Maternal Immunization as a Strategy to Decrease Susceptibility to Infection in Newborn Infants

Benjamin Lindsey; Beate Kampmann; Christine Jones

Disclosures

Curr Opin Infect Dis. 2013;26(3):248-253. 

In This Article

Abstract and Introduction

Abstract

Purpose of review Following on from the success of maternal tetanus vaccination, recent research has shown that other vaccines given in pregnancy can protect against vaccine-preventable infections in early infancy. This review will outline these recent developments and highlight the impact on current clinical practice.

Recent findings Maternal immunization provides protection to the newborn through the transfer of vaccine-induced IgG across the placenta, a process that is affected by multiple variables. The safety of newly recommended maternal vaccines has been further tested in recent studies. Maternal vaccination against influenza and pertussis is recommended in the United Kingdom and United States, with new studies indicating their efficacy. A number of additional maternal vaccines are also in the pipeline, which could be used to combat neonatal infection. Recent research findings have highlighted some of the reasons for the poor uptake of current recommendations among pregnant women.

Summary Tetanus, influenza and pertussis vaccines are now recommended for use during pregnancy, with new vaccines, such as group B streptococcus and respiratory syncytial virus, being developed to prevent important neonatal infections in the future.

Introduction

The concept of maternal immunization has been established for some time; however, there has been recent renewed interest and focus in maternal immunization as a means to protect young infants from vaccine-preventable infections. During early infancy, newborns are partially protected through placental transfer of maternal immunoglobulin. Maternal levels of specific immunoglobulin are however frequently suboptimal and therefore do not necessarily provide adequate protection to the infant.[1] The aim of maternal vaccination is to enhance maternal antibody levels against particular infections, so that a protective level of antibody is transferred to the infant. It is an attractive strategy as it can provide protection against infectious diseases to the mother, her developing fetus and the newborn infant. The firm proof-of-principle was best demonstrated by the success of maternal tetanus vaccination, which is part of routine care in many countries. This review provides an update of maternal vaccination, describing the principles underlying maternal immunization, potential concerns and challenges, and focuses on vaccines that are currently recommended for all pregnant women. We finally outline some future applications.

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