BMJ Paediatrics Open · 9 authors, 7 centres
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A cross-sectional study of 293 mother-newborn pairs in Kampala, Uganda found that 88.1% of neonates had protective antitetanus antibody titres. High maternal titres, a first antenatal visit at or after 12 weeks, and receiving a tetanus toxoid dose at or after 28 weeks of gestation were associated with protective neonatal antibodies.
This cross-sectional study examined antitetanus toxoid antibody transfer in 293 mother-newborn pairs at Kawempe National Referral Hospital in Kampala, Uganda. Cord blood and maternal venous blood were collected at delivery and titred using a quantitative ELISA kit. The primary outcome was the proportion of newborns with protective antibody titres (≥0.1 IU/mL). Factors associated with protective neonatal antibodies included high maternal titres, a first antenatal visit at or after 12 weeks, and receiving a tetanus toxoid dose at or after 28 weeks of gestation. Vaccination before the current pregnancy was not associated with protective neonatal antibodies regardless of the number of historical doses. Low birth weight was associated with lower antibody levels. HIV status did not significantly affect antibody responses. Limitations included difficulties in reliably assessing gestational age and a relatively small sample size resulting in wide confidence intervals. Findings support administering a tetanus toxoid dose during the third trimester of each pregnancy.
