title: Pertussis Antibody Concentrations in Infants Born Prematurely to Mothers Vaccinated in Pregnancy.
abstract: Maternal antenatal pertussis-containing vaccination is recommended for the prevention of neonatal pertussis, but the ability of maternal vaccination to protect premature infants is unknown. We hypothesized that that infants born prematurely to antenatally vaccinated women would have higher pertussis antibody concentrations than those born to unvaccinated women.
  
  
  
  Mothers had been offered a combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine from 28 weeks' gestation as part of their routine antenatal care. Premature infants of vaccinated and unvaccinated mothers enrolled in a randomized controlled trial of pneumococcal conjugate vaccine schedules had antibody concentrations (pertussis toxin, filamentous hemoagglutinin [FHA], and fimbriae 2 and 3) measured at 2 months (before primary vaccination), 5 months (1 month after primary vaccination), and 12 months of age.
  
  
  
  Mothers of 31 (19%) of 160 premature infants had received combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine in pregnancy. Compared with infants of unvaccinated mothers, those born to vaccinated mothers had significantly higher antibody concentrations at 2 months for all measured vaccine antigens (P < .001). The number of days between maternal vaccination and delivery and immunoglobulin G concentration at 2 months of age was positively correlated for pertussis toxin (P = .011) and FHA (P = .001). After primary immunization, infants of vaccinated mothers had significantly lower antibody concentrations for FHA (P = .003) compared with infants of unvaccinated mothers; these differences had resolved by 12 months of age.
  
  
  
  Maternal vaccination administered early in the third trimester may provide protection for infants born prematurely.
authors.affiliation: Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's, University of London, London, United Kingdom; alisonkent@doctors.org.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: Kent
authors.affiliation: Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's, University of London, London, United Kingdom; Immunisation, Hepatitis, and Blood Safety Department, Public Health England, Colindale, London, United Kingdom;
authors.forename: Shamez N
authors.initials: SN
authors.lastname: Ladhani
authors.affiliation: Statistics, Modelling, and Economic Department, Public Health England, London, United Kingdom; and.
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Andrews
authors.affiliation: Immunoassay Laboratory, Public Health England, Porton Down, United Kingdom.
authors.forename: Mary
authors.initials: M
authors.lastname: Matheson
authors.affiliation: Immunoassay Laboratory, Public Health England, Porton Down, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: England
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department, Public Health England, Colindale, London, United Kingdom;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
authors.affiliation: Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's, University of London, London, United Kingdom;
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
mesh_terms: D018829:Adhesins, Bacterial / Q000276:immunology; D000907:Antibodies, Bacterial / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001886:Bordetella pertussis / Q000276:immunology*; D005260:Female; D010861:Fimbriae, Bacterial / Q000276:immunology; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000276:immunology*; D008297:Male; D037342:Pertussis Toxin / Q000276:immunology; D010567:Pertussis Vaccine / Q000276:immunology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control*; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care / Q000379:methods*; D010566:Virulence Factors, Bordetella / Q000276:immunology; D014917:Whooping Cough / Q000276:immunology / Q000517:prevention & control*
chemical_list: D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; D015415:Biomarkers; D007074:Immunoglobulin G; D010567:Pertussis Vaccine; D010566:Virulence Factors, Bordetella; C065273:filamentous hemagglutinin adhesin, Bordetella pertussis; D037342:Pertussis Toxin