Medizinische Universität Graz - Research portal
Selected Publication:
Gomme, J.
The Impact of Timing of Maternal Tdap Immunisation on Infant Antibody Levels at Birth.
[ Diplomarbeit/Master Thesis (UNI) ] University of Antwerp; 2020. pp.53.
FullText
- Authors Med Uni Graz:
- Advisor:
- Herzog Sereina Annik
- Altmetrics:
- Abstract:
- Maternal immunisation (MI) has proved an effective strategy at reducing pertussis-related morbidity and mortality in early infancy and is recommended across several countries. Although multiple studies have demonstrated the effectiveness of MI in the second or third trimester of pregnancy, the optimal timepoint to afford the newborn maximum protection is yet to be elucidated. The primary aim of this thesis was to model the impact of timing of MI on infant antibody titers at birth in order to determine the optimal timeframe between vaccination and delivery. We conducted secondary analysis on a cohort of mother-infant pairs (n=698) vaccinated between 13.4-37.1 weeks gestation. Data were taken from 4 parent studies on pertussis vaccination during pregnancy. We used natural cubic splines and linear mixed models to model the association of both gestational age at vaccination and the interval between vaccination and delivery, with cord antibody titers. The association was investigated in antibody titers to pertussis antigens included in the vaccines administered during pregnancy. Our results show that term-born infants on average achieve the highest antibody titers at birth if wom-en are vaccinated earlier than the 31st gestational week. When considering both term and preterm de-liveries, our results suggest that an interval of at least 7.5 weeks is required between vaccination and delivery before the highest cord antibody titers are achieved. The models suggest that vaccinating ear-lier than these will also afford the infant equally high titers. Vaccinating in the second and early third trimester affords the infant the highest antibody levels at birth. National guidelines for MI need to account for preterm births not being afforded the same pro-tection as term-born infants, and recommendations for vaccination should aim to cover both.