title: Positive rates for rubella antibody in pregnant women and benefit of post-partum vaccination in a Japanese perinatal center.
abstract: OBJECTIVE
  This study of pregnant women was undertaken to clarify their immune status for rubella and to evaluate the efficacy of, and adverse reaction to, post-partum rubella vaccination.
  
  
  METHODS
  We determined the levels of both rubella antibody by hemagglutination inhibition test and IgM antibody by enzyme-linked immunosorbent assay in the first gestational trimester and surveyed the positive rates for rubella antibody in pregnant women at our perinatal center; we recommended post-partum vaccination for women with poor immune status. We also evaluated the effectiveness of the vaccine and any adverse reaction.
  
  
  RESULTS
  Among 2741 pregnant women, 185 cases (6.7%) were seronegative for rubella virus. This rate was especially high (12.4%) in the population who had opted out of the vaccination because of a change in Japanese government policy. A total of 30 cases (1.1%) were positive or false-positive for IgM antibody, but no congenital rubella syndrome (CRS) developed. The seropositive rate was 93.3% in total, but this figure includes those who required post-partum vaccination (558 cases or 20.3%) because their titers were 16x or lower. Among 145 cases who received post-partum rubella vaccine, no severe adverse reaction was detected, and in all 37 cases with hemagglutination inhibition antibody titers of 8x or lower, the efficacy rate was 100%.
  
  
  CONCLUSIONS
  It is necessary to appropriately evaluate the CRS risk. Also, we need to emphasize the importance and safety of post-partum rubella vaccination in Japan.
authors.affiliation: Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan. m-okuda@zap.att.ne.jp
authors.forename: Mika
authors.initials: M
authors.lastname: Okuda
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamanaka
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Endoh
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007564:Japan; D008875:Middle Aged; D049590:Postpartum Period / Q000276:immunology*; D011247:Pregnancy / Q000276:immunology*; D012411:Rubella Vaccine / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D012412:Rubella virus / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012411:Rubella Vaccine; C040901:rubella antibodies