Jill Hutton1, Paul Rowan2, Anthony Greisinger3, Melanie Mouzoon4. 1. Department of Obstetrics and Gynecology, The Woman's Hospital of Texas, Houston. 2. Division of Management, Policy, and Community Health, University of Texas, Houston, School of Public Health, Houston. 3. Kelsey Research Foundation, Houston. 4. Department of Pediatrics, Kelsey-Seybold Clinic, Houston, TX.
Abstract
OBJECTIVE: Although it is commonly accepted that rubella is well-controlled, a recent reemergence of both pertussis and measles might also predict a reemergence of rubella. This study was designed to estimate the current incidence of rubella exposure in pregnancy. STUDY DESIGN: This was a prospective, descriptive study, conducted in Houston, TX, at The Woman's Hospital of Texas. Women are typically screened for rubella immunity at the beginning of pregnancy. Rubella nonimmunity is defined as a titer less than 10 IU/mL in the US. Women who were non-immune early in pregnancy (<20 weeks) were recruited for this study and asked to be tested again for rubella immunity at the time of delivery. RESULTS: Of 298 women who were rubella nonimmune (IgG <10 IU/mL) early in pregnancy, 19 converted to immune status (IgG >40 IU/mL, defined as at least a 4-fold increase) at time of delivery, a rate of 6.38% (4.12% to 9.75%; 95% Wilson-Score confidence interval). For the 19 patients who converted to immune status at time of delivery, 8 patients had levels of 40-150 IU/mL, 6 patients had levels of 151-300 IU/mL, 2 patients had levels of 301-500 IU/mL, and 3 patients had levels >500 IU/mL. CONCLUSION: Pregnancy is a critical time to evaluate rubella exposure. This study estimated the current incidence of rubella exposure in pregnancy to be 6.38%.
OBJECTIVE: Although it is commonly accepted that rubella is well-controlled, a recent reemergence of both pertussis and measles might also predict a reemergence of rubella. This study was designed to estimate the current incidence of rubella exposure in pregnancy. STUDY DESIGN: This was a prospective, descriptive study, conducted in Houston, TX, at The Woman's Hospital of Texas. Women are typically screened for rubella immunity at the beginning of pregnancy. Rubella nonimmunity is defined as a titer less than 10 IU/mL in the US. Women who were non-immune early in pregnancy (<20 weeks) were recruited for this study and asked to be tested again for rubella immunity at the time of delivery. RESULTS: Of 298 women who were rubella nonimmune (IgG <10 IU/mL) early in pregnancy, 19 converted to immune status (IgG >40 IU/mL, defined as at least a 4-fold increase) at time of delivery, a rate of 6.38% (4.12% to 9.75%; 95% Wilson-Score confidence interval). For the 19 patients who converted to immune status at time of delivery, 8 patients had levels of 40-150 IU/mL, 6 patients had levels of 151-300 IU/mL, 2 patients had levels of 301-500 IU/mL, and 3 patients had levels >500 IU/mL. CONCLUSION: Pregnancy is a critical time to evaluate rubella exposure. This study estimated the current incidence of rubella exposure in pregnancy to be 6.38%.
Authors: Bettie Voordouw; Barry Rockx; Thomas Jaenisch; Pieter Fraaij; Philippe Mayaud; Ann Vossen; Marion Koopmans Journal: Clin Microbiol Rev Date: 2019-12-11 Impact factor: 26.132