LOWER TRANSPLACENTAL ANTIBODY TRANSPORT FOR MEASLES, MUMPS, RUBELLA AND VARICELLA ZOSTER IN VERY PRETERM INFANTS

Monday, 6th of October 2014

[source]PLoS One[|source]

Maternal Immunoglobulin G (IgG) is transported across the placenta (transplacental transport) by an active, receptor mediated process during pregnancy thereby protecting term infants against infections. In general, higher IgG concentrations are associated with longer protection. Previous studies showed that the degree of transplacental transport of IgG is dependent on the duration of the gestation. Besides gestational age, maternal IgG antibody level and IgG subclass are important predictors of the neonatal IgG antibody level. Notably, the IgG antibody concentration at birth of term infants is usually higher than the maternal IgG antibody concentration, especially for IgG1 vaccine antibodies.

In this report, the authors investigate the concentration of antibodies against measles, mumps, rubella and varicella in mothers and their preterm infants with gestational age (GA) <32 weeks and/or birth weight (BW) <1500 g, and in mothers and their healthy term infants. The report demonstrates lower transplacental transport of IgG antibodies against measles, mumps, rubella and varicella in the vulnerable group of preterm infants with GA <32 weeks compared to term infants with GA>36 weeks, resulting in lower antibody levels in preterm infants at birth. Detailed methods, results and analysis of determinants of geometric mean concentration of IgG against vaccine preventable diseases at birth are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984210/#!po=78.1250

 

ABSTRACT

BACKGROUND: Maternal antibodies, transported over the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. In term infants, this protection does not last until the first recommended measles-mumps-rubella vaccination at 14 months in the Netherlands, while these viruses still circulate. The aim of the study was to investigate the antibody concentration against measles, mumps, rubella and varicella (MMRV) in mothers and preterm infants or healthy term infants at birth.

METHODS: Antibody concentrations specific for MMRV were measured in cord blood samples from preterm (gestational age <32 weeks and/or birth weight <1500 g) and term infants, and matched maternal serum samples, using a fluorescent bead-based multiplex immune-assay.

RESULTS: Due to lower placental transfer ratios of antibodies against MMRV in 96 preterm infants (range 0.75–0.87) compared to 42 term infants (range 1.39–1.65), the preterm infants showed 1.7–2.5 times lower geometric mean concentrations at birth compared to term infants. Maternal antibody concentration is the most important determinant of infant antibody concentration against MMRV.

CONCLUSIONS: Preterm infants benefit to a lesser extent from maternal antibodies against measles, mumps, rubella and varicella than term infants, posing them even earlier at risk for infectious diseases caused by these still circulating viruses.