Rubella Immune Status in Pregnant Women in a Northern Mexican City

Rubella seroprevalence among pregnant women in the region of Rabat, Morocco: a cross-sectional study

OBJECTIVES

The aim of the present research is to update data on the seroprevalence of rubella and to identify the associated risk factors among pregnant women in the Rabat region of Morocco in order to take immediate action to monitor the virus.

DESIGN

A cross-sectional study.

SETTING

The study was conducted at Ibn Sina University Hospital and at referral healthcare centres in the region of Rabat.

PARTICIPANTS

A total of 502 pregnant women (mean age 29.7±6.3 years, range 17-44 years) attending the maternity department during 8 months were selected for serological testing.

OUTCOME MEASURES

A structured questionnaire was used to obtain sociodemographic, reproductive and clinical characteristics after obtaining written informed consent. Venous blood samples were collected to determine rubella-specific IgG antibodies using an automated chemiluminescent microparticle immunoassay (ARCHITECT i1000SR and i2000SR, Abbott Diagnostics).

RESULTS

Antirubella IgG antibodies (≥10 IU/mL) were found in 408 (85.9%) pregnant women examined. The rate of susceptibility to rubella virus infection among pregnant women was found to be 14.1%. These protective rates were found to differ significantly between uneducated pregnant women (80.9%) and those with university-level education (95.5%) (p=0.02). Pregnant women in the 17-24, 25-34 and 35-44 years age groups accounted for 92.5%, 85.2% and 82.8%, respectively (p=0.015). Also, IgG seropositivity status was found to differ significantly between multiparous (83.3%) and primiparous (92.5%) pregnant women (p=0.01). None of the other characteristics was significantly associated with rubella infections.

CONCLUSION

Vaccination programmes need to be updated to ensure that campaigns reach their specified goals. Thus, implementing an effective, large-scale screening programme for congenital rubella infection in different regions of Morocco is highly recommended. On the other hand, seronegative pregnant women should be given special preventive care and health education about rubella transmission and congenital rubella syndrome sequelae.

Related factor of igg rubella-specific in couples of childbearing age in bolaang mongondow district

OBJECTIVE

This study aims to determine the determinant factors associated with the amount of Specific Rubella IgG levels in women of childbearing age.

METHODS

The study design used observational analytic with cross-sectional, while sample was women of childbearing age who were in Maelang Health Center, as well as fulfilling the specified inclusion criteria 125 samples.

RESULTS

There was no significant relationship between age (p=0.097), type of work (p=0.302), education (p=0.160), income (p=0.099) and parity (p=0.314) with immunological status rubella, and significant is history of miscarriage (p=0.027). Multivariate analysis showed history of miscarriage was dominant factor in immunological status of rubella (p=0.027; OR=5.469).

CONCLUSION

It is expected that health workers in study area increase counseling about the danger of rubella virus either at posyandu or subdistrict level musrembang activities and government is expected to support and provide latest innovations.

Rubella Immunity in Pregnant Iranian Women: A Systematic Review and Meta-Analysis

Rubella infection within the first trimester of pregnancy may lead to adverse pregnancy outcomes. The present study was conducted to evaluate the immunity against rubella among the pregnant Iranian women. The steps of meta-analyses were conducted based on the MOOSE protocol and results were reported according to the PRISMA guideline. To review the associated English and Persian literature, a comprehensive search was conducted among the international databases such as Scopus, PubMed/Medline, Science Direct, Embase, Cochrane library, Web of Science and Google Scholar search engine as well as Iranian databases, until April 1, 2018 using the following medical subject headings (MeSH) keywords: 'Pregnant', 'Gestational', 'Prenatal care', 'Complications of pregnancy', 'Pregnancy', 'Rubella infection', 'Prevalence, 'Epidemiology', 'Immunity', 'Immunization', 'Antibody', 'Immunogenicity' and 'Iran'. Cochran's Q test and I2 index were used to investigate heterogeneity in the studies. Random effects model was used to estimate the rate of rubella immunity. The obtained data were analyzed using Comprehensive Meta-Analysis Ver.2. Fifteen studies constituting 7,601 pregnant Iranian women met the inclusion criteria. The overall pooled rubella immunity rate was 90.1% [95% confidence interval (CI): 86.1-93.1]. Rubella immunity rates were respectively 88.6% (95% CI: 80.6-93.6) and 91.5% (95% CI: 88.1-93.9) before and after national vaccine program. Rubella immunity rates were 91.4% (95% CI: 87.8-94.0) and 87.2% (95% CI: 74.3-94.1) based on the enzyme-linked immunosorbent assay (ELISA) and haemagglutination-inhibition (HAI) methods, respectively. There was no significant association between rubella immunity and vaccination program (P=0.398), diagnostic methods (P=0.355), geographic regions (P=0.286), quality of the studies (P=0.751), occupation (P=0.639), residence (P=0.801), and year of the studies (P=0.164), but it was significantly associated with age (P<0.001). Despite high rubella immunity among the pregnant Iranian women, anti-rubella antibody screening is recommended for all women of childbearing age.

The 'Dangerous Cocktail': an epidemiological survey on the attitude of a population of pregnant women towards some pregnancy risk factors

Many investigations have shown the important role played by risk factors such as tobacco and alcohol and infectious agents (especially Rubella) in the development of congenital anomalies (CAs). Through the administration of a questionnaire, we evaluated the attitude of a population of pregnant women towards some risk factors in pregnancy (smoking and alcohol habit and risk of contracting one of TORCH agents). 14% of the women continued to smoke despite pregnancy; the majority of these were 34-35 years old, divorced, workers and with a high educational level. The 4.3% who identified as moderate drinkers; were mainly younger and married. Concerning the TORCH agents, it a high percentage were negative to the Rubella antibodies (62.8%). In order to improve the awareness of pregnant women on these risk factors, health education campaigns represent a public health cornerstone. Impact statementWhat is already known on this subject? Several investigations have shown an association between congenital anomalies (CAs) and various exogenous factors such as air pollutants, pesticides, metals, radiations and others present in the environmental matrices. Moreover, an important role is played by some risk factors linked to the lifestyles (i.e. tobacco and alcohol).What do the results of this study add? Our study shows that the awareness of the women about the importance of these risk factors is still rather poor, especially concerning the avoidable risks associated with smoke and alcohol and the preventable risk associated with rubella infection.What are the implications of these findings for clinical practice and/or further research? Our results highlight the importance of continuous health education both about the risk to smoke and drink during pregnancy and about the risk not to have had contract the rubella infection before the pregnancy. Particularly, about the latter issue, it appears necessary to increase the pre-conceptional diagnosis and, eventually, to vaccinate the women resulted negative in order to eliminate congenital rubella.

Rubella virus infections and immune status among pregnant women before the introduction of rubella vaccine in Amhara Regional State, Ethiopia

BACKGROUND

Rubella and its associated congenital anomalies have been greatly reduced in most developed countries through use of the rubella vaccine. However, the magnitude of the problem is underestimated and there are no well-established rubella/congenital rubella syndrome prevention and control strategies in many developing countries, including Ethiopia. The aim of this study was to determine the prevalence of rubella virus infections among pregnant women and their immune status before the introduction of rubella vaccine in Amhara Regional State, Ethiopia.

METHODS

A prospective cross-sectional study was conducted among pregnant women in Dessie, Felege-Hiwot, and University of Gondar referral hospitals, from December 2015 to February 2017. After obtaining written informed consent, socio-demographic data, reproductive history, clinical manifestations, and the possible risk factors for rubella virus infections were collected using a structured questionnaire. The laboratory analysis of rubella-specific antibodies was done using an enzyme-linked immunoassay method on venous blood samples. Data were entered and analyzed using IBM SPSS Statistics version 20. Binary logistic regression was used to determine the strength of association between the dependent variables and covariates.

RESULTS

A total of 600 pregnant women were included in the study. Their mean age was 26.4±5years (range 16-40 years). The overall seroprevalence of rubella infection was 89%. Of the total study participants, 9.5% were positive for rubella-specific IgM antibody, which indicates acute/recent rubella virus infection. In contrast, 79.5% of them had protective levels of rubella-specific IgG antibody and were immune as a result of previous wild-type rubella infection. However, 11% of the pregnant women were negative for both rubella-specific antibodies; these women represent the susceptible group.

CONCLUSIONS

A large number of pregnant women had acute/recent rubella virus infections at the time of data collection, indicating that the virus is endemic in the study area. More than a tenth of pregnant women were found to be susceptible to acquiring the infection in future pregnancies, with the possible risk of rubella-associated congenital anomalies. Hence screening of all women of child-bearing age before conception and during pregnancy might reduce the devastating effects of the virus on the developing fetus.

Rubella seroprevalence among pregnant women in Beijing, China

Background

Rubella infection in pregnant women can result in serious effects, such as miscarriages, stillbirths, and congenital rubella syndrome (CRS). However, very little is known about the rubella seroprevalence among pregnant women in China.

Methods

This is a cross-sectional and hospital-based study. From June 2016 through March 2017, a total of 324 serum samples from healthy pregnant women were collected in the Shunyi Women and Children’s Hospital of Beijing Children’s Hospital. Rubella-specific IgG antibody was determined by ELISA (Euroimmun, Lübeck, Germany) kits. International assigned cut-off values of ≥10 IU/ml were used to assess the percentage of pregnant women with protective IgG concentrations.

Results

The total rate of protected individuals was 83.3% (95% CI: 78.9%–87.0%). The protective rates of pregnant women in 17–26 years group, 27–36 years group and 37–46 years group were 84.0% (95% CI: 75.3%–90.1%), 81.9% (95% CI: 74.9%–87.4%) and 84.9% (95% CI: 75.8%–90.9%) respectively. No significant difference in protective rates among the three age groups was found (P = 0.83). There were also no statistically significant correlations between protective rates and gravidity (P = 0.84), parity (P = 0.84), birth place (P = 0.16), residence area (P = 0.58), education (P = 0.40) or occupation (P = 0.65).

Conclusions

Despite the generally low vaccination coverage for rubella, most of Chinese pregnant women had potent rubella immunity. However, at least 16.7% of pregnant women were susceptible to rubella, which suggested rubella immunization in Chinese women at or before child-bearing age.