Abstract
Maternal immunisation schedules are increasingly coming under the spotlight as part of the development of lifetime immunisation programmes for the role that they play in improving maternal, foetal, and neonatal health. Maternally-acquired antibodies are critical in protecting infants during the first months of their lives. Maternal immunisation was previously overlooked owing to concerns regarding vaccinations in this untested and high-risk population but is now acknowledged for its potential impact on the outcomes in many domains of foetal and neonatal health, aside from its maternal benefits. This article highlights the role that maternal immunisation may play in reducing infections in preterm and term infants. It explores the barriers to antenatal vaccinations and the optimisation of the immunisation uptake. This review also probes the part that maternal immunisation may hold in the reduction of perinatal antimicrobial resistance and the prevention of non-infectious diseases. Both healthcare providers and expectant mothers should continue to be educated on the importance and safety of the appropriate immunizations during pregnancy. Maternal vaccination merits its deserved priority in a life-course immunization approach and it is perhaps the only immunization whereby two generations benefit directly from a single input. We outline the current recommendations for antenatal vaccinations and highlight the potential advances in the field contributing to “preventive neonatology”.
Highlights
Immunization has been effective in preventing and reducing the number of devastating infections globally
This review outlines the rationale, evidence, challenges, and perceptions of vaccination during the pregnancy, as well as the recent developments, and will highlight the impact on the current and future clinical practices. This narrative review on maternal vaccination aims to discuss the types of vaccines that are available and are approved for the safe general uptake during pregnancy, the vaccines that are recommended during pregnancy based on risk factors and special circumstances, the vaccines that are currently under research and are in development for licensure for maternal-foetal immunization, and the barriers to maternal immunization
The unique relationship a mother holds in the protection of the foetus or infant from infection is through the pathway of vertical transmission, whereby maternally derived antibodies cross the placenta to the foetus (IgG) and are transferred through breastfeeding (IgG, IgA, IgM) to the neonates and infants [7]
Summary
Immunization has been effective in preventing and reducing the number of devastating infections globally. The immunization of pregnant women is an important strategy, to protect the mothers from infection and to provide immunity to the young infants [2]. Public Health 2018, 15, 847; doi:10.3390/ijerph15050847 www.mdpi.com/journal/ijerph This paucity or relative inability argues against the provision of neonatal vaccinations in preventing infections during early infancy and requires a more comprehensive preventative strategy to reduce the morbidity associated with infectious diseases in this vulnerable cohort. Maternal vaccination programmes will hopefully undergo a paradigm shift as society and healthcare providers accept and recognize the benefits that are achievable from this strategy, for the pregnant woman and for the developing foetus and the young infant [6]. This review outlines the rationale, evidence, challenges, and perceptions of vaccination during the pregnancy, as well as the recent developments, and will highlight the impact on the current and future clinical practices
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