010

John A. Myers, PhD , School of Public Health and Information Sciences, University of Louisville, Louisville, KY
Pedro Ramos, MS , Department of Biostatistics, University of Louisville, Louisville, KY
Beatrice Ugiliweneza, MS , Department of Biostatistics, University of Louisville, Louisville, KY
Tiffany Ciszewski, BSS , Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY
Stanley Gall, MD , Obstectrics and Gynecology, University of Louisville, Louisville, KY
Background: Current guidelines to prevent pertussis recommend that infants be immunized with Tdap at 2, 4, and 6 months leaving infants highly susceptible to contracting pertussis between birth and 2 months. This study investigated if administrating Tdap to mothers during the third trimester of pregnancy provides newborns protection against pertussis, when compared to newborns born from mothers who did not receive Tdap during pregnancy.

Methods: Pregnant women were randomly assigned to receive (n=53) or not receive (n=51) Tdap during pregnancy. Antibody responses to filamentous hemagglutinin (FHA), pertactin (PRN), pertussis toxin (PT), and the toxoids of tetanus and diphtheria were measured in maternal and infant serum. Protection was defined as follows: if an individual's diphtheria antitoxin level was >0.10, and if an individual's pertussis antitoxin level was >5.

Results: Newborns born from mothers who received Tdap during pregnancy have significantly higher concentrations of diphtheria (0.650 vs. 1.820, p=0.007) and PRN (11.628 vs. 25.625, p<0.0001) antibodies as well as FHA (28.235 vs. 101.750, p=0.010) and PT (26.510 vs. 340.904, p<0.0001) antibodies when compared to newborns born from mothers who did not receive Tdap during pregnancy. In addition, the odds of protection against pertussis (84.6% vs. 52.9%, OR=4.89, 95% CI = 1.92-12.42, p=0.001) and diphtheria (98.1% vs. 86.3%, OR=8.11, 95% CI = 0.96-68.53, p=0.025) were higher in the treatment group.

Conclusions: Administering Tdap during pregnancy increases newborn protection against pertussis during the first two months of life. Therefore, Tdap during pregnancy could be used to prevent neonatal contraction of pertussis and diphtheria.

Learning Areas:
Basic medical science applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Provision of health care to the public
Public health or related nursing
Public health or related public policy

Learning Objectives:
Identify an effective intervention to decrease neonatal morbidity and mortality due to pertussis.

Keywords: Immunizations, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I performed and/or directed all analyses performed for the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5018.0: Infant and Child Health Poster Session