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Fetal infection resulting from maternal rubella after the first trimester of pregnancy

Published online by Cambridge University Press:  19 October 2009

J. E. Cradock-Watson ,
Margaret K. S. Ridehalgh ,
Mary J. Anderson ,
J. R. Pattison  and
H. O. Kangro
J. E. Cradock-Watson
Affiliation:
Public Health Laboratory, Withington Hospital, Manchester M20 8LR
Margaret K. S. Ridehalgh
Affiliation:
Public Health Laboratory, Withington Hospital, Manchester M20 8LR
Mary J. Anderson
Affiliation:
Department of Medical Microbiology, King's College Hospital, Medical School, London SE5 8RX
J. R. Pattison
Affiliation:
Department of Medical Microbiology, King's College Hospital, Medical School, London SE5 8RX
H. O. Kangro
Affiliation:
Department of Virology, The London Hospital Medical College, Turner Street, London E1 2AD
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We have tried to measure the incidence of prenatal infection in 304 infants whose mothers had had rubella at various times after the first 12 weeks of pregnancy. Two methods of assessment were used: first, serum obtained soon after birth was tested for specific IgM antibody; secondly, serum obtained after the age of eight months was tested for specific IgG. When maternal rubella occurred 12–16 weeks after the last menstrual period specific IgM antibody was detected in 28 out of 50 infants (56%). The proportion fell progressively to 12% after maternal rubella at 24–28 weeks, rose to 19% after rubella at 28–36 weeks and then to 58% when the illness occurred during the last month of pregnancy. In all, IgM antibody was detected in 77 out of 260 infants (29%). The fetus can thus be infected at any time during the second and third trimesters of pregnancy, but the risk varies at different stages.

The figures for the prevalence of IgG antibody were greater throughout, because some infants had IgG who had previously lacked specific IgM. After maternal rubella at 12–16 weeks IgG antibody persisted in 22 out of 31 infants (71%). The proportion fell to 28% after rubella at 24–28 weeks and then increased progressively to 94% after rubella during the last month. In all, IgG antibody persisted in 94 out of 190 infants (49%). The true rate of fetal infection probably lies between the rates estimated from the presence of IgM antibody and the subsequent prevalence of IgG.

Infants whose mothers had rubella at any time during pregnancy should be examined regularly for possible evidence of damage.

Type
Research Article
Information
Journal of Hygiene , Volume 85 , Issue 3 , December 1980 , pp. 381 - 391
Copyright
Copyright © Cambridge University Press 1980

References

REFERENCES

Alford, C. A. Jr, Neva, F. A. & Weller, T. H. (1964). Virologic and serologic studies on human products of conception after maternal rubella. New England Journal of Medicine 271, 1275.CrossRefGoogle ScholarPubMed
Bradstreet, C. M. P., Kirkwood, B., Pattison, J. R. & Tobin, J. O'H. (1978). The derivation of a minimum immune titre of rubella haemagglutination-inhibition (III) antibody. A Public Health Laboratory Service collaborative study. Journal of Hygiene 81, 383.CrossRefGoogle Scholar
Chantler, S., Devries, E., Allen, P. R. & Hurn, B. A. L. (1976). A rapid immunofluorescont procedure for the detection of specific IgG and IgM antibody in sera using Staphylococcus aureus and latex-IgG as absorbents. Journal of Immunological Methods 13, 307.CrossRefGoogle ScholarPubMed
Cooper, L. Z., Green, R. H., Krugman, S., Giles, J. P. & Mirick, G. S. (1965). Neonatal thrombocytopenic purpura and other manifestations of rubella contracted in utero. American Journal of Diseases of Children 110, 410.Google ScholarPubMed
Cradock-Watson, J. E., Bourne, M. S. & Vandervelde, E. M. (1972). IgG, IgA and IgM responses in acute rubella determined by the immunofluorescent technique. Journal of Hygiene 70, 473.CrossRefGoogle ScholarPubMed
Cradock-Watson, J. E., Ridehalgh, M. K. S. & Chantler, S. (1976). Specific immunoglobulins in infants with the congenital rubella syndrome. Journal of Hygiene 76, 109.CrossRefGoogle ScholarPubMed
Cradock-Watson, J. E., Ridehalgh, M. K. S., Pattison, J. R., Anderson, M. J. & Kangro, H. O. (1979). Comparison of immunofluorescence and radioimmunoassay for detecting IgM antibody in infants with tho congenital rubella syndrome. Journal of Hygiene 83, 413.CrossRefGoogle Scholar
Hardy, J. B., McCracken, G. H. Jr, Gilkeson, M. R. & Sever, J. L. (1969). Adverse fetal outcome following maternal rubella after the first trimester of pregnancy. Journal of the American Medical Association 207, 2414.Google Scholar
Horstmann, D. M., Banatvala, J. E., Riordan, J. T., Payne, M. C, Whittemore, R., Opton, E. M. & Florey, C. de V. (1965). Maternal rubella and the rubella syndrome in infants. American Journal of Diseases of Children 110, 408.CrossRefGoogle ScholarPubMed
Kangro, H. O., Pattison, J. R. & Heath, R. B. (1978). The detection of rubella-specific IgM antibodios by radioimmunoassay. British Journal of Experimental Pathology 59, 577.Google ScholarPubMed
Kurtz, J. B., Mortimer, P. P., Mortimer, P. R., Morgan-Capner, P., Shafi, M. S. & White, G. B. B. (1980). Rubella antibody measured by radial haemolysis. Characteristics and performance of a simple screening method for use in diagnostic laboratories. Journal of Hygiene 84, 213.Google Scholar
Lundström, R. (1962). Rubella during pregnancy. A follow-up study of children born after an opidemic of rubella in Sweden, 1951, with additional investigations on prophylaxis and troatmont of matornal rubella. Acta Paediatrica Scandinavica 51 (Suppl. 133), 1.Google Scholar
Manson, M. M., Logan, W. P. D. & Loy, R. M. (1960). Rubella and other virus infections during pregnancy. Reports on Public Health and Medical Subjects No. 101. London: Ministry of Health.Google Scholar
Monif, G. R. G., Sever, J. L., Schiff, G. M. & Traub, R. G. (1965). Isolation of rubella virus from products of conception. American Journal of Obstetrics and Gynecology 91, 1143.Google Scholar
Pitt, D. & Keir, E. H. (1965). Results of rubella in pregnancy. Medical Journal of Australia 2, 647.CrossRefGoogle ScholarPubMed
Rawls, W. E., Desmyter, J. & Melnick, J. L. (1968). Serologic diagnosis and fetal involvement in maternal rubella. Journal of the American Medical Association 203, 627.CrossRefGoogle ScholarPubMed
Rowe, D. S., Grah, B. & Anderson, S. G. (1972). An international reference preparation for human serum immunoglobulins G, A and M: content of immunoglobulins by weight. Bulletin of the World Health Organization 46, 67.Google Scholar
Schiff, G. M. & Dine, M. S. (1905). Transmission of rubella from newborns. American Journal of Diseases of Children 110, 447.Google Scholar
Siegel, M., Fuerst, H. T. & Guinee, V. F. (1971). Rubella epidemicity and embryopathy. Results of a long-torm prospective study. American Journal of Diseases of Children 121, 469.CrossRefGoogle ScholarPubMed
Thompson, K. M. & Tobin, J. O'H. (1970). Isolation of rubella virus from abortion material. British Medical Journal ii, 264.CrossRefGoogle Scholar
Vejtorp, M. & Mansa, B. (1980). Rubella IgM antibodies in sera from infants born after maternal rubella later than tho twelfth week of pregnancy. Scandinavian Journal of Infectious Diseases 12, 1.CrossRefGoogle Scholar
Vesikari, T. (1971). Rubella antibodies in infants whose mothers had rubella during the second and third trimesters of pregnancy. Scandinavian Journal of Infectious Diseases 3, 1.CrossRefGoogle ScholarPubMed
Vesikari, T. (1972). Immuno response in rubella infection. Scandinavian Journal of Infectious Diseases, Suppl. 4, 1.CrossRefGoogle Scholar