title: A relatively high number of pregnant women in Kuwait remain susceptible to rubella: a need for an alternative vaccination policy.
abstract: OBJECTIVE
  To measure the prevalence of anti-rubella IgG and hepatitis B surface antigen (HBsAg) among pregnant women in Kuwait in order to assess the effectiveness of the current vaccination programs.
  
  
  METHODS
  This retrospective study involved 4,062 pregnant women evaluated in health centers in the Hawalli Province of Kuwait. They were screened for anti-rubella IgG and HBsAg using commercially available assays. The data were obtained from medical laboratory records.
  
  
  RESULTS
  The mean age of the pregnant women was 29.2 ± 5.26 years (range 17-49). The rubella IgG prevalence among the pregnant women was 88.4% (n = 3,589); 276 (6.8%) of the pregnant women had no antibody to rubella, and 197 (4.8%) had rubella antibody levels ≤10 IU/ml. Therefore, 473 (11.6%) of the pregnant women were susceptible to rubella. The proportion of susceptible women increased with increasing age from 3.4 to 10.3% and from 3.4 to 6.7% among women aged <20 years and those aged ≥40 years, respectively (p = 0.016). The prevalence of HBsAg was 0.3%, and it did not vary with age.
  
  
  CONCLUSIONS
  The prevalence of both anti-rubella IgG and HBsAg among pregnant women in Kuwait was relatively high. However, about 11.6% of pregnant women in Kuwait remain susceptible to rubella infection and hence congenital infection and fetal malformation.
authors.affiliation: Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
authors.forename: Nada
authors.initials: N
authors.lastname: Madi
authors.forename: Haya
authors.initials: H
authors.lastname: Al-Tawalah
authors.forename: Dina
authors.initials: D
authors.lastname: Abdul Khalik
authors.forename: Widad
authors.initials: W
authors.lastname: Al-Nakib
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006291:Health Policy; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007730:Kuwait; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012409:Rubella / Q000276:immunology / Q000517:prevention & control*; D012411:Rubella Vaccine / Q000008:administration & dosage* / Q000276:immunology; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens; D007074:Immunoglobulin G; D012411:Rubella Vaccine