Vaccinate Mom. Save the Baby.

April 23, 2010 - PRLog -- My job as an OBGYN is to help make a woman’s pregnancy, and her baby’s birth, as smooth and wondrous as possible. This update may help you understand what to do about vaccinations during pregnancy and why your OBGYN will want you to be completely protected in order to protect your baby.

As a form of protection from acquiring certain serious diseases, women should be vaccinated. Unfortunately, pregnancy poses a special risk from vaccination because a developing fetus could acquire disease from a live virus or bacteria contained within the vaccine itself. It could result in a congenital birth defect. Therefore, only inactivated vaccines or vaccines containing toxoids (bacterial toxins that have been chemically altered) are generally recommended and administered during pregnancy. These immunizations are recommended when the risk of infection is high and when the vaccine is not live.

Recently, the American College of Obstetrics and Gynecology released a new statement regarding the administration of Tdap, (pertussis, tetanus, and diphtheria) for pregnant and postpartum women and their infants.

Their recommendations are as follows:

1.Pregnant women who were NOT previously vaccinated with Tdap should receive the vaccine upon discharge from the hospital after delivery. 2.All pregnant women should receive Tdap in the IMMEDIATE postpartum period before discharge from the hospital if the previous vaccination was greater than 2 years ago. 3.The safety and efficacy of the pertussis vaccine has not been demonstrated in pregnancy and therefore it is not routinely recommended, except in the rare instance of a community outbreak. However, in cases where it was inadvertently given, there was no increased morbidity or mortality. 4.All women thinking of becoming pregnant should be vaccinated. 5.Adults and others in a household who anticipate contact with an infant less than 12 months old, are recommended to receive the vaccine. In other words, get the vaccine, before you get pregnant if possible. If not possible get the vaccine after the baby is born and right before you leave the hospital.

What is pertussis?

Pertussis, or whooping cough, is a bacterial infection of the respiratory system caused by the organism Bordetella pertussis. The bacteria produces many toxins which damage respiratory epithelium and mucosal cells. Parents, and in particular new mothers, are a major source of infection for infants that are less than 12 months old. Unfortunately, this is also the age when fatalities are highest.

1.Pertussis disease can range from a mild infection with no symptoms, to a prolonged severe illness sometimes lasting up to 6 months. 2.Petussis is highly contagious, attacking 80 to 100% of individuals in a household that are not immunized. 3.Pertussis is transmitted from person to person by coughing or sneezing. 4.Pertussis in pregnancy is no more severe than for a non-pregnant woman. 5.Most cases of pertussis present with spasms of whooping-like coughing, choking, post-cough vomiting and incontinence. 6.Risks to the unborn child are relatively rare with no relationship to malformations in fetal development. 7.Disease in adolescents and adults is marked by a prolonged coughing illness.

The biggest risk in pertussis is for infants that are less than 12 months old, especially within the first 6 months of birth. Complications, including death, are often due to coincident pneumonia that can involve other bacteria and viruses, and pulmonary hypertension (high blood pressure). Almost all infant deaths have occurred among unvaccinated infants.

Due to this fact, it is believed that vaccination of 90% of household contacts (children, adolescents, and adults) could prevent 75% of pertussis cases among infants between the ages of 0 and 23 months. In addition, vaccination of health care workers can prevent outbreaks in maternity wards, prenatal clinics ,and the nurseries in hospitals.

What is the incidence of pertussis?

The number of reported cases of pertussis has been increasing each year. There are worldwide cyclic outbreaks every 3–5 years. It is more frequent in the summer and autumn. Approximately 600,000 cases are reported each year in the United States and many milder forms are not reported. The majority of deaths occur within the first 3 months of life.

What is the treatment for pertussis?

A pregnant woman near term with documented pertussis can infect her child. Therefore, treatment with antibacterial agents and prophylaxis are essential in prevention of the newborn acquiring the infection. All members of the household including the newborn should be treated along with the infected person to prevent transmission to the newborn. Examples of antibiotics which are safe in pregnancy include erythromycin, azithromycin, or clarithromycin. For newborns, azithromycin is the preferred drug for newborns because of fewer side effects. Cough suppressants are generally not effective.

What is the latest information on the pertussis vaccine?

The pertussis vaccine’s protection lasts from 5 to 10 years. After this period of time people are again susceptible to the infection. The most common side effects from the vaccine include pain from the injection site, swelling and redness, headache, fatigue, and fever.

In summary:

Pertussis is a major cause of infant mortality and morbidity.

The CDC Advisory committee recommends routine vaccination for postpartum women before leaving the hospital, if they were not vaccinated in the past and have not been vaccinated in the last 2 years, in order to provide protection and prevent transmission of pertussis to their newborns.


Best regards,

Dr. Michele Brown,

OBGYN and Founder of Beauté de Maman

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Since the beginning of her Obstetrics and Gynecology practice in 1982, Dr. Michele Brown has delivered more than 3,000 babies. She has her medical training to guide her in the development of Beauté de Maman's unique health and beauty products. Dr. Brown has a busy obstetrical practice in Stamford, Connecticut. As a clinical attending, she actively teaches residents from Stamford Hospital and medical students from Columbia Presbyterian Hospital in New York. Dr. Brown is a board-certified member of the American College of Obstetrics and Gynecology, a member of the American Medical Association, the Fairfield County Medical Association, Yale Obstetrical and Gynecological Society and the Women's Medical Association of Fairfield County.

Please visit http://www.beautedemaman.com

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