Introduction:The tetanus-diphtheria vaccine administered during
pregnancy is used as a toxoid vaccine with an intact antigen structure. In this
study, we investigated the association of tetanus-diphtheria vaccination (TDV)
during pregnancy with adverse maternal and neonatal outcomes and particularly
preeclampsia that may occur during pregnancy. Materials and Methods: From
the patients who presented to our clinic between 01.01.2016 and 31.12.2016 and
underwent a cesarean section, a total of 435 patients, 327 who received TDV and
108 who did not receive TDV, were included in the study. The groups were
compared with respect to their demographic characteristics. The patient data on
the gestational week, birth weight, normal newborn, preeclampsia, small for
gestational age (SGA), early membrane rupture, preterm labor, diabetic mother’s
baby, prematurity, temporary neonatal tachypnea, newborn’s need for intensive
care, and neonatal mortality were recorded. Results: While 14.7% of the
women who had been administered TDV had preeclampsia diagnosis during their
pregnancy, 12% of those who had not been vaccinated were diagnosed with
preeclampsia. This showed no significant correlation between having been
vaccinated during pregnancy and preeclampsia (p=0.474).
The other outcomes we had specified had also no statistically significant
correlations with vaccination during pregnancy. Having been vaccinated during
pregnancy was found correlated only with the place of residence and nulliparity
(p=
References
[1]
American College of Obstetricians and Gynecologists (2013) Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology, 122, 1122.
[2]
Sibai, BM. and Stella, C.L. (2009) Diagnosis and Management of Atypical Preeclampsia-Eclampsia. American Journal of Obstetrics and Gynecology, 200, 481-e1.
https://doi.org/10.1016/j.ajog.2008.07.048
[3]
Elhawary, T.M., El-Bendary, AS. and Demerdash, H. (2012) Maternal Serum Endoglin as an Early Marker of Pre-Eclampsia in High-Risk Patients. International Journal of Women’s Health, 4, 521. https://doi.org/10.2147/IJWH.S35318
[4]
Gautret, P. and Wilder-Smith, A. (2010) Vaccination against Tetanus, Diphtheria, Pertussis, and Poliomyelitis in Adult Travelers. Travel Medicine and Infectious Disease, 8, 155-160. https://doi.org/10.1016/j.tmaid.2010.02.007
[5]
Kliegman, R.M., Stanton, B.F., Schor, N.F., St. Geme III, J.W. and Behrman, R.E. (2015) Nelson Pediatric. Saunders, Phialdelphia, 991-994.
[6]
Agudelo, C., Villar, J. and Lindheimer, M. (2008) Maternal Infection and Risk of Preeclampsia: Systematic Review and Metaanalysis. American Journal of Obstetrics & Gynecology, 198, 7. https://doi.org/10.1016/j.ajog.2007.07.040
[7]
Cunningham, F.G., Leveno, K.J., Bloom, S.L., Spong, C.Y., Dashe, J.S., Hoffman, B.L., Casey, B.M. and Sheffield, J.S. (2016) Williams Obstetrics. 24th Edition, McGraw-Hill Professional Publishing, New York, 728-779.
[8]
Jamieson, D.J., Theiler, R.N. and Rasmussen, S.A. (2006) Emerging Infections and Pregnancy. Emerging Infectious Diseases Journal, 12, 1638-1643.
https://doi.org/10.3201/eid1211.060152
[9]
Centers for Disease Control and Prevention (CDC) (2013) Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women: Advisory Committee on Immunization Practices (ACIP), 2012. Morbidity and Mortality Weekly Report, 62, 131-135.
[10]
WHO (2012) Vaccines against Influenza WHO Position Paper. The Weekly Epidemiological Record, 87, 461-476.
[11]
WHO (2006) Tetanus Vaccine. The Weekly Epidemiological Record, 81, 198-208.
[12]
Swamy, G.K. and Heine, R.P. (2015) Vaccinations for Pregnant Women. Obstetrics & Gynecology, 125, 212-226. https://doi.org/10.1097/AOG.0000000000000581
[13]
Elimination of Maternal and Neonatal Tetanus, Health, UNICEF.
https://www.unicef.org/health/index_43509.html
[14]
Salama, M.M., Hady, O.A., Ashour, W., Mostafa, A., El Alkamy, S., El Sayed, N., et al. (2009) A Randomized Controlled Trial Administration of Tetanus Toxoid (TT) versus Tetanus and Reduced Diphtheria (Td) in Pregnant Women. Journal of Clinical Immunology, 29, 524-531. https://doi.org/10.1007/s10875-009-9289-5
[15]
Morgan, J.L., Baggari, S.R., McIntire, D.D. and Sheffield, J.S. (2015) Pregnancy Outcomes after Antepartum Tetanus, Diphtheria, and Acellular Pertussis Vaccination. Obstetrics & Gynecology, 125, 1433-1438.
https://doi.org/10.1097/AOG.0000000000000862
[16]
Kharbanda, E.O., Vazquez-Benitez, G., Lipkind, H.S., Klein, N.P., Cheetham, T.C., Nalewaye, A.L., Lee, G.M., Hambidgeg, S., Jackson, M.L., Omeri, S.B., McCarthyj, N. and Nordina, J.D. (2016) Maternal Tdap Vaccination: Coverage and Acute Safety Outcomes in the Vaccine Safety Datalink, 2007-2013. Vaccine, 34, 968-973.
[17]
Berenson, A.B., Hirth, J.M., Rahman, M., Laz, T.H., Rupp, R.E. and Sarpong, K.O. (2016) Maternal and Infant Outcomes among Women Vaccinated against Pertussis during Pregnancy. Human Vaccines & Immunotherapeutics, 12, 1965-1971.
https://doi.org/10.1080/21645515.2016.1157241
[18]
Kharbanda, E.O., Vazquez-Benitez, G., Lipkind, H.S., Klein, N.P., Cheetham, T.C., Naleway, A., McCarthy, N.L., et al. (2014) Evaluation of the Association of Maternal Pertussis Vaccination with Obstetric Events and Birth Outcomes. Jama, 312, 1897-1904. https://doi.org/10.1001/jama.2014.14825
[19]
Maertens, K., Caboré, R.N., Huygen, K., Hens, N., Van Damme, P. and Leuridan, E. (2016) Pertussis Vaccination during Pregnancy in Belgium: Results of a Prospective Controlled Cohort Study. Vaccine, 34, 142-150.
https://doi.org/10.1016/j.vaccine.2015.10.100
[20]
Zheteyeva, Y.A., Moro, P.L., Tepper, N.K., Rasmussen, S.A., Barash, F.E., Revzina, N.V., et al. (2012) Adverse Event Reports after Tetanustoxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines in Pregnant Women. American Journal of Obstetrics & Gynecology, 207, 59.e1-7. https://doi.org/10.1016/j.ajog.2012.05.006
[21]
Dabrera, G., Amirthalingam, G., Andrews, N., Campbell, H., Ribeiro, S., Kara, E., et al. (2015) A Case-Control Study to Estimate the Effectiveness of Maternal Pertussis Vaccination in Protecting Newborn Infants in England and Whales, 2012-2013. Clinical Infectious Diseases, 60, 333-337. https://doi.org/10.1093/cid/ciu821
[22]
Donegan, K., King, B. and Bryan, P. (2014) Safety of Pertussis Vaccination in Pregnant Women in UK: Observational Study. BMJ, 349, g4219.
https://doi.org/10.1136/bmj.g4219
