Seroprevalence of Anti-Rubella and Anti-Measles IgG Antibodies in Pregnant Women in Shiraz, Southern Iran: Outcomes of a Nationwide Measles-Rubella Mass Vaccination Campaign

Behnam Honarvar,Neda Odoomi,Kamran Bagheri Lankarani,Mohsen Moghadami,Afagh Moattari,Amir Emami,Ray Borrow

doi:10.1371/journal.pone.0055043

Behnam Honarvar, Neda Odoomi + Show 5 more

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https://doi.org/10.1371/journal.pone.0055043

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Journal: PloS one	Publication Date: Jan 31, 2013
Citations: 49	License type: CC BY 4.0

Affiliation: Shiraz University of Medical Sciences

Abstract

ObjectiveNonimmune pregnant women are at risk of developing congenital rubella syndrome and measles complications. We aimed to identify pregnant women susceptible to rubella or measles in order to determine the need for immunity screening and supplemental immunization in women of childbearing age.MethodThis seroprevalence survey was conducted by convenience sampling in obstetric hospitals affiliated with Shiraz University of Medical Sciences (southern Iran). Serum IgG levels were measured by ELISA.ResultMean age of the 175 pregnant women was 27.3±5.3 (range 16 to 42) years. The geometric mean concentration of anti-rubella IgG was 14.9 IU/mL (CI 95%,14.1–15.5), and that of anti-measles IgG was 13.8 IU/mL (CI 95%, 13–14.5). One hundred sixty-eight women (96%) had a protective serologic level (>11 IU/mL) of IgG against rubella, and 143 (81.7%) had a protective level against measles. Except for a significant inverse correlation that was showed by univariate analysis between anti-rubella IgG and the women’s age (P = 0.01), immunity did not correlate with demographic or obstetric characteristics or medical history. There was no significant correlation between anti-rubella and anti-measles IgG levels (P = 0.25).ConclusionNearly a decade after Iran’s nationwide measles-rubella vaccination campaign for the population aged 5–25 years, most pregnant women up to 34 years of age had humoral immunity against rubella. We recommend rubella immunity screening or catch-up immunization for women older than 35 years who wish to become pregnant, and measles immunity screening and appropriate vaccination for all women of childbearing age.

Highlights

Rubella is a teratogenic virus [1] and congenital rubella syndrome (CRS) is an important cause of severe birth defects
As rubella control progresses towards elimination, the sensitivity and specificity of surveillance systems should increase, and if resources permit, periodic seroprevalence surveys can be used to monitor the impact of immunization programs
This cross-sectional and questionnaire-based seroprevalance study was conducted from November 2011 to January 2012 at obstetrics and maternity hospitals affiliated with Shiraz University of Medical Sciences in Shiraz, the capital city of Fars province in southern Iran

Summary

Introduction

Rubella is a teratogenic virus [1] and congenital rubella syndrome (CRS) is an important cause of severe birth defects. When a woman acquires rubella virus early in pregnancy, she has a 90% chance of passing the virus on to her fetus. This can cause the death of the fetus, and may cause CRS [2]. If measles occurs during the late stages of pregnancy, maternal and fetal morbidity will be increased. These pregnant women are exposed to a higher risk of miscarriage, severe respiratory distress, pneumonitis, hospital admission and death. Prematurity and subacute sclerosing panencephalitis are seen more often in infants of these women [4]

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