An audit of rubella IgG antibody status in antenatal women in a NHS Trust over 5 years (2005–2009)

Rubella seronegativity in antenatal screening – Is it influenced by the introduction of universal childhood rubella immunization?

“…Recent literature suggested declining rubella immunity despite universal immunization [3][4][5][6][7][8][9][10], and our study may help to shed light on this paradox, especially when we have included in the analysis the potentially confounding effect of the influx of parturients not covered by a similar immunization program in the obstetric population. Although rubella vaccine is the most effective component in the MMR vaccine [44,45], antibody levels declined substantially over time even after two doses [44], but especially if a second dose was not given [46].…”

“…Despite the impressive statistics, 8.1% of our Hong-Kong-born parturients were seronegative [30]. In light of declining rubella immunity despite universal rubella immunization reported elsewhere [3][4][5][6][7][8][9][10], and the sizable influx of non-Hong-Kong-born parturients (mostly from mainland China) in the past decade, this study was performed to examine the impact of rubella immunization, using maternal year-of-birth as proxy for exposure to the different childhood immunization protocols, on antenatal rubella serology in Hong-Kong-born parturients, comparing with non-Hong-Kong-born parturients who were not covered by the same immunization protocols.…”

“…Furthermore, recent findings indicated declining rubella immunity and incidence of antibody levels of ≥10 IU/ml among women born after, compared with women born before, the introduction of routine universal rubella immunization in Sweden [3], the UK [4][5][6], Israel [7,8], Poland [9] and Taiwan [10]. A rubella-specific antibody titer of <10 IU/ml usually equates susceptibility, predisposing to fetal congenital rubella syndrome (CRS) if infection occurs in pregnancy.…”

Post-partum MMR immunisation rates in rubella-susceptible antenatal women

“…In our previous study (Matthews et al 2010) we highlighted the increasing percentage of pregnant women susceptible to rubella. In this study we have examined the uptake of post partum MMR and found in an audit of notes that despite identification of susceptible women during pregnancy, less than 90% had an offer of post-partum immunisation recorded in their notes and almost quarter were discharged without immunisation having been given.…”

“…(Matthews et al, 2010). In this study, susceptible women were identified from laboratory blood samples, and were then followed up by mailing of questionnaires during pregnancy to determine attitudes to, and history of immunisation.…”