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目的通过配对研究母亲及其分娩新生儿的麻疹抗体水平的动态变化过程,探询低月龄婴儿麻疹高发的原因,为制定麻疹免疫策略提供理论依据。方法采用横断面研究的方式,采集母亲外周血2 ml和分娩时脐带血(代表新生儿出生时的水平)2 ml,同时在婴儿3、5、7月龄时随访动态观察,采用德国IBL公司试剂ELESA方法测定血清中麻疹Ig G抗体水平。结果孕产妇及新生儿脐带血的麻疹抗体滴度分别是:Max孕妇=6 522,Min孕妇=62,Med孕妇=834.5和Max脐带=6 233,Min脐带=61,Med脐带=760.5,两者差异无统计学意义(t=0.87,P=0.39)。母亲及婴儿脐带血麻疹血清抗体阳性率分别为84.48%和86.21%,血清抗体保护率分别为50.00%和46.55%。母婴麻疹血清抗体水平具有正相关性(r=0.83,P<0.01),婴儿脐带血抗体水平随母亲抗体水平的升高而升高(χ2=42.85,P<0.01)。婴儿麻疹抗体阳性率3月龄时为29.27%,5月龄时为5.88%,7月龄及以后全阴。母亲保护性抗体阳性者的婴儿脐带血保护性抗体阳性率(89.66%)比母亲保护性抗体阴性者的(3.45%)高(χ2=20.06,P<0.01)。不论母亲是否有保护性抗体,3月龄及以后各月龄时婴儿的麻疹保护性抗体阳性率均为0。结论目前新生儿麻疹抗体水平低且衰减速度快,7月龄时已经全部转阴,3月龄时婴儿胎传抗体已无保护性。育龄期妇女孕前麻疹抗体水平对婴儿麻疹抗体水平有直接影响,孕前接种麻疹疫苗可在一定程度上提高婴幼儿麻疹抗体水平。
OBJECTIVE: To study the reason of the high incidence of measles in low-age infants by paired study on the dynamic changes of measles antibody in mothers and their newborn infants, and to provide a theoretical basis for the development of measles immunization strategies. Methods A cross-sectional study was conducted to collect 2 ml blood from the mother’s blood and 2 ml cord blood at birth (representing the newborn’s birth rate). At the same time, the infants were followed up at 3, 5 and 7 months of age. Reagents ELESA method for determination of measles Ig G antibody levels in serum. Results The measles antibody titers of maternal and neonatal umbilical cord blood were: Max pregnant women = 6,522, Min pregnant women = 62, Med pregnant women = 834.5 and Max umbilical cord = 6,233, Min umbilical cord = 61, Med umbilical cord = 760.5, The difference was not statistically significant (t = 0.87, P = 0.39). The positive rates of serum antibodies to umbilical cord blood measles in mothers and infants were 84.48% and 86.21% respectively, and the serum antibody protection rates were 50.00% and 46.55% respectively. Serum antibody levels of maternal and measles were positively correlated (r = 0.83, P <0.01). The level of umbilical cord blood antibody in infants increased with the increase of maternal antibodies (χ2 = 42.85, P <0.01). The positive rate of measles antibody in infancy was 29.27% at 3 months of age, 5.88% at 5 months of age and all yin at 7 months of age and later. The positive rate of cord blood protective antibodies in maternal protective antibody positive (89.66%) was higher than that of maternal protective antibody negative (3.45%) (χ2 = 20.06, P <0.01). The positive rate of measles protective antibodies in infants at 3 months of age and later was 0, regardless of whether the mother had protective antibodies. Conclusions At present, the level of neonatal measles antibody is low and its decay rate is very fast. At 7 months of age, it has all turned negative. At 3 months of age, the fetus has no protective function. Pre-pregnancy measles antibody levels in women of childbearing age have a direct impact on the level of measles antibody in infants. Immunization with measles vaccine before pregnancy may improve the antibody level of measles in infants and children.