title: Rubella monitoring in pregnancy as a means for evaluating a possible reemergence of rubella.
abstract: OBJECTIVE
  Although it is commonly accepted that rubella is well-controlled, a recent reemergence of both pertussis and measles might also predict a reemergence of rubella. This study was designed to estimate the current incidence of rubella exposure in pregnancy.
  
  
  METHODS
  This was a prospective, descriptive study, conducted in Houston, TX, at The Woman's Hospital of Texas. Women are typically screened for rubella immunity at the beginning of pregnancy. Rubella nonimmunity is defined as a titer less than 10 IU/mL in the US. Women who were non-immune early in pregnancy (<20 weeks) were recruited for this study and asked to be tested again for rubella immunity at the time of delivery.
  
  
  RESULTS
  Of 298 women who were rubella nonimmune (IgG <10 IU/mL) early in pregnancy, 19 converted to immune status (IgG >40 IU/mL, defined as at least a 4-fold increase) at time of delivery, a rate of 6.38% (4.12% to 9.75%; 95% Wilson-Score confidence interval). For the 19 patients who converted to immune status at time of delivery, 8 patients had levels of 40-150 IU/mL, 6 patients had levels of 151-300 IU/mL, 2 patients had levels of 301-500 IU/mL, and 3 patients had levels >500 IU/mL.
  
  
  CONCLUSIONS
  Pregnancy is a critical time to evaluate rubella exposure. This study estimated the current incidence of rubella exposure in pregnancy to be 6.38%.
authors.affiliation: Department of Obstetrics and Gynecology, The Woman's Hospital of Texas, Houston.
authors.forename: Jill
authors.initials: J
authors.lastname: Hutton
authors.affiliation: Division of Management, Policy, and Community Health, University of Texas, Houston, School of Public Health, Houston.
authors.forename: Paul
authors.initials: P
authors.lastname: Rowan
authors.affiliation: Kelsey Research Foundation, Houston.
authors.forename: Anthony
authors.initials: A
authors.lastname: Greisinger
authors.affiliation: Department of Pediatrics, Kelsey-Seybold Clinic, Houston, TX.
authors.forename: Melanie
authors.initials: M
authors.lastname: Mouzoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology*; D011446:Prospective Studies; D012409:Rubella / Q000453:epidemiology / Q000276:immunology*; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; C040901:rubella antibodies
keywords: obstetrics; pregnancy complications infectious/etiology; rubella immunology; rubella transmission; rubella virus