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Fetal risk associated with rubella vaccination during pregnancy.

AbstractBACKGROUND:
Costa Rica implemented a nationwide measles-rubella vaccination campaign among men and women (15-39 years old) in May 2001. A protocol was developed to follow-up the vaccinated women who were unknowingly pregnant, to determine the risk of congenital rubella syndrome (CRS) or congenital rubella infection only associated with the administration of the rubella vaccine RA27/3 during pregnancy.
METHODS:
To classify the prevaccination maternal immune status, a serum sample was taken at the initial evaluation to detect IgM and IgG rubella antibodies (enzyme-linked immunosorbent assay). All pregnancies were followed up and all newborns were evaluated. A cord serum sample of their children was taken at birth. We calculated odds ratio, OR (95% confidence interval, 95% CI) associated with miscarriage, stillbirth, prematurity, low birth weight, and the presence of defects compatible with CRS.
RESULTS:
The prevaccination immune status was established in 797 women and 1191 mother and child pairs were analyzed. Adjusted OR for miscarriage (OR = 0.60, 95% CI = 0.26-1.39), stillbirth (OR = 1.32, 95% CI = 0.10-16.81), prematurity (OR = 0.25, 95% CI = 0.03-2.39), low birth weight (OR = 0.25, 95% CI = 0.03-2.23) and defects compatible with CRS (OR = 1.09, 95% CI = 0.34-3.54) showed no association between immune and susceptible maternal status. There were no cases of CRS and no children were IgM positive.
CONCLUSIONS:
No adverse pregnancy outcome such as miscarriages or CRS was documented in women who were vaccinated and unknowingly pregnant. These results support RA27/3 rubella vaccine safety.
AuthorsXiomara Badilla, Ana Morice, Maria L Avila-Aguero, Elizabeth Saenz, Ilse Cerda, Susan Reef, Carlos Castillo-Solórzano
JournalThe Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 26 Issue 9 Pg. 830-5 (Sep 2007) ISSN: 0891-3668 [Print] United States
PMID17721380 (Publication Type: Journal Article)
Chemical References
  • Immunoglobulin G
  • Immunoglobulin M
  • Rubella Vaccine
Topics
  • Adolescent
  • Adult
  • Costa Rica (epidemiology)
  • Databases, Factual
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fetus (drug effects, virology)
  • Humans
  • Immunoglobulin G (blood)
  • Immunoglobulin M (blood)
  • Infant, Newborn
  • Male
  • Mass Vaccination
  • Pregnancy (immunology)
  • Pregnancy Complications, Infectious (epidemiology, immunology)
  • Pregnancy Outcome (epidemiology)
  • Rubella (congenital, immunology, prevention & control)
  • Rubella Vaccine (administration & dosage, adverse effects, immunology)

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