The Indian Journal of Pediatrics

, Volume 76, Issue 3, pp 279–282 | Cite as

Congenital rubella syndrome after rubella vaccination in 1–4 weeks periconceptional period

  • R. Nasiri
  • J. Yoseffi
  • M. Khajedaloe
  • M. Sarafraz Yazdi
  • F. Delgoshaei
Original Article

Abstract

Objective

To examine weather exposure to rubella vaccine during 1–4 wk periconceptional period can cause congenital rubella syndrome (CRS).

Methods

This prospective study was performed in 60 pregnant women who received rubella vaccine inadvertently 1–4 wk pre or post conception. Time of conception was determined by last menstrual period (LMP) and first trimester sonography. In addition to gathering mother’s obstetric and demographic information, all neonates were evaluated for CRS signs by systemic physical examination and anti rubella IgG and IgM antibody titers in cord blood samples.

Results

A total of 60 pregnant women with the median gestational age of 38 weeks were studied. The mean maternal age was 22 years and 58.3% of pregnancies were unintended. In 90% of mothers there were no post vaccination side effects (fever, lymphadenopathy, arthritis, arthralgia). None of the mothers had a history of drug abuse, smoking or teratogenic exposures. Mean neonatal weight was 3100grs and 6.7% of them were premature. No signs of CRS were found in the neonates based on systemic physical exam at birth and one month later. Mean value of cord blood anti rubella IgG titere was 148/28±67/26 lu/ml. cord blood anti rubella IgM was negative in all of the neonates.

Conclusion

In this study inadvertent rubella vaccination 1–4 wk before and after conception did not cause CRS in neonates and according to all reasearches pregnancy termination is not indicated in these cases.

Key words

Congenital rubella syndrome Pregnancy Rubella vaccination 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infections Diseases. In Gershon AA. Rubella virus, 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2005;1929.Google Scholar
  2. 2.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap L, Wenstrom KD. Williams’s Obstetrics, 22nd ed. New York; Mc Graw-Hill, 2005; 1282.Google Scholar
  3. 3.
    Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of pediatrics. In Stoll BJ, Kliegman RM, Nervous system disorders, 17th ed. Philadelphia; Sannders, 2004; 569.Google Scholar
  4. 4.
    Modlin JF, Brandling-Bennet AD, Witte JJ et al. A review of 5 years experience with Rubella vaccine in the united states. Pediatrics 1975; Ss: 20.Google Scholar
  5. 5.
    Tingle AY, Chantler JK, Pot KH et al. Postpartum Rubella immunization Association with development of prolonged arthritis,neurological sequelas and chronic rubella viremia. J Infect Dis 1985;152:606–612.PubMedGoogle Scholar
  6. 6.
    Sheridan E, Aitken C, Jeffries D et al. congenital Rubella Syndrome: A risk in immigrant populations. Lancet 2002;359:674–675.PubMedCrossRefGoogle Scholar
  7. 7.
    Phillips CA, Maeck JV, Rogers WA, Savel H. Intrauterine rubella infection following immunization with rubella vaccine. JAMA 1970;213: 624–625.PubMedCrossRefGoogle Scholar
  8. 8.
    Centers for Disease control and prevention. Rubella vaccination during pregnancy 1971–1988. MMWR 1989; 38:289–293.Google Scholar
  9. 9.
    Enders G. Rubella antibody titers in vaccinated and nonvaccinated women and results of vaccination dring pregnancy. Rew Infect Dis 1985; 1:S103–107.Google Scholar
  10. 10.
    Preblud SR, Williams NM. Fetrl Risk Associated with Rubella Vaccine: Implications for Vaccination of Susceptible Women. Obstet Gynecol 1985; 66: 121–123.PubMedGoogle Scholar
  11. 11.
    Burgess MA. Rubella Vaccination just before or During Pregnancy. Med J Austral 1990; 152:507–508.PubMedGoogle Scholar
  12. 12.
    Centers for Disease control and prevention. Notice to readers: revised ACIP recommendation for avoiding pregnancy after receiving rubella containing vaccine MMWR Morb Martal Wkly Rep 2001; 50:1117.Google Scholar
  13. 13.
    Haas DM, flowers CA, Congdon cl. Rubella, Rubeola and Mumps in Pregnant Women: Susceptibilities and Strategies For testing and Vaccinating. Obstet Gynecol 2005; 162: 295–300.Google Scholar
  14. 14.
    Su SB, Guo HR. Seroprevalence of Rubella among Women of Childbearing age in Taiwan after Nationwide Vaccination. Am J Trop Med Hyg 2002; 67:549–553.PubMedGoogle Scholar
  15. 15.
    Bakbook DN, el nafaty AU, Obed Sy. Prevalence of rubella specific IgG antibody in non-immunized pregnant women in Maiduguri, north eastern Nigeria. Cent Eur J Public Health 2002; 10: 21–23.Google Scholar
  16. 16.
    Baradaran H, Borhani M, Edalatian Z. Evaluation of serumanti rubella antibody in 504 16–22 years old girls. Medical J Mashhad University of Medical Sciences 1993; 3643–44: 5–9.Google Scholar
  17. 17.
    Soleimanjabi H, Bamdad T, Fotouhi F, Roustai MH, Faghihzadeh. Sprevalence of HI antibody titer against rubella virus to determine the effect of mass vaccination in Tehran. J Clin Virol 2005; 34: 153–154.CrossRefGoogle Scholar
  18. 18.
    Benjamin Bar-oz, Zina Levichek, Myla E. Moretti, Corinna Mash, Stella Andreou, Gideon Koren. Pregnancy outcome following rubella vaccination: a prospective controlled study. Am J Med Genetics 2004; 130A:52–54.CrossRefGoogle Scholar
  19. 19.
    Hamkar R, Jalilvand S et al. Inadvertant rubella vaccination of pregnant women: evaluation of possible transplacental infection with rubella vaccine. Vaccine 2006; 24:3558–3563.PubMedCrossRefGoogle Scholar
  20. 20.
    Bart Sw, Stetler HC, Preblud SR, Williams NM, Orenstein WA, Bart KJ et al. Fetal risk asso ciated with rubella vaccine: An update. Review Infect Dis 1985 7: S95. S102.Google Scholar
  21. 21.
    Tookey PA, Jones G, Miller BH, Peckham GS. Rubella vaccination in pregnancy. CDR (Lond Eng Rev) 1991; 1: R86–R88.Google Scholar
  22. 22.
    Hofman J, Kortang M, Pustowoit B, Faber R, Piskazeck U, Leibert UG. Persistent fetal rubella vaccine virus infection following inadvertent vaccination during early pregnancy. J Med Virol 2000; 61: 155–158.CrossRefGoogle Scholar
  23. 23.
    Ushida M, Kataw S, Furu Kawa S. Congenital rubella Syndrom due to infection after maternal antibody conversion with vaccine. Jpn J Infect Dis 2003; 56: 68–69.PubMedGoogle Scholar
  24. 24.
    Namazaki K, Fujikawa T. Intracranial calcification with congenital rubella syndrom in a mother with serologic immunity. J Child Neurol 2003; 18: 296–297.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2009

Authors and Affiliations

  • R. Nasiri
    • 1
    • 2
  • J. Yoseffi
    • 1
  • M. Khajedaloe
    • 1
  • M. Sarafraz Yazdi
    • 1
  • F. Delgoshaei
    • 1
  1. 1.Department of Obstetrics and Gynecology, Department of Neonatalogy, Bahman HospitalIslamic Azad UniversityMashhad, KhorasanIran
  2. 2.Department of Obstetrics and Gynecology, Department of Neonatalogy, 22 Bahman HospitalIslamic Azad UniversityMashad, KhorasanIran

Personalised recommendations