Decline of IgG pertussis toxin measured in umbilical cord blood, and neonatal and early infant serum

Eur J Clin Microbiol Infect Dis. 2014 Sep;33(9):1541-5. doi: 10.1007/s10096-014-2110-2. Epub 2014 Apr 23.

Abstract

Maternal pertussis-specific antibodies are passively acquired by infants during pregnancy. An IgG pertussis toxin (IgG-PT) concentration of >20 U/ml is considered to protect neonates against pertussis. To evaluate the IgG concentration at birth and during the first two months of life, we examined the IgG-PT concentration in the umbilical cord blood and three times during the neonatal and early infant period. IgG-PT was measured by validated IgG-specific enzyme-linked immunosorbent assays (ELISA) in umbilical cord blood and in Guthrie card blood samples of umbilical cord blood in 2,790 children, born between 1 August 2006 and 1 December 2008. These measurements were comparable. All children with concentrations of IgG-PT >30 U/ml were included. IgG-PT was also measured in Guthrie card blood samples, when the neonates or early infants were 5 days, 1 month and 2 months old. The mean concentrations of IgG-PT were calculated. The mean concentration of IgG-PT in umbilical cord blood was 60.1 U/ml (LN 4.1; 0.6 SD; n = 103). At the age of 5 days, 1 month and 2 months, the mean concentration of IgG-PT was 40.6 U/ml (LN 3.7; 0.5 SD; n = 103), 20.7 U/ml (LN 3.0; 0.7 SD; n = 62) and 16.7 U/ml (LN 2.8; 0.9 SD; n = 61), respectively. Four percent of the neonates had a concentration of IgG-PT >30 U/ml in umbilical cord blood, which declined to levels around the concentration needed for protection against pertussis (>20 U/ml) in the first two months of life. Hence, it is of great importance to further investigate the safety of maternal immunisation during pregnancy to prevent life-threatening pertussis in newborns.

MeSH terms

  • Adult
  • Antitoxins / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fetal Blood / immunology*
  • Humans
  • Immunity, Maternally-Acquired*
  • Immunoglobulin G / blood*
  • Infant
  • Infant, Newborn
  • Male
  • Pertussis Toxin / immunology*
  • Pregnancy
  • Serum / immunology*
  • Whooping Cough / immunology*
  • Whooping Cough / prevention & control
  • Young Adult

Substances

  • Antitoxins
  • Immunoglobulin G
  • Pertussis Toxin