title: Maternally acquired IgG immunity in neonates born to renal transplanted women.
abstract: Neonates born to renal transplanted women are exposed in utero to immunosuppressors and to antenatal conditions that may predispose the neonate to a high risk of prematurity and intrauterine growth retardation. These factors might interfere with the transfer of maternal IgG immunity. Total IgG levels and specific antibodies to measles, varicella, tetanus, Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (serotypes 4,6B,9V,14,18C,19F and 23F) were evaluated on maternal and cord blood samples of 23 sets of renal transplanted women and their newborns and 32 sets of healthy women-newborns at term. Total IgG levels were measured by nephelometry and specific antibodies, by ELISA. Renal transplanted mothers had lower median tetanus antibodies (0.67IU/mL) than controls (1.53IU/mL; p=0.017). Neonates from renal transplanted mothers had lower median tetanus antibodies (0.95IU/mL) than controls (1.97IU/mL, p=0.008). Antibodies to measles, varicella, Hib and the 7 serotypes of S. pneumoniae were similar between groups. Maternal antibodies were associated with an increase in neonatal antibodies for all antigens; gestational age was associated with an increase in Hib neonatal antibodies. Preeclampsia was associated with a decrease in neonatal total IgG and serotype 4 S. pneumoniae antibodies; chronic hypertension was associated with a decrease in neonatal serotype 6B S. pneumoniae antibodies. As neonates from transplanted women may be born with lower tetanus antibodies than controls, efforts should be made to keep maternal vaccines up-to-date. Clinical antenatal care with control of preeclampsia, chronic hypertension and prevention of premature delivery might also contribute to neonatal antibody levels to specific antigens at birth.
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Patrícia Oliveira
authors.initials: PO
authors.lastname: Viana
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Erika
authors.initials: E
authors.lastname: Ono
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Maria Isabel Saraiva
authors.initials: MI
authors.lastname: Dinelli
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Beatriz Tavares
authors.initials: BT
authors.lastname: Costa-Carvalho
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Amélia Miyashiro Nunes Dos
authors.initials: AM
authors.lastname: Santos
authors.affiliation: Department of Obstetrics, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Sass
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil. Electronic address: m.isabelmp@uol.com.br.
authors.forename: Maria Isabel de
authors.initials: MI
authors.lastname: Moraes-Pinto
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007074:Immunoglobulin G / Q000097:blood*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D016030:Kidney Transplantation; D008297:Male; D009391:Nephelometry and Turbidimetry; D011247:Pregnancy; D011248:Pregnancy Complications; D051437:Renal Insufficiency / Q000601:surgery*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents
keywords: Immunosuppression; Measles; Placental antibody transfer; Renal transplant; Tetanus