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Measles Antibody Titers in Early Infancy

Medha Kamat, MD; Suma Pyati, MD; Rosita S. Pildes, MD; Norman Jacobs, MD; Marietta Luayon, MD; Robert Muldoon, PhD; Paul S. Levy, ScD
Arch Pediatr Adolesc Med. 1994;148(7):694-698. doi:10.1001/archpedi.1994.02170070032005.
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Objective:  To determine the prevalence of measles seronegativity among infants younger than 6 months and to ascertain their serologic response to measles vaccine.

Design:  Cross-sectional measles antibody survey during the 1989 measles epidemic in Chicago, Ill.

Setting:  Inner-city perinatal center.

Participants:  Two hundred three infants younger than 6 months who had been admitted to the neonatal intensive care unit at birth; 130 (64%) of these infants were premature. Transplacental antibody transfer was evaluated in a subset of 89 mother-newborn pairs.

Intervention:  Administration of measles monovalent vaccine to seronegative infants.

Measurements/Results:  Measles IgG antibody was measured using indirect fluorescent assay. At birth, 19 (38%) of 50 neonates born at less than 37 weeks' gestation had antibody titers that were twofold to fourfold lower than those of their mothers compared with three (8%) of 39 neonates born at more than 37 weeks' gestation (P<.01). Of the 203 study infants, fewer than 4% were seronegative at birth, while 74% of these infants aged 4 to 5 months were seronegative. Univariate logistic regression analysis indicated that the independent variables related to seronegativity were as follows: gestational age at birth (P=.007), chronological age (P<.001), history of having received three or more packed red blood cell transfusions (P<.001), and maternal age at delivery (P=.001). Multiple logistic regression analysis confirmed the association of seronegativity with chronological age (P<.001), gestational age (P<.02), and maternal age at delivery (P<.001). Seroconversion following administration of the measles vaccine was documented in 11(79%) of 14 infants.

Conclusion:  A significant proportion of 4- to 5-month-old infants who had been admitted to the neonatal intensive care unit at birth lack measurable measles antibody; this population should be taken into account when strategies to control measles are considered.(Arch Pediatr Adolesc Med. 1994;148:694-698)


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