title: Tetanus and diphtheria immunity among term and preterm infant-mother pairs in Turkey, a country where maternal and neonatal tetanus have recently been eliminated.
abstract: The aim of our study was to investigate the anti-tetanus and anti-diphtheria antibody titres and the placental transfer of these antibodies in a group of vaccinated and unvaccinated mothers and their term or preterm offsprings. Anti-tetanus and anti-diphtheria toxoid IgG antibodies were measured quantitatively by ELISA in 91 infant-mother pairs. Protective concentrations of anti-tetanus and anti-diphtheria were found in 58.3 and 50% of mothers in the unvaccinated group and 94.5 and 85.5% of the mothers in the vaccinated group. Protective concentrations were found in 63.9 and 50% of cord samples, respectively, in the unvaccinated group and in 96.4 and 85.5% of cord samples, respectively, in the vaccinated group (p = 0.0001). There were no differences in the maternal and cord geometric mean concentrations (GMCs) of anti-toxoid antibodies between those who received two doses or one dose of Td. The GMCs of maternal and cord anti-tetanus and anti-diphtheria were statistically similar between preterm and term groups. Placental transfer ratios (TR) for anti-tetanus and anti-diphtheria were 175 and 150%, respectively, in the preterm group and 213 and 178%, respectively, in the term group. There was a strong correlation between maternal and cord anti-toxoid antibody levels. Maternal vaccination was the only predictor of having protective concentrations of anti-toxoid antibodies in cord blood.
  
  
  CONCLUSIONS
  Vaccinating pregnant women with at least one dose of Td would confer protection for both the term and preterm infant-mother pairs. Therefore, health personnel caring for pregnant women have the responsibility to emphasize the importance of Td vaccination to avoid missed immunization opportunities.
authors.affiliation: Department of Neonatology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey, terenerercan@gmail.com.
authors.forename: Tugba
authors.initials: T
authors.lastname: Erener-Ercan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aslan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Vural
authors.forename: Ethem
authors.initials: E
authors.lastname: Erginoz
authors.forename: Bekir
authors.initials: B
authors.lastname: Kocazeybek
authors.forename: Gokmen
authors.initials: G
authors.lastname: Ercan
authors.forename: Lale Wetherilt
authors.initials: LW
authors.lastname: Turkgeldi
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Perk
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D004165:Diphtheria / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D006801:Humans; D007112:Immunity, Maternally-Acquired / Q000276:immunology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology*; D008297:Male; D011247:Pregnancy; D047929:Term Birth / Q000276:immunology*; D013742:Tetanus / Q000276:immunology*; D014421:Turkey; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial