title: Decline of IgG pertussis toxin measured in umbilical cord blood, and neonatal and early infant serum.
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.
authors.affiliation: Department of Pediatrics, Groene Hart Ziekenhuis, 2803 HH, Gouda, The Netherlands, louisesmallenburg@hotmail.com.
authors.forename: L C S
authors.initials: LC
authors.lastname: Smallenburg
authors.forename: N A
authors.initials: NA
authors.lastname: van Welie
authors.forename: L H
authors.initials: LH
authors.lastname: Elvers
authors.forename: J C M
authors.initials: JC
authors.lastname: van Huisseling
authors.forename: P F M
authors.initials: PF
authors.lastname: Teunis
authors.forename: F G A
authors.initials: FG
authors.lastname: Versteegh
mesh_terms: D000328:Adult; D000992:Antitoxins / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007074:Immunoglobulin G / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D037342:Pertussis Toxin / Q000276:immunology*; D011247:Pregnancy; D044967:Serum / Q000276:immunology*; D014917:Whooping Cough / Q000276:immunology* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000992:Antitoxins; D007074:Immunoglobulin G; D037342:Pertussis Toxin
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