# name
Rubella susceptibility in pregnant women and results of a postpartum immunization strategy in Catalonia, Spain

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BACKGROUND: Elimination of congenital rubella syndrome depends
                not only on effective childhood immunization but also on the
                identification and immunization of rubella susceptible women. We
                assessed rubella susceptibility among pregnant women and
                evaluated the adherence and response to postpartum immunization
                with measles, mumps and rubella (MMR) vaccine. METHODS:
                Cross-sectional study of women who gave birth at the Hospital
                Clinic de Barcelona (Spain) between January 2008 and December
                2013. Antenatal serological screening for rubella was performed
                in all women during pregnancy. In rubella-susceptible women, two
                doses of MMR vaccine were recommended following birth. We
                evaluated rubella serological response to MMR vaccination in
                mothers who complied with the recommendations. RESULTS: A total
                of 22,681 pregnant women were included in the study. The mean
                age was 32.3 years (SD 5.6), and 73.6% were primipara. The
                proportion of immigrants ranged from 43.4% in 2010 to 38.5% in
                2012. The proportion of women susceptible to rubella was 5.9%
                (1328). Susceptibility to rubella declined with increasing
                maternal age. Immigrant pregnant women were more susceptible to
                rubella (7.6%) than women born in Spain (4.6%). Multivariate
                analyses showed that younger age (</=19 years) aOR 1.7 (95%
                CI 1.1-2.5), primiparas aOR 1.3 (95% CI 1.1-1.5) and immigrant
                women aOR 1.6 (95% CI 1.4-1.8) were more likely to be
                susceptible. The second dose of MMR vaccine was received by
                57.2% (718/1256) of rubella-susceptible women, with the highest
                proportion being immigrant women compared with women born in
                Spain. After vaccination, all women showed rubella immunity.
                CONCLUSIONS: The higher rubella susceptibility found in the
                three youngest age groups and in immigrant women highlights the
                relevance of antenatal screening, in order to ensure
                identification and postpartum immunization. The postpartum
                immunization strategy is an opportunity to protect women of
                childbearing age and consequently prevent occurrence of CRS, and
                to increase vaccination coverage against rubella and other
                vaccine-preventable diseases.

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Versió postprint del document publicat a:             http://dx.doi.org/10.1016/j.vaccine.2015.02.043

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Rubella susceptibility in pregnant women and results of a postpartum immunization strategy in Catalonia, Spain