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  • Title: Placental transfer of tetanus toxoid antibodies in Nigerian mothers.
    Author: Hood N, Chan MC, Maxwell SM, Familusi JB, Hart CA.
    Journal: Ann Trop Paediatr; 1994; 14(3):179-82. PubMed ID: 7825989.
    Abstract:
    The aim of this study was to assess the efficacy of the tetanus toxoid immunization programme in Nigeria, specifically the placental transfer of antibody to newborn Nigerian babies. Tetanus toxoid antibody levels were measured in 39 mother-baby pairs in Ibadan, Nigeria and compared with 78 British mother-baby pairs. Geometric means of the ratios of cord/mother (sequestration index SI) were 0.776 for Nigerian pairs and 1.306 for British pairs, indicating a limitation in the placental transfer of tetanus toxoid in the Nigerian population. These findings confirm that there is a block in the placental transfer of anti-tetanus toxoid antibodies in African populations which will affect current immunization programmes and requires further investigation. In 1989, in Ibadan, Nigeria, clinicians collected sera samples from 39 mothers and their full-term infants born at the Adeoyo Maternity Hospital and the University College Hospital to determine the placental transfer of tetanus toxoid antibodies and to compare the tetanus toxoid antibody levels with those of 78 UK mother-infant pairs. The primary aim of the study was to evaluate the efficacy of the tetanus toxoid immunization program. The protective antitetanus toxoid level was greater than 0.01 IU/ml in all the Nigerian infants and mothers. 59% of Nigerian infants had a tetanus toxoid antibody level lower than that of their mothers compared with 12% of UK infants (p .0001). In fact, the concentration of tetanus toxoid antibodies of the Nigerian infants was lower than that of their mothers (1.930 vs. 2.374 IU/ml). On the other hand, the concentration of tetanus toxoid antibodies of the UK infants was higher than that of their mothers (1.532 vs. 1.113 IU/ml). The geometric mean of the ratio of cord blood to maternal antibody levels for Nigerian pairs was lower than that of the UK pairs (0.776 vs. 1.306), suggesting a flaw in the transplacental transfer of antibodies. Possible mechanisms involved in blocking placental transfer of tetanus toxoid antibodies may be high maternal IgG levels and heavy malarial placental infection. This block of placental transfer of antibodies affects current immunization programs and necessitates further study.
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