Maternal Immunization to Benefit the Mother, Fetus, and Infant

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Key points

  • Prevention of vaccine-preventable diseases through immunization is one of the greatest public health achievements in the United States and worldwide.

  • Pregnant women are at risk for the same infections as their nonpregnant peers and, in some cases, have increased morbidity and mortality.

  • Maternal immunization provides maternal, fetal (preterm birth, fetal growth restriction, and fetal demise), and infant benefit (infection during early life).

  • Future research should focus on maternal vaccine

Maternal benefits of immunization

During pregnancy there are physiologic and immunologic changes that increase a woman’s susceptibility to infection, making prevention and, thus, vaccination a highly important component of routine prenatal care. The immune response is modified to decrease inflammatory immune responses and diminish fetal rejection.16 In addition, there is a shift from a T-helper 1 (Th1) response toward a more Th2-favored response, allowing for fetal antigen tolerance, but potentially increasing maternal

Fetal benefits of maternal immunization

One commonly cited barrier to maternal vaccination is parental and provider fear of causing fetal harm.40 Given the theoretical risks associated with antepartum vaccination, the safety of recommended vaccines in pregnancy has been looked at extensively. As discussed previously, only inactivated vaccines are considered for use during pregnancy. Moreover, inadvertent administration of live attenuated vaccines in early pregnancy, specifically measles-mumps-rubella and varicella vaccines, has never

Infant benefits of maternal immunization

Early infant immunity is fairly immature, complex, and highly dependent on maternal immunity because of the phenomenon of transplacental transfer of maternal antibodies to the developing fetus. First studied in the 1800s, it was observed that infants born to mothers who had survived pertussis were less likely to contract pertussis early in life.52 In the 1970s, antibody levels of women colonized with group B Streptococcus (GBS) were found to correlate with neonatal infection, such that infants

Summary

Prevention of VPDs through immunization is one of the greatest public health achievements in the United States and worldwide. Immunizing women during pregnancy with recommended vaccines provides direct maternal benefit. In addition, maternal immunization has potential fetal benefits by preventing adverse pregnancy outcomes (preterm birth, fetal growth restriction, and fetal demise), and potential infant benefit by preventing infection during early life. Research should continue to focus on

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  • Cited by (0)

    Dr. Swamy has received past support from GlaxoSmithKline, Inc. for consultant and speaker activities which ended March 2012. Dr. Swamy has received funding from the National Institutes of Health, the Centers for Disease Control and Prevention, the American College of Obstetrics & Gynecology,and GlaxoSmithKline, Inc. to conduct vaccine-related research.

    Dr. Garcia-Putnam - none.

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