新生儿与孕母麻疹抗体水平的关系及新生儿抗体随时间变化的规律分析

The correlation between newborns and pregnant women measles antibody level and the regularity of the change of newborns antibody with time

目的 分析新生儿与孕母麻疹抗体水平的相关性及新生儿抗体随时间变化的规律.方法 采集青岛市第八人民医院2016年3月至2017年9月127例孕母产前静脉血及其新生儿脐带血,并随访采血新生儿3个月龄79例、6个月龄72例、9个月龄57例的静脉血,通过酶联免疫吸附法检测入选对象麻疹IgG抗体的水平.结果 孕母麻疹抗体几何平均浓度为（639.56 ±3.15） mIU/mL,较新生儿血抗体浓度的（1 102.46 ±2.86） mIU/mL 显著降低（ P ＜0.05）. 3、6、9 个月龄新生儿麻疹抗体几何平均浓度分别为（159.95 ±3.25）mIU/mL、（126.35 ±4.06）mIU/mL、（113.04 ±4.32）mIU/mL,较新生儿出生时的水平显著降低（P＜0.05）.随着月龄的增加,新生儿抗体阳性率与保护率明显降低（P＜0.05）.采用趋势性χ2检验结果发现,随着母亲麻疹抗体水平的提高,新生儿麻疹抗体水平亦随之升高（χ2＝9.46,P＜0.05）.经Pearson相关性分析结果发现,孕母血抗体对数水平与新生儿脐带血（r＝0.78）、3 个月龄（r＝0.54）、6 个月龄（r＝0.47）、9个月龄（r＝0.53）血抗体对数水平密切相关（均P＜0.05）.经单因素分析结果发现,新生儿麻疹抗体几何平均浓度与新生儿性别、分娩方式、胎龄、出生体质量、孕母年龄均存在显著相关性（均P＜0.01）.结论 随着时间的增加,新生儿麻疹抗体逐渐衰减,并且其抗体水平与孕母抗体水平密切相关.故此,目前应积极实施针对育龄妇女的麻疹疫苗接种,采取改善孕母抗体浓度的方法以增加新生儿麻疹抗体浓度,达到预防或减少小月龄婴儿发生麻疹的目的.

Objective To analyze the correlation between newborn and mother＇s measles antibody level and the regularity of the change of newborn antibody with time .Methods Prenatal venous blood and newborns′umbilical cord blood of 127 pregnant women in the Eighth People＇s Hospital of Qingdao were collected ,and venous blood of 3-month-old in 79 cases,6-month-old in 72 cases and 9-month-old in 57 cases of newborns were followed up . The level of measles IgG antibody was detected by enzyme -linked immunosorbent assay .Results The geometric mean concentration of the maternal measles antibody was （639.56 ±3.15） mIU/mL,which was significantly lower than that of the neonatal blood antibody concentration [（1 102.46 ±2.86）mIU/mL]（P〈0.05）.The geometric means of neonatal measles antibody in 3,6,9 months old newborns were （159.95 ±3.25） mIU/mL,（126.35 ± 4.06）mIU/mL,（113.04 ±4.32）mIU/mL respectively,which were significantly lower than those of the newborn at birth（all P〈0.05）.With the increase of the age,the positive rate and protection rate of the newborn all decreased significantly（all P〈0.05）.Using trend Chi square test,it was found that the level of measles antibody increased with the increase of measles antibody level （χ2=9.46,P〈0.05）.Pearson correlation analysis showed that the logarithmic level of maternal blood antibody was closely correlated with the umbilical cord blood （r=0.78）,3-month-old（r=0.54）,6-month-old（r=0.47）,9-month-old（r=0.53） blood antibody logarithm level （all P〈0.05）.Univari-ate analysis showed that the geometric mean of neonatal measles antibody was significantly correlated with neonatal sex,delivery mode,gestational age,birth weight and maternal age （all P〈0.01）.Conclusion With the increase of time,the measles antibody gradually attenuates ,and the level of antibody is closely correlated with the level of mater-nal antibody.Therefore,we should actively implement measles vaccination for women of childbearing age ,and adopt a way to improve maternal antibody concentration to increase the concentration of neonatal measles antibody ,so as to prevent or reduce measles in infants .